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Agoraphobia

Medical Author: Roxanne Dryden-Edwards, MD
Medical Editor: Melissa Conrad Stöppler, MD

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.



Next: What are the risk factors for agoraphobia? »

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Agoraphobia

What is a depressive disorder?

Depressive disorders have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.

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