Agoraphobia

1. The presence of Agoraphobia related to fear of developing panic-like symptoms (e.g., dizziness or diarrhea).
   Criteria for Agoraphobia
   1. Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed Panic Attack or panic-like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile.
      Note: Consider the diagnosis of Specific Phobia if the avoidance is limited to one or only a few specific situations, or Social Phobia if the avoidance is limited to social situations.
   2. The situations are avoided (e.g., travel is restricted) or else are endured with marked distress or with anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a companion.
   3. The anxiety or phobic avoidance is not better accounted for by another mental disorder, such as Social Phobia (e.g., avoidance limited to social situations because of fear of embarrassment), Specific Phobia (e.g., avoidance limited to a single situation like elevators), Obsessive-Compulsive Disorder (e.g., avoidance of dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., avoidance of leaving home or relatives).
2. Criteria have never been met for Panic Disorder
3. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
4. The symptoms do not represent Bereavement.
5. If an associated general medical condition is present, the fear described in Criterion A is clearly in excess of that usually associated with the condition.

Treatment

Agoraphobia with panic attacks. Choices include SSRIs, TCAs, benzodiazepines, or MAOIs. See Treatment section on Panic Disorder for detailed medication description. Medications in combination with behavioral therapy most beneficial.
Agoraphobia alone. Systematic desensitization with exposure to real-life feared situations is the treatment of choice. Consult a psychologist.

• Depressed Mood
• Somatic/Sexual Dysfunction
• Addiction
• Anxious or Fearful or Dependent Personality

Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which one needs to be ruled out to establish a precise diagnosis.

• Panic Disorder with Agoraphobia;
• Social Phobia;
• Specific Phobia;
• Major Depressive Disorder;
• Delusional Disorder;
• Obsessive-Compulsive Disorder;
• Separation Anxiety Disorder;
• Any Realistic Concerns.