agnosed if the avoidance behaviors associated wi th the panic attacks do not extend to avoid-
ance of two or more agoraphobic situations.
Acute stress disorder and post traumatic stress disorder. Acute stress disorder and
posttraumatic stress disorder (PTSD) can be differentiated from agoraphobia by examin-
ing whether the fear, anxiety, or avoidance is related only to situations that remind the
individual of a traumatic event. If the fear, anxiety, or avoidanc e is restricted to trauma re-
minders, and if the avoidance behavior does not extend to two or more agoraphobic situ-
ations, then a diagnosis of agoraphobia is not warranted. 
Major depressive disorder. In major depressive disorder, the individual may avoid leav-
ing home because of apathy, loss of energy, low self-esteem, and anhe donia. If the avoid-
ance is unrelated to fears of panic-like or other incapacitating or embarrassing symptoms,
then agoraphobia should not be diagnosed.
Other medical conditions. Agoraphobia is not diagnosed if the avoidance of situations
is judged to be a physiological consequence of  a medical condition. This determination is
based on history, laboratory findings, and a physical examination. Other relevant medical
conditions may include neurod egenerative disorders with associated moto r disturbances
(e.g., Parkinson’s disease, multiple sclerosis), as well as cardiovascular disorders. Individ-
uals with certain medical conditions may av oid situations because of realistic concerns
about being incapacitate d (e.g., fainting in an individual  with transient ischemic attacks)
or being embarrassed (e.g., diarrhea in an individual with Crohn’s disease). The diagnosis
of agoraphobia should be given only when the fear or avoidance is clearly in excess of that
usually associated with these medical conditions. 
Comorbidity