The world can be a scary place sometimes. You never know what situations you might encounter from the moment you step out your front door. So, to a certain degree, it’s normal to be a bit cautious or fearful of the things that could happen when you leave your home.
While most people can accept the uncertainty that comes with the world around them, others face intense anxiety that keeps them indoors. If you’re extremely fearful about leaving your home, you may have an anxiety disorder like agoraphobia or obsessive-compulsive disorder (OCD).
Keep reading to learn more about these anxiety disorders and how evidence-based treatment can help reduce your fear of leaving home.
Unsure of whether your fears are tied to a specific phobia or OCD? We can help.
Why do I have a fear of leaving my house?
Before diving into anxiety disorders, it’s important to understand that being afraid to leave your house is not always linked to a mental health condition.
According to Patrick McGrath, PhD, Chief Clinical Officer at NOCD, there are a few reasons. “You could be afraid of leaving your house if you live in a bad neighborhood,” he says. “If the weather’s bad, you might be afraid to leave your house.”
But if you’re having such an intense, debilitating fear of leaving your house that it’s affecting your ability to handle your day-to-day responsibilities, it could be a sign of agoraphobia, a specific phobia, or OCD.
Agoraphobia (fear of leaving home)
Agoraphobia is a type of phobia that involves a fear of leaving your home because you’re afraid you won’t be able to escape easily, you’ll need help and no one will be there to help you, or you fear the panic and anxiety symptoms that will arise in these situations.
“If you have agoraphobia, you may be afraid to leave your house because you’re going to have to do things that are uncomfortable or have to leave your safe zone,” says Dr. McGrath.
According to the DSM-5, agoraphobia can cause a strong fear or anxiety about the following scenarios:
- Using public transportation
- Being in open spaces
- Being in enclosed spaces
- Standing in line or being in a crowd
- Being outside of the home alone
Being agoraphobic may cause physical symptoms that resemble a panic or anxiety attack. These symptoms include:
- Rapid heart rate or chest pain
- Fear or a shaky feeling
- Difficulty breathing or hyperventilation
- Dizziness or lightheadedness
- Stomach upset
- Excessive sweating
- Sudden chills or flushing (red, hot face)
Specific phobia
Specific phobias can seem very similar to agoraphobia. However, with any specific phobia, there is usually only one phobic stimulus—that is, a situation or object that triggers your fears.
On the flip side, agoraphobia can involve multiple, nonspecific situations where escape could be difficult or help may be unavailable. For example, a person who only fears being assaulted while away from home may be diagnosed with a specific phobia, whereas a person who fears leaving the home and being in a crowd would most likely be diagnosed with agoraphobia.
Obsessive-compulsive disorder (OCD)
Having severe anxiety about leaving your home could be a sign of obsessive-compulsive disorder (OCD). OCD is a chronic (or long-term) mental health condition characterized by obsessions and compulsions. A fear of leaving the home involving intrusive thoughts or worries about contamination, harm, self-control, or similar fears while outside the home is likely related to OCD.
Common OCD obsessions
Obsessions are recurring, intrusive thoughts, images, feelings, or urges that cause distress, anxiety, or fear. If you have OCD and a fear of leaving the house, you may experience persistent obsessions about things that might happen if you leave the house.
Here are some examples of obsessions related to a fear of leaving home:
- If I leave my house, I will catch a disease.
- I will harm someone if I drive my car or go outside of my house.
- Someone will harm me if I leave the house.
- What if my house burns down?
- What if I get robbed?
- What if my family is harmed while I’m gone?
Common OCD compulsions
Because obsessions cause fear and anxiety, you may feel a strong urge to engage in compulsions in order to feel better. Compulsions are mental or physical behaviors done in an attempt to relieve distress or to prevent a feared outcome related to your fears.
Below are some examples of compulsions related to a fear of leaving your home:
- Avoiding going outside.
- Only doing online work.
- Only leaving the house for activities that are deemed “safe.”
- Excessive cleaning after you’ve spent time outside the home.
- Doing rituals that allow you to leave the home (e.g., having to wear certain clothes or wearing a mask/gloves when not medically necessary).
