An evolutionary perspective on panic disorder and agoraphobia

Abstract

Panic, when viewed ethologically, is not pathological in itself; it is rather an adaptation that evolved to facilitate escape in dangerous situations. Patients with panic disorder have panic with normal form, but the attacks occur in the absence of real danger. The agoraphobia syndrome can be understood as a related adaptation that is expected after repeated panic attacks. These hypotheses account for many aspects of panic and agoraphobia that are difficult for proximate theories to explain, and they suggest new research questions and strategies.