Jennifer is currently accepting new patients and
generally has the soonest appointment availability.
For most new patients, we recommend scheduling with
Jennifer as the first choice.
Dr. Gabriella Farkas, MD, PhD
Limited Availability
Psychiatrist · MD, PhD
Dr. Farkas continues to see new patients on a more
limited basis. Patients specifically seeking an
appointment with Dr. Farkas may view her availability
in the scheduling portal.
On the scheduling screen, Jennifer Reilly will appear
first. Select your preferred clinician to continue
with available appointment times.
Agoraphobia isn’t just “fear of open spaces” — that translation has misled people for decades. The actual clinical condition involves fear of situations where escape might be difficult or help unavailable if anxiety symptoms emerge — leading to avoidance that progressively shrinks the patient’s accessible world.
According to the National Institute of Mental Health, agoraphobia affects about 1.3% of U.S. adults in any given year and 2.6% over a lifetime. It frequently develops as a complication of panic disorder but can also occur independently. Untreated, it can become severely impairing — in extreme cases, patients become unable to leave their homes.
Telepsychiatry is particularly well-suited to agoraphobia treatment.
What Agoraphobia Actually Is
DSM-5-TR criteria require marked fear or anxiety about two or more of:
Using public transportation (buses, trains, planes)
Being in open spaces (parking lots, marketplaces, bridges)
Being in enclosed places (shops, theaters, cinemas)
Standing in line or being in a crowd
Being outside the home alone
Plus:
Fear that escape might be difficult or help unavailable if panic-like or other incapacitating symptoms develop
Active avoidance, need for companion, or endured with intense distress
Disproportionate to actual danger
Persistent (typically 6+ months)
Causes significant distress or impairment
The Common Progression
Many agoraphobia cases follow a recognizable pattern:
First panic attack — often in a public place (grocery store, on the highway, in a crowded venue)
Anticipatory fear of future attacks
Avoidance of the specific location where the first attack occurred
Progressive generalization of avoidance to similar situations
Increasingly restricted range of acceptable locations
Difficulty traveling alone, then with others
In severe cases, inability to leave home at all
Each step seems reasonable to the patient — they’re trying to prevent another panic attack. But the cumulative effect is a progressively shrinking world.
Why Early Intervention Matters
The longer agoraphobic avoidance persists, the more entrenched it becomes. Early panic disorder, treated promptly, often doesn’t progress to agoraphobia at all. Established agoraphobia is more challenging to treat but still highly responsive to evidence-based intervention.
Evidence-Based Treatment
SSRIs/SNRIs
First-line medications. They address underlying anxiety and panic biology — making it possible to do the behavioral work without overwhelming symptoms. Effect begins 2-4 weeks, full effect 6-8 weeks.
Cognitive-behavioral therapy with exposure
The behavioral foundation of agoraphobia treatment. Graduated exposure to avoided situations, ideally combined with cognitive work on catastrophic thinking. Effective when done systematically.
Time-limited benzodiazepine support
Occasionally appropriate for severe cases during initial stabilization or specific exposure work, with careful planning and time limits to avoid dependence.
Specific tools
Breathing retraining
Interoceptive exposure (deliberately bringing on physical symptoms to desensitize)
Cognitive restructuring around catastrophic predictions
In vivo exposure (gradual real-world situation exposure)
Agoraphobia Outcomes
Treatment response with CBT plus medication
Combination treatment produces substantial response in most agoraphobia patients — particularly when started before avoidance becomes severely entrenched.
Source: American Psychiatric Association clinical guidelines.
Why Telepsychiatry Works Well
Agoraphobia is one of the conditions where telepsychiatry has a particular advantage. The condition itself makes office visits difficult — sometimes impossible. Receiving care from home removes a major barrier to treatment initiation and continuation. Many agoraphobia patients who hadn’t been able to access in-person care can finally engage in treatment via telehealth.
As treatment progresses and the patient’s range expands, in-person care may eventually become feasible. But early treatment can begin from home, breaking the cycle of inaccessibility.
⚠️
The Problem
Treatment inaccessibility
Agoraphobia makes it hard to attend office-based appointments — paradoxically blocking access to the treatment that would help.
🔬
The Approach
Care from home
Dr. Farkas provides telepsychiatry that meets patients where they are — literally — and supports gradual expansion of their accessible world.
✓
The Outcome
Reclaimed mobility
Most patients with agoraphobia substantially expand their accessible range with combined treatment — often regaining travel, social activities, and full functioning.
Can I be agoraphobic without having panic disorder?
Yes — agoraphobia is now a distinct diagnosis from panic disorder. Some patients have agoraphobia without ever having full panic attacks.
How long does treatment take?
Most patients see meaningful improvement within 3-6 months of combined treatment. Severely entrenched cases may take longer but typically still respond.
Will I be able to travel again?
Most patients regain substantial mobility with treatment. The specific timeline varies, but progressive expansion is the rule, not the exception. See our related articles on panic attacks and phobias.
What if I can barely leave home now?
Treatment can begin even in severe cases. Telepsychiatry removes the barrier of needing to travel for treatment. Initial work focuses on medication stabilization and very gradual behavioral progress.
Your world doesn’t have to keep shrinking.
Telepsychiatry meets you where you are. Most patients reclaim substantial mobility.
