Agoraphobia vs. Social Anxiety Disorder

Though both anxiety disorders can result in avoidance of situations, agoraphobia involves places while social anxiety disorder involves social situations.

Agoraphobia and social anxiety disorder are similar yet distinct mental health disorders. Though both are types of anxiety disorders and can result in an individual avoiding specific situations, the underlying causes of agoraphobia and social anxiety disorder are different.

Agoraphobia Definition and Characteristics

Agoraphobia is defined as the fear, anxiety or avoidance of two or more of the following situations or places:

• Open spaces
• Enclosed spaces
• Crowds or waiting in line
• Being away from home alone
• Public transportation

The defining characteristic of agoraphobia is that the fear or anxiety provoked by the situation is disproportionate to the actual risk or danger posed by the situation.

There are several physical symptoms of agoraphobia. When exposed to a triggering situation, a person with this anxiety disorder may experience:

• Racing heartbeat or chest pain
• Sweating or shakiness
• Labored breathing
• Stomach trouble and nausea
• Headache or dizziness
• Feeling out of control
• Feeling like they are dying

Those with severe agoraphobia will completely avoid triggering situations and may even refuse to leave their homes. They may also turn to alcohol or substance abuse to manage their symptoms, which can have detrimental long-term consequences.

Social Anxiety Disorder and Symptoms

Social anxiety disorder is rooted in the fear that the individual will embarrass themselves, offend others or be rejected. The symptoms of social anxiety disorder include an unusually high level of anxious feelings when in social situations. As a result, an individual with social anxiety disorder will either endure social situations with great difficulty or avoid them altogether. Like agoraphobia, individuals with social anxiety symptoms may use alcohol or other substances to cope.

Shared Association with Panic Attacks

Agoraphobia and social anxiety disorder can both occur with panic attacks. A panic attack is a sudden, causeless feeling of extreme fear or worry coupled with increased heart rate, sense of impending doom, shortness of breath and nausea. Panic attacks may be rare or frequent. A diagnosis of panic disorder, or panic attack disorder, requires an individual to not only experience recurring panic attacks but also experience fear or worry that they are on the verge of experiencing a future panic attack.

A person with panic disorder is at an increased risk of developing agoraphobia, and the onset of agoraphobia is often triggered by a panic attack in a specific situation. This diagnosis is called panic disorder with agoraphobia. However, panic disorder and agoraphobia can occur separately.

Social anxiety and panic attacks are similarly related. Individuals who experience panic attacks are more likely to also have social anxiety. Further, individuals who experience panic attacks tend to have more severe cases of social anxiety disorder.

How Agoraphobia and Social Anxiety Differ

Though agoraphobia and social anxiety may both result in individuals avoiding situations, the reasons for the avoidance are not the same. Further, individuals with social anxiety disorder are not known to also have agoraphobia. The difference between agoraphobia and social anxiety disorder is that a person with agoraphobia fears having an anxiety attack or losing control in specific situations while a person with social anxiety disorder worries about experiencing embarrassment or judgment in social situations. Both anxiety disorders can cause a person to attempt to manage their symptoms by using substances like tranquilizers, alcohol, marijuana, pain killers, cocaine, tobacco and stimulants.

Rate of Co-Occurrence

Though agoraphobia and social anxiety disorder do not co-occur often, there is a correlation between anxiety disorders and substance use disorders. The co-occurrence of anxiety disorders and substance use disorders is associated with higher disability and increased severity of symptoms than is expected for each disorder separately.

Addiction and substance abuse can mask symptoms of anxiety disorders and lead to anxiety being untreated. Treating substance abuse without also addressing co-occurring anxiety disorders increases the risk of substance abuse relapse. For the best outcomes, it is best to consider and treat co-occurring anxiety disorders when treating addiction and substance abuse.

Both agoraphobia and social anxiety disorder can lead to addiction and substance abuse as individuals seek to cope with these often debilitating mental illnesses. If you or a loved one is using addiction or substance abuse to handle symptoms of agoraphobia or social anxiety disorder, The Recovery Village can help. Contact The Recovery Village today to learn about the various treatments available.

Editor – Megan Hull

Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more

Medically Reviewed By – Dr. Aleishia Harris-Arnold, PhD

Aleishia Harris-Arnold earned her PhD in Immunology in 2014 from Stanford University School of Medicine. Read more