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Dual Diagnosis: Agoraphobia and Addiction

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In an article by Medical News Today, it was confirmed that 1.8 million people over 18 had been diagnosed with agoraphobia without a history of panic disorder. The issue goes further than that, and many people with agoraphobia try to self-medicate with drugs or alcohol.

Although most people’s intentions are good, and fear is something that nobody wants to live with, using drugs or alcohol to self-medicate can result in drug dependence and addiction. When paired with a mental disorder, addiction becomes a dual diagnosis.

What Is The Definition Of Dual Diagnosis?

Dual Diagnosis (co-occurring disorders) is explained by the U.S. National Library of Medicine (NLM) as when a person “has both a mental disorder and an alcohol or drug problem. These conditions occur together frequently.”

In many cases, of dual diagnosis, substance use disorders occur with the following mental disorders:

  • Depression
  • Anxiety (Agoraphobia)
  • Schizophrenia
  • Personality

What Is The Connection Between Agoraphobia Anxiety Disorders And Addiction?

Many people with agoraphobia self-medicate with alcohol, benzodiazepines, marijuana, barbiturates, and other central nervous system (CNS) depressants.

Even though these substances may temporarily ward off the symptoms of anxiety and panic, they can also have the undesired result of substance use disorders, and physical and mental addictions.

Someone who’s addicted to drugs may display some of these behaviors from the U.S. National Library of Medicine:

  • Continuing to use drugs even when health, work, or family are being harmed
  • Episodes of violence
  • Neglecting to eat
  • Hostility when confronted about drug dependence
  • Lack of control over drug use, being unable to stop or reduce alcohol intake
  • Making excuses to use drugs
  • Using drugs even when they’re alone
  • Missing work or school, or a decrease in performance
  • Need for daily or regular drug use to function
  • Not caring about physical appearance
  • No longer taking part in activities because of drug use
  • Secretive behavior to hide drug use

Agoraphobia can be aggravated by simply abusing drugs like marijuana or LSD which often make people paranoid, anxious, or afraid of public places. This is one example of how substance use can be the precursor to a mental condition.

The withdrawal symptoms of CNS depressants can be similar to symptoms of anxiety disorders. In psychology, this counter-effect is commonly referred to as a drug-rebound; where lack of a substance leads to the very symptoms that it’s meant to treat. The symptoms of agoraphobia aren’t much different and can be amplified when a person stops using certain drugs.

These symptoms include:

  • being afraid of spending time alone
  • being afraid of places where escape might be hard
  • being afraid of losing control in a public place
  • depending on others
  • feeling detached or separated from others
  • feeling helpless
  • feeling that the body is not real
  • feeling that the environment is not real
  • having an unusual temper or agitation
  • staying in the house for long periods

Physical symptoms can include:

  • chest pain or discomfort
  • choking
  • dizziness or fainting
  • nausea or other stomach distress
  • racing heart
  • short of breath
  • sweating
  • trembling

Understanding Drug And Alcohol Addiction

There are several factors that can contribute to a substance use disorder or addiction. Those factors include “a person’s genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and environmental stress” (NLM).

Similarly, there are factors that most likely played into a person’s agoraphobia—whether that was something they saw in a film, something they were teased about growing up, something that happened in a dream, or various other factors.

The exact reason that a person develops agoraphobia isn’t clear, but interestingly enough, from Substance Abuse and Mental Health Services Administration, “victims of bullying were nearly three times as likely to have issues with generalized anxiety as those who were not bullied and 4.6 times as likely to suffer from panic attacks or agoraphobia.”

Addiction is often the most severe form of a substance use disorder and has several stages of drug use that lead up to it.

In many cases, the stages of addiction look something like this:

Experimental Use

Typically involves peers, done for recreational use; a person who’s using drugs may enjoy defying parents or other authority figures. Experimental use can occur at home, at parties, or any other fitting location. One example of experimental use is when alcohol, medication, other drugs, or tobacco are stolen from parents.

Regular Use

When someone misses more and more school or work because of drug use; worries about losing drug source; uses drugs to “fix” negative feelings; begins to stay away from friends and family; may change friends to those who are regular users; shows increased tolerance and ability to “handle” the drug.

Problem Or Risky Use

When a person loses any motivation; does not care about school and work; has obvious behavior changes; thinking about drug use is more important than all other interests, including relationships; drug use becomes more secretive; they may begin dealing drugs to help support habit; use of other, harder drugs may increase; legal problems may increase.


When a person cannot face daily life without drugs; denies problem; physical condition gets worse; loss of “control” over use; may become suicidal; financial and legal problems get worse; may have broken ties with family members or friends.

Treatment for Long Term Agoraphobia And Addiction

Self-medicating for agoraphobia may temporarily make a person you care about feel better, but it can be seriously dangerous and, as we’ve previously stated, often results in drug dependence. Other times it is the substance use disorder that came first, and drug use leads to emotional and mental problems.

In either case, it will be pertinent to determine if the cause of a patient’s agoraphobia is drug related. If agoraphobia is drug related, it will be essential to treat both mental and substance use disorders as critical. In other words, to get the most out of treatment and recovery, a person must stop drinking or using drugs.

The most effective dual diagnosis treatments for agoraphobia and addiction are behavioral therapies such as:

  • Cognitive Behavior Therapy
  • Dialectical Behavior Therapy
  • Holistic Therapies

For some people, supervised detoxification and medication-assisted therapy will be necessary to properly treat their physical addiction, but this usually depends on the drug and how often they use it.

We Can Help Find A Rehab Treatment Center Right For You

Contact Vertava Health to learn more about evidence-based treatment, dual diagnosis, and inpatient rehab. Our addiction specialists can help you find the best rehab center, figure out how to pay for it, and start setting goals for your new life. Your recovery journey can start as soon as today.