I think I was born a socially sensitive baby...my parents said that one time when they took me to an exhibition, I covered my eyes, and when they asked me why, I said, because I don't want people to see me. They thought that was a great joke, and told the story often. It was no joke. I believe I have always been socially withdrawn, possibly due to a rotten childhood and possibly genetically. I could not relate to other children in kindergarden and on up. In the teen years it became worse, as the added tension of boys and girls added to the social phobia and fear of blushing. Panic attacks would occur from time to time throughout my life. If I was under more stress, they would become worse. If things were going better, they would subside a bit. Agoraphobia started to strike in my thirties, and eventually I started taking medications anti-depressants and anti-anxiety meds since I was around 34. Since then I have been on and off various meds. and I still suffer panic and depression from time to time even with medications. My panic attacks have stopped now for about a month or so...this site has helped me think instead of just feeling when they start to come on, so I know what my thoughts are that trigger the panic. But now that the panic has dissipated, I am experiencing more loneliness and depression because I am living in a foreign country for the past five years, and I cannot communicate well in my new language, therefore, I cannot seem to find any really good friends who understand me. I still email some of my old friends from back home, but my overwhelming thoughts now seem to be of not being liked by anyone. When I feel that way, I try to get on this site and write to someone. So the answer to your question is, I believe in my case, genetic pre-disposition, as well as life experiences, and lack of a good support system, I have had these kinds of problems all my life, but I am just trying to deal with it better as I go along and learn more. Stressful lifestyle or conditions make it worse. My father and one brother also had these sorts of problems.