Causes and Development of Agoraphobia

Agoraphobia Causes- Part 2: Physiological Factors

The following physical factors are commonly present in people that develop agoraphobia or have panic attacks:

1. Sensitivity to adrenalin and hormonal changes
In general, people with agoraphobia have overactive adrenal glands and are more likely to experience an adrenalin rush or “fight or flight” response when faced with a perceived threat. This makes them more susceptible to panic attacks.

In agoraphobia patients, adrenalin and a hormone called cortisol (a stress fighting hormone) are overproduced by the adrenal gland during times of prolonged stress.

The overproduction of adrenaline and cortisol interferes with the production of serotonin and dopamine. Serotonin and dopamine are neurotransmitters that stabilize your mood and sense of well-being. When serotonin and dopamine levels are low, your mood becomes unstable and you are less able to cope with stress.

In this state of chemical imbalance, you become more easily fatigued, your immune system is compromised, and you are more at risk for experiencing anxiety and panic attacks. Even after the original stressor is gone, you are likely to stay in a heightened state of anxiety.

2. Sensitivity to medications
People with agoraphobia often demonstrate a greater sensitivity to medications, including side effects. The side effects and/or withdrawal symptoms for some medications, including anti-anxiety medications, mimic the symptoms of anxiety and panic attacks. Because of this, medications prescribed to people who have panic attacks should be prescribed in smaller doses at first and then increased gradually as it is possible.

3. Sensitivity to physical stimulus
People with agoraphobia who have panic attacks usually have a heightened sensitivity to bright lights, temperatures, sudden or harsh sounds, and other sources of physical stimulation. Physical stimulus will more easily overwhelm someone with agoraphobia, create an aura of disorientation, and lead to a release of adrenalin which triggers the “fight or flight” response or panic attack.

4. Sensitivity to large amounts of sodium lactate
Some researchers have found unusually large amounts of sodium lactate in the bloodstream of people that have agoraphobia or panic attacks. Sodium lactate is produced when muscle cells convert sugar into energy. It is the basic solution in intravenous fluids given in the hospital.
In one study, patients suffering from panic disorder and agoraphobia experienced a dramatic increase in blood flow to the temporal lobes of the brain when given sodium lactate. The temporal lobes are the same area of the brain affected when subjects in other studies (who do not have panic disorder or agoraphobia) are given an electric shock!