How Does Agoraphobia Affect the Brain?

Agoraphobia is an anxiety disorder characterized by a pervasive, irrational fear of specific places and situations. Luckily, the condition only affects around 1.3% of the population.

However, agoraphobia tends to be hugely debilitating for those suffering from it.

Agoraphobia severely reduces an individual’s quality of life, making it difficult to go to work, socialize, and even leave the house. To make matters worse, it also wreaks havoc on the body and mind.

The question is: how does agoraphobia affect the brain?

Agoraphobia and the Brain: Which Regions are Impacted?

Most research focuses on the effect of anxiety disorders on the brain rather than agoraphobia itself. Findings demonstrate that chronic stress and pathological anxiety alter the functioning of the amygdala, hippocampus, and prefrontal cortex, influencing emotion regulation, learning, memory, and cognitive control.

Studies looking into agoraphobia alone are few and far between. Instead, the research tends to focus on anxiety disorders as a whole. The findings of such studies identify some striking links between prevalent anxiety/stress and neurobiology.

Hippocampus and Prefrontal Cortex

A recent scientific review ran by the Rotman Research Institute found that chronic stress and pathological anxiety can lead to structural degeneration and dysfunction of the hippocampus and prefrontal cortex.

The hippocampus has heavy involvement in learning and memory, so dysfunction of this brain region may lead to difficulties in taking in and storing information.

Meanwhile, experts believe the prefrontal cortex plays a role in dopamine secretion and cognitive control, impacting our ability to attend, be psychologically flexible, and inhibit impulses.

Amygdala

This same study also found that those experiencing chronic stress have overactive amygdalas. However, this finding is unsurprising when you look into the research on the stress response system.

The amygdala is believed to play a fundamental role in the body’s reaction to stress, supposedly regulating emotions like fear and aggression. The stress response system is activated when the body is exposed to a threat (either perceived or actual).

This system is continually being triggered in those suffering from an anxiety disorder or chronic stress, so it makes sense that pervasive anxiety is linked to heightened amygdala functioning.

It’s been suggested that the neurobiological changes associated with prevalent stress/anxiety put these individuals at a higher risk of developing certain neuropsychiatric conditions such as depression and dementia.

However, do these findings show that agoraphobia causes brain abnormalities? 

Not necessarily. The question “does agoraphobia affect the brain?” is not dissimilar to the age-old conundrum, “which came first, the chicken or the egg?”.

We must ask which factor precedes the other, agoraphobia or neurological anomalies.

Do Brain Abnormalities Cause Agoraphobia?

As we have seen, the evidence does suggest that those with agoraphobia (and anxiety disorders in general) have differences in their neurobiology.

But is this because of the development of agoraphobia, or does agoraphobia arise due to these brain abnormalities?

While this research is limited, some studies do indicate a genetic link.

Hereditary Link

A study examining the familial occurrence of agoraphobia found that 12.5% of parents and siblings of probands (individuals suffering from agoraphobia) also had the condition, suggesting agoraphobia is at least partially hereditary.

A 2001 meta-analysis supports this idea. They found that individuals with phobias were more likely to have first-degree relatives experiencing similar conditions.

But regardless of whether it’s agoraphobia that causes neurological irregularities or vice versa, the brain abnormalities present have a knock-on effect that adds to the debilitating nature of this condition.

Effect of Brain Abnormalities in Agoraphobics

The negative impact of agoraphobia doesn’t end with brain abnormalities.

Prevalent anxiety and stress set off a chain reaction of other, life-limiting effects that make agoraphobia particularly challenging to cope with day-to-day.

For example, evidence illustrates that anxiety can impact appetite.

Anxiety, Appetite & Hunger

While appetite is, of course, linked to hunger, it’s not the same thing. Hunger is a physiological phenomenon that refers to the body’s response to low energy levels. Appetite, in contrast, is associated with desire, namely, the desire to eat.

Hunger can trigger appetite, but so can emotional and environmental factors.

This means that if you’re upset, bored, exposed to delicious-smelling food, or extremely stressed, your appetite may increase.

The stress response causes a range of physiological changes, among them pupil dilation, increased heart rate and blood pressure, muscle constriction, etc., but it also suppresses functions deemed “non-essential” to ensure short-term survival.

Appetite Suppression

Findings from a 2018 literature review suggest that the secretion of certain stress hormones suppresses appetite and digestion.

However, there’s evidence indicating that anxiety can also increase the risk of overeating, also known as “binge eating,” especially if the stress is chronic.

Binge Eating

It’s also been found that anxiety is significantly positively related to disinhibition, an eating behavior characterized by overconsumption of food due to various factors, including difficulty regulating food intake.

But that’s not all — if you have agoraphobia, you may also be more likely to experience memory difficulties.

Agoraphobia and Memory Loss

While everyday anxiety might actually aid memory, pervasive anxiety may lead to memory loss.

Sinoff and Werner describe the relationship between anxiety and memory loss as “inter-related and inseparable”. Furthermore, they propose that the presence of anxiety will likely lead to future cognitive decline and depression.

More research is needed to fully understand the link between these two phenomena.

However, some evidence demonstrates that acute stress may disrupt the memory collection and storage process. And it supposedly does this by impairing the communication between cells in the brain regions responsible for learning and memory.

Conclusion

Agoraphobia affects people in various ways: neurologically, biologically, and in everyday life. Research highlights a clear link between agoraphobia and brain abnormalities.

However, there’s still much to uncover before determining whether it’s anxiety that causes brain changes or vice versa.

Related posts:

Agoraphobia and Autism: Are They Intrinsically Linked? Can Emotional Abuse Cause Agoraphobia? Agoraphobia and Extraversion: Social Yet Scared Agoraphobia and OCD – Are they related?