According to Dr. McGrath, a fear of leaving your home can be a symptom of just about any OCD subtype or theme. “If you have to drive, it could be a hit-and-run OCD fear,” he says. “If you have pedophile OCD, and there are children in the neighborhood, you could be afraid you might molest them. If it’s relationship OCD, you could be afraid of walking around and becoming attracted to someone, as that could be seen as cheating on your partner.”
How can I tell the difference between agoraphobia, a specific phobia, and OCD?
At this point, you still might need some clarity on the differences between phobias and OCD, and that’s completely understandable. Like OCD, if you have a phobia, you may seek reassurance about your fears. However, with a specific phobia or agoraphobia, there is usually an absence of intrusive thoughts underlying your fears. Simply put, if you have a specific phobia about leaving home, you may have a strong reaction to being outside, but it will not be related to the intrusive thoughts that most often characterize OCD.
Also, when it comes to OCD versus phobias, phobias don’t cause a cycle of obsessions and compulsions. “Let’s say someone has a phobia of an elevator,” says Dr. McGrath. “They’re just not going to take elevators. OCD would continue to bother you, even if you’ve done the compulsion. It will sneak back in, and you’ll be in a cycle.”
Another difference that distinguishes the three disorders is that OCD symptoms often wax and wane from their onset. If you have OCD, you may spend only a few months consumed by obsessions and compulsions related to your fears—after which your intrusive thoughts and compulsive behavior may switch to another theme. With specific phobias and agoraphobia, your fears and behaviors usually remain consistent if left unmanaged.
Getting help for a fear of leaving your home
A fear of leaving home—whether a symptom of OCD, specific phobia, or agoraphobia—can be treated with exposure and response prevention (ERP) therapy. ERP is an evidence-based treatment and is an effective way of treating all forms of OCD, as well as phobias. During your ERP sessions, you’ll learn how to carefully confront your triggers and intrusive thoughts head-on and learn to resist the urge to respond with compulsions.
So, what does a typical ERP session look like? You’ll work with a therapist specializing in ERP to build an exposure hierarchy and begin gradually working through one trigger at a time. Your therapist will start with an exposure that is expected to bring about a low level of fear and anxiety—such as standing outside your house for a few minutes—and work up to the harder exposures as you build more confidence—such as getting in your car and taking a trip to a nearby store.
Examples of exposures done to treat OCD, agoraphobia, or a specific phobia centered around a fear of leaving the house may include:
- Writing a script about leaving the house.
- Watching a video involving being outside.
- Standing outside the house for five minutes.
- Going to a restaurant and not engaging in washing rituals after returning home.
- Saying hello to a stranger on the sidewalk.
Your therapist will also guide you in resisting the urge to respond to fear and anxiety with compulsions by doing response prevention techniques. Through these exercises, you’ll learn to sit with the discomfort of your intrusive thoughts without allowing them to interfere with your life.
Examples of response prevention techniques that may be done to treat agoraphobia more specifically:
- Taking public transportation.
- Standing in line at a cafe.
- Leaving the home without a “safety” person.
- Riding on an elevator.
- Spending time in an open field.
Dr. McGrath shares an example of ERP exercises tied to a phobia of elevators. “If somebody’s afraid of an elevator, I’ll find a building with an elevator to do ERP,” he explains. “We’ll get on the elevator a few times and not let the door close. Then, we might let the door close halfway, put an arm in it, let it close, and hit the open button. We’ll gradually do more and more with the elevator. We can do similar things with OCD.”
The goal of ERP is to learn to tolerate anxiety without relying on compulsions or avoidance to feel better. While your symptoms won’t go away entirely, if you stay consistent with your therapy sessions and do your homework, you can see a significant reduction in the number of intrusive thoughts and compulsions—which can make a phobia or OCD much more manageable.
Constantly worrying about the potential dangers outside the world can be a huge strain on your mental health. If you’re dealing with a severe fear of leaving the house, consider talking to a therapist who specializes in treating phobias and OCD. They can identify your triggers and teach you evidence-based exercises to reduce your fear and anxiety.