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New Explanation of Agoraphobia

James Howard jmhoward at sprynet.com
Wed Oct 15 09:26:21 EST 1997

This is designed to explain agoraphobia.  First, a little background to 
put my explanation into a meaningful context.  (Remember this is part of 
my theory; anyone interested in reading more about it, may do so at 
http://www.naples.net/~nfn03605.)  I am a biologist, who has developed a 
theory of human evolution.  In my studies of human evolution, I found it 
necessary to explain the "fight or flight" phenomenon.  I decided that 
the two major steroid hormones of the adrenal glands, DHEA and cortisol, 
evolved specifically together.  My work suggests that DHEA is used for 
activation of all genes, so DHEA activates the nervous system.  When 
DHEA is high, it activates the nervous system.  In the case of humans, a 
confrontation stimulates the adrenal glands, so DHEA and cortisol are 
both stimulated.  According to my theory, if DHEA is high enough, it 
stimulates the brain, so when one male sees another, DHEA is stimulated 
and a "fight" might occur.  

This motivation to fight is alright, because it might mean the victor 
gets to eat, to drink, or have sex; all important things.  The problem 
is that two large, aggressive males, who are predisposed, will injure 
each other.  Even if one succeeds in not being mortally wounded, this 
would decrease the numbers of males.  In all likelihood, both might be 
wounded enough to harm the chances of both leaving offspring for the 
future of the species.  I suggest that cortisol evolved to counteract 
the effects of DHEA.  Cortisol, in large amounts and over lengthy 
periods of time, is damaging to all tissues, especially the brain.  In 
1985, I first suggested that the function of cortisol is that of an 
"anti-DHEA."  That is, cortisol is designed to interfere with the 
effects of DHEA on the brain.  Cortisol is designed to reduce the 
motivating effects of DHEA on behavior.   It is known that cortisol 
increases when people are stressed; if cortisol gets too high, I 
suggest, they take "flight."  Cortisol makes us "chicken out," so the 
big guy does not kill or severely harm us.  I think the ratio of DHEA to 
cortisol determines where we are on the "pecking order."

I think in some individuals, probably normally for them, or learned, the 
cortisol ratio is too high.  In some people, this results in merely 
being "shy," while in others I think it results in agoraphobia.  That 
is, the "flight" part of their natures are turned on.  Confrontations of 
almost any kind result in too much cortisol, and, therefore, their brain 
activation is decreased, and they cannot face a new situation, new 
people, or even go outside.  This is supported by research:  "In 
conclusion, it is suggested that the elevated postdexamethasone cortisol 
levels sometimes observed in agoraphobic PD patients are more closely 
related to the agoraphobic behavior than to the panic attacks per se." 
(Biol Psychiatry 1991; 30(3):247-256).  (I think panic attacks might 
result from another form of reduced availability of DHEA.  That is, the 
inability to convert DHEA from its source, DHEA sulfate.  The ratio of 
DHEAS to cortisol is significantly higher in people with panic disorders 
(Psychiatry Res 1989; 28(3):345-350).)

Now, I have been studying DHEA since 1985.  When I was able to purchase 
it, I started taking it.  One of the first effects I discovered was a 
significant decrease in my shyness, as I was quite shy.  I suggest that 
DHEA, over time, might help with agoraphobia, especially if taken prior 
to attempts to leave one's home.

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