When should one seek medical care for agoraphobia?

Call your doctor when the signs and symptoms of anxiety are not easily, quickly, and clearly relieved. For example:

• if the symptoms are so severe that you believe medication may be needed
• If the symptoms are interfering with your personal, social, or professional life
• if you have chest pain, shortness of breath, headaches, palpitations, dizziness, fainting spells, or unexplained weakness
• if you are depressed and feel suicidal or homicidal

When the signs and symptoms suggest that anxiety may have been present for a prolonged period (more than a few days) and appear to be stable (not getting worse rapidly), you may be able to make an appointment with your doctor for evaluation. But when the signs and symptoms are severe and come on suddenly, they may indicate serious medical illness that needs immediate evaluation and treatment in a hospital's emergency department.

How is agoraphobia diagnosed?

Interestingly, agoraphobia, like other phobias, is often diagnosed and treated when patients seek treatment for other medical or emotional problems rather than as the primary reason that care is sought. As with other mental disorders, there is no single, specific test for agoraphobia. The primary-care doctor or psychiatrist will take a careful history, perform or refer to another doctor for a physical examination, and order laboratory tests as needed. If you have another medical condition that you know about, there may be an overlap of signs and symptoms between the old and the new conditions. Just determining that anxiety does not have a physical cause does not immediately identify the ultimate cause. Often, determining the cause requires the involvement of a psychiatrist, clinical psychologist, and/or other mental-health professional.

In order to diagnose agoraphobia, the professional will likely ask questions to ensure that the anxiety of the sufferer is truly the result of a fear of being in situations that make it impossible, difficult, or embarrassing to escape rather than in the context of another emotional problem (for example, fear of being near people that remind one of an abuser in the case of posttraumatic stress disorder or the fear of hearing voices that have no basis in reality as occurs in schizophrenia).