Doc: Agoraphobia a diagnosis, reclusiveness is not

Dear Dr. Roach: How does one differentiate between reclusiveness and agoraphobia? I realize both are medical terms/diagnoses.

T.H.

Dear T.H.: Of the two, only agoraphobia is a medical diagnosis. Reclusiveness is a personality trait with a broad definition, meaning someone who is withdrawn from society. In agoraphobia, this tendency is associated with intense fear or anxiety in at least two of the following situations: using public transportation; being in open spaces; being in enclosed places; standing in line or being in a crowd; and being outside alone. The diagnosis of agoraphobia is very specific in terms of the amount of fear, anxiety and incapacity caused by these situations. It requires experience to make this diagnosis, so I think it’s reasonable to seek out an expert ( a psychiatrist or psychologist) to make the diagnosis and discuss treatment.

I often hear people use medical terms to describe a person’s symptoms, but people can have tendencies toward a particular disease or condition without meeting strict criteria for a diagnosis. This is often because the degree of severity to make the diagnosis is so high. For example, I hear people described as narcissistic, but the diagnosis of a narcissistic personality disorder requires multiple criteria. Everyone should be careful of using medical diagnoses lightly, but particularly medical professionals who are in the media.

Dear Dr. Roach: The bottom of my arms looks like chicken skin. Am I missing vitamins?

C.L.H.

Dear C.L.H.: That sounds like keratosis pilaris, an extremely common skin condition. It usually comes on during adolescence, but it can be earlier or later. It’s not caused by lack of vitamins. A dermatologist can diagnose it just by appearance. I usually recommend lactic acid or urea creams as first-line treatment.

Dear Dr. Roach: I just found out that I was exposed to Agent Orange when I was in Thailand. Can Agent Orange cause peripheral neuropathy?

J.H.

Dear J.H.: According to the Department of Veterans Affairs, peripheral neuropathy that occurred within one year of exposure to Agent Orange is presumed to be due to Agent Orange and therefore is eligible for disability compensation and health care.

Email questions to ToYourGoodHealth@med.cornell.edu.