Are we genetically programmed to be agoraphobic?

Agoraphobia is one of the anxiety disorders along with separation anxiety, selective mutism, specific phobias, social anxiety, generalized anxiety disorder and panic disorder. It is defined as significant anxiety in (or avoidance of) situations where it would be difficult to get help or escape from panic attack symptoms. Common to these disorders is an intensification of fear and anxiety in certain situations such as, in agoraphobia, moving away from home, being in a crowd or queue, on a bridge or in a means of locomotion. These situations are either avoided or endured with very intense anxiety, even to the point of panic attacks.

We are genetically programmed to feel anxiety (anticipatory fear). Its primary role is to protect us from danger. Feeling anxiety is necessary and indispensable. We did not arrive in the 21st century without having developed a good system of protection and defence for our species. To protect ourselves in the face of danger, the organism can develop three different behaviours: fight, flight or freeze, feigning death (these are automatic reflexes). To enable these behavioural responses, the brain in the face of danger commands the activation of the orthosympathetic nervous system to help us cope. Its mission is to produce a physiological response of tension to ensure the survival of the individual (muscular contractions, vasoconstriction, increase in blood pressure, acceleration of the heart rate…). These responses and automatisms are genetically transmitted.

Increasingly, science is looking at genetic and biological characteristics to try to account for psychopathological disorders. Today, family studies report a greater likelihood of developing an anxiety disorder when a family member already has one. However, it is important to point out that even if some people have a genetic vulnerability, this will not necessarily reveal itself. It is also important to mention the role of the learning that the individual will make during his life through the different experiences he has lived through. We are talking here about environmental vulnerability.

Let’s take the example of a young woman who has a genetic vulnerability to anxiety but who does not have any particular disorder. This person is walking in a department store at a very busy time. The lights are bright, it’s hot. She begins to feel symptoms of discomfort: feelings of heat, dizziness, blurred vision. At this moment she feels fear. The stress reactions will be interpreted by the person’s brain as a life threatening situation. Following this experience, the person will fear the return of this stress reaction and the associated feeling of not being in control.

This vulnerability, called environmental, will resonate with genetic and biological vulnerabilities and lead to an incorrect triggering, by learning, of the body’s defence system which will tend to generalise to many situations.

If we are indeed genetically programmed to suffer from an anxiety disorder, this vulnerability must be combined with environmental factors to develop agoraphobia.

Marie Thomas

Psychologist-psychotherapist specialised in behavioural and cognitive therapy.

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