How to tell the difference between anxiety and agoraphobia

For many people, the onset of the coronavirus (COVID-19) pandemic has led to new or worsening mental health issues like anxiety. It can be hard to tell, however, if what you’re experiencing are actually symptoms of an anxiety disorder and if so, what type of disorder that may be. And if you’ve been particularly worried about going outside and potentially getting sick, you may be concerned that you have agoraphobia. But there are a few things experts want you to understand about what it means to have anxiety versus an actual phobia.

How is a phobia different from anxiety?

There are several different types of anxiety disorders, with the most common being generalized anxiety disorder (GAD), according to the Anxiety and Depression Association of America. “[GAD] refers to chronic excessive anxiety and worry about several activities, events, or situations that lasts for most days during a period of six months or more,” explains Dr. Carla Manly, licensed clinical psychologist and author of Joy from Fear: Create the Life of Your Dreams by Making Fear Your Friend. For your symptoms to qualify as GAD, “the degree of anxiety must be sufficient to interfere with daily areas of functioning and/or cause significant personal distress. The anxiety is difficult to control and results in a variety of symptoms such as fatigue, irritability, restlessness, and disturbed sleep,” Dr. Manly adds.

For people with GAD, anxiety doesn’t have to stem from one particular fear. Phobias, on the other hand, have more specific causes. “A phobia is distinct, elevated fear or anxiety about a particular situation or object. In general, the phobic object or situation will trigger an immediate fearful for anxious response,” Dr. Manly explains. If you have a phobia, most of your anxiety and any resulting panic will be surrounding thoughts of that specific trigger.

According to the National Institute of Mental Health, 12.5% of adults in the U.S. will experience a phobia at some point in their lives. Therapists at TalkSpace note that the most common phobias they see in clients are atychiphobia (fear of failure), thanatophobia (fear of death), and social phobias (like agoraphobia).

What are the symptoms of agoraphobia?

According to the Mayo Clinic, agoraphobia is a type of anxiety disorder characterized by an intense fear an avoidance of situations that may cause you to feel trapped. Psychology Today notes that 1.7% of adults in the U.S. will be diagnosed with agoraphobia, with a fear of going outside as the most common symptom.

“To be diagnosed with agoraphobia, elevated fear and anxiety must be experienced in at least two of these situations: using public transportation; being alone outside of your home; being in a crowd or standing in line; being in an open space; being in an enclosed area or place,” Dr. Manly says.

The Mayo Clinic also states that symptoms of agoraphobia include constantly worrying about situations that trigger feelings of being trapped. Someone with agoraphobia may also require the support of another person to help them confront the object of their anxiety, Dr. Manly notes. For example, if the person is afraid of going to the grocery store, they may have a friend or family member accompany them. They also might need help planning an escape route, as if an agoraphobic is confronted with their trigger, “a full panic attack may occur,” says Dr. Manly. But, she adds, “a panic attack is not necessary for a diagnosis of agoraphobia.”

How to know if you have agoraphobia or general anxiety

In the context of the pandemic, the difference between phobias and general anxiety can become a bit murky. You may be feeling an increase in anxiety overall, but notice that you especially start panicking when you leave the house or are surrounded by people. “It’s important to remember that a great deal of general uncertainty exists given the unprecedented nature of the pandemic and resulting quarantine,” Dr. Manly says. “A certain amount of fear and anxiety about the safety of the external world is to be expected as we navigate how to move forward securely.”

If going outside seems like the trigger for your anxiety, agoraphobia might seem like an easy label. But the biggest misconception about agoraphobia, says Dr. Manly, is that it is limited to a fear of leaving your home. As mentioned earlier, the condition is more about feeling like you’re unable to escape a situation. So before calling yourself an agoraphobe, think deeply about your fears and how they’re manifesting. For example, if you can picture yourself leaving your house when the pandemic passes because you’ll no longer worried about catching the virus, that may be general anxiety rather than agoraphobia.

How to get help for agoraphobia

If you’ve noticed your fears are getting worse, continue to monitor how you’re feeling to help better distinguish if the anxiety stemming from the pandemic is actually translating to agoraphobia. If you think it is, reach out to a mental health expert to discuss getting a formal diagnosis and a treatment plan. Agoraphobia can become very persistent and chronic,” Dr. Manly says. “If an individual does not seek immediate treatment, there is an increased likelihood that the situation will worsen over time.”

Like GAD, agoraphobia is usually officially diagnosed after six months of the person having persistent symptoms, explains Dr. Manly. To find a therapist, Dr. Paul Greene, director of the Manhattan Center for Cognitive-Behavioral Therapy, suggests focusing on people who note that they specifically treat phobias. “Seek a consultation with a mental health professional who has experience in cognitive-behavioral therapy (CBT) for anxiety,” he adds. CBT therapy can be particularly helpful for people with phobias because it helps identify the root of a fear and gives ways to cope when confronted with triggers.

To start your therapist search, Dr. Greene suggests exploring directories from the Anxiety and Depression Association of America and the Association of Behavioral and Cognitive Therapies. Psychology Today can also help you tailor your search to your specific issues and insurance. If you don’t have insurance, apps like Talkspace or BetterHelp offer therapy virtually with affordable plan options.

Feeling anxious is a pretty universal experience right now, but only you can tell if that anxiety is becoming debilitating or seeming like it’s turning into a phobia. Reaching out to a mental health expert can help you get more insight into why you may be struggling and what you can do to feel better.

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