Agoraphobia is primarily caused by a combination of genetic, biological, psychological, and environmental factors. It often develops as a complication of panic disorder, which involves sudden, intense episodes of fear or panic. After experiencing a panic attack in public or certain situations, a person may start to fear having another attack, which leads to avoiding these situations and eventually developing agoraphobia. Key causes and risk factors include:
- Having another anxiety or panic disorder, especially if untreated.
- A history of panic attacks, leading to anticipatory anxiety about being in places where attacks occurred.
- Genetic predisposition, as the condition often runs in families.
- Traumatic life events such as the death of a parent, abuse, or other stressful experiences (e.g., divorce, job loss).
- A nervous or anxious temperament.
- Biological factors like an exaggerated "fight or flight" response to stress.
- Certain sensory integration issues (e.g., difficulties with spatial orientation and vestibular function).
- Substance use, including chronic use of tranquilizers, benzodiazepines, alcohol, or tobacco, which may contribute to onset.
- Psychological factors such as attachment deficits, phobias, and perceived loss of safe spatial environments.
- Evolutionary perspectives suggest that fear of open or unfamiliar spaces may have roots in adaptive survival mechanisms.
Some people develop agoraphobia without panic disorder, triggered by irrational fears such as fear of violent crime or embarrassment in public. In summary, agoraphobia arises from complex interactions between biological susceptibilities, environmental stresses, and psychological factors, particularly linked to panic disorders and traumatic experiences.
