Agoraphobia is an intense and irrational fear of being trapped in a situation where escape would be difficult or embarrassing, or help would be unavailable in the event of a panic attack.
Agoraphobia generally appears in clusters of feared activities. Common clusters are public transportation; driving or being in a car; being on a bridge; being in a line or crowd; and being away from home. Symptoms are generally lessened when a companion is present.
Agoraphobia may be associated with panic disorder or may occur alone. The DSM-IV (Diagnostic and Statistical Manual, 4th Ed.) defines specific criteria for diagnosing agoraphobia without history of panic disorder.
- Marked, Intense Fear: A pronounced and irrational fear of being unable to get help or find escape if a panic attack should occur. In agoraphobia without history of panic disorder, the expected panic attack is generally limited in symptoms.
- Avoidance or Extreme Distress: The feared situations are avoided if possible. They can be endured, but only with extreme distress.
- Not Caused by or Related to a Physical Condition: The symptoms are not caused by a medical condition or medication. If a medical condition is present, the fear is beyond that normally experienced by those with that condition.
- Not Caused by Another Disorder: Several mental disorders have similar symptoms. The therapist will rule out other disorders before diagnosing agoraphobia.
- Criteria Not Met for Panic Disorder: In agoraphobia without history of panic disorder, the criteria for a diagnosis of panic disorder have never been met.
Agoraphobia cannot be diagnosed by reading a list of diagnostic criteria. If you suspect that you or a family member may suffer from agoraphobia, contact a local mental health professional. He or she will use clinical judgment and skills to arrive at the correct diagnosis.
Source:American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th Ed.). Washington, DC: Author.
