Agoraphobia: Symptoms and Diagnosis of Agoraphobia and Panic Attacks
The formal diagnosis of agoraphobia (and some other psychiatric disorders) rests on these symptoms, which can be evaluated by psychiatrists and other mental health professionals.
Please see our separate note on Treatment, Mental Disorders and Basic Science for important caveats on the role and definition of diagnostic criteria.
Symptoms of Panic Attacks and Agoraphobia
The DSM-IV TR (where ‘IV TR’ indicates fourth edition, text revision) summarizes that “The essential feature of Agoraphobia is 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 a Panic Attack…or panic-like symptoms” (p. 432). The following diagnostic criteria for Agoraphobia are reproduced verbatim from page 433 of the DSM-IV TR.
Criteria for Agoraphobia
A. 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.
B. 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.
C. 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).
