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Agoraphobia

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Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What is agoraphobia?

A phobia is generally defined as the unrelenting fear of a situation, activity, or thing that causes one to want to avoid it. The definition of agoraphobia is a fear of being outside or otherwise being in a situation from which one either cannot escape or from which escaping would be difficult or humiliating.

Phobias are largely underreported, probably because many phobia sufferers find ways to avoid the situations to which they are phobic. The fact that agoraphobia often occurs in combination with panic disorder makes tracking how often it occurs all the more difficult. Other facts about agoraphobia include that researchers estimate it occurs in less than 1 percent to almost 7 percent of the population and that it is specifically thought to be grossly underdiagnosed.

What causes agoraphobia?

There are a number of theories about what can cause agoraphobia. One hypothesis is that agoraphobia develops in response to repeated exposure to anxiety-provoking events. Mental-health theory that focuses on how individuals react to internal emotional conflicts (psychoanalytic theory) describes agoraphobia as the result of a feeling of emptiness that comes from an unresolved Oedipal conflict, which is a struggle between the feelings the person has toward the opposite-sex parent and a sense of competition with the same-sex parent. Although agoraphobia, like other mental disorders, is caused by a number of factors, it also tends to run in families and for some people, may have a clear genetic factor contributing to its development.

What are the symptoms of agoraphobia?

The symptoms of agoraphobia include anxiety that one will have a panic attack when in a situation from which escape is not possible or is difficult or embarrassing. The panic attack associated with agoraphobia, like all panic attacks, may involve intense fear, disorientation, rapid heart beat, dizziness, or diarrhea. Agoraphobic individuals often begin to avoid the situations that provoke these reactions. Interestingly, the situations that are often avoided by people with agoraphobia and the environments which cause people with balance disorders to feel disoriented are quite similar. This leads some cases of agoraphobia to be considered as vestibular function agoraphobia.