Posts Tagged ‘Agoraphobic’

Understanding the Meaning of Agoraphobia from an Ex-Sufferer

There are two things that are apparent when you start to seek a definition for agoraphobia and that is that, depending on where you look, there is more than just one definition. If we take a look in a dictionary, we will find that the interpretation given there is similar to the following: a disease which results in the sufferer being afraid of open or public spaces which, can result in the sufferer becoming housebound.

The second usual definition goes something like this: An anxiety disorder where the sufferer lives in fear of finding themselves in an embarrassing situation from which there is no escape. More advanced agoraphobics may, indeed, become confined to their home in order to avoid any such discomfort occurring whilst in public.

We can see that the result of being housebound is the same in both definitions, how the sufferer becomes housebound, though, is quite different. So, let’s compare both definitions to the real-life experiences of an agoraphobic.

I became an agoraphobic more than twenty years ago, following a series of panic attacks that occurred whilst I was travelling. At that time, my phobia was only connected to travel by any mode of transport that I chose: car, train, bus etc. but walking around outside posed no threat whatsoever. However, as the years progressed so did the severity of the condition and eventually, after around 18 years or so, I became totally housebound.

So, what is it that can make an agoraphobic’s life so limited? I’ll try to explain as best I can. But, if after reading this you can’t quite grasp the whole concept, don’t worry, most health professionals that I’ve consulted over the years couldn’t grasp it either.

As an agoraphobic, I lived in fear of when my next panic attack would strike. I was lucky, in one respect, in that I’ve never had a panic attack whilst within the confines of my home. However, I do know of other agoraphobics that do suffer them at home, sometimes quite frequently. For me, there was a fear bigger than the fear of having yet another panic attack and that was of having a massive panic attack that left me in a condition whereupon I could no longer stand up and walk or would result in some uncontrollable and embarrassing emotional outburst.

Knowing that certain situations could trigger my panic fuelled the second part of my condition. Being in heavy traffic made me feel very panicky and uncomfortable or standing still and not progressing forward on public transport had the same effect. So any thought of such an encounter brought on my “what if” syndrome. I’d be travelling down a road where the traffic was light and flowing freely when a thought such as: “I hope the traffic isn’t backed up at this or that road intersection” would enter my head and this would get me “what ifing”. “What if the traffic is backed up and we’re stuck there for twenty minutes and what if I have a panic attack and what if I can’t get to work and can’t get home?” This kind of thinking had just one outcome; it made me scared. And being scared and away from my safe zone just brought on my panic. This was one of the worst parts of my agoraphobia; me thinking my way into a panic attack.

Agoraphobia and its partners in crime, panic attacks and anxiety, stole everything that made my life good. But it didn’t stop there. It’s effects upon me altered the lives of my family and friends too. Having recovered from this nightmare existance, it’s only now that I can look back and see just how debilitating this condition truly is.

Let’s Define Agoraphobia

Commonly referred to a fear of open spaces, agoraphobia is anything but. In order to define agoraphobia, one first needs to translate its meaning from Greek – ‘agora’ is the Greek word for the market place and phobia is the Greek word for fear; and so we have a fear of the market place. Most market places are crowded and noisy and one cannot typically exit without firstly pushing through the throngs.

And this is precisely what most agoraphobics are afraid of. They fear panicking and making a fool of themselves in a public place with no possibility of an easy escape. Because of this fear, they will go out of their way to avoid certain places or situations. Avoidance behavior like this will only make the problem worse and finally, the agoraphobic will limit themselves to a very narrow comfort zone such as their home or to restricted behaviors and routines. Even then, anxiety is the predominant emotion which can be a constant companion.

But how do they arrive at this point? This definition presupposes the existence of a panic disorder – in order to dread panic, you need to have experienced it. In fact, while agoraphobia and panic disorder may seem like two different conditions, it is highly unlikely to suffer from agoraphobia without firstly having a panic disorder. Likewise, about a third of those suffering from panic disorders will go on to develop agoraphobia; typically those who do not seek treatment early enough.

The precise causes of panic disorders and therefore agoraphobia are not known. Perhaps there are different triggers for each case and this is why treatment needs to be personally tailored after careful individual analysis. It is commonly thought that there is a combination of factors involved which could be genetic, biological, environmental or social in origin. In some cases, the panic response may be a learned behavior and in others, it may be innate.

Fortunately, whatever the case, successful treatment is available. This is usually a combination of therapies. Medication may be used to control the symptoms of panic and anxiety in the beginning of treatment but as anti-anxiety drugs have side effects, dosages should be reduced over time. In the meanwhile, psychological therapy concentrates on changing the mindset and behavior patterns that contributed to the development of the condition.

Panic Disorder and Agoraphobia

It is actually easy to get confused about panic disorder and agoraphobia. Actually, the difference between the two is quite a task to determine. In agoraphobia’s case, its symptoms include the same symptoms as that of panic disorder, plus some more. Hence, this article will try to put a line in between this two.

There are people who get pangs of panic or anxiety in a crowded place. The reason for this would be the idea that they will have a panic attack in front of many people. Hand in hand with fear and anxiety, people with Agoraphobia would rather stay at home, where they feel safe.

It is not correct to conclude that Agoraphobia is a fear of huge spaces. It is more of being afraid by embarrassment. Moreover, the fear of not being able to escape a crowded area is another trigger for the attack. Since their anxiety attacks are quite severe, an agoraphobic would not like to be stuck in a place where he or she could not get help or treatment immediately. The mere thought of that can produce an attack.

For a case to be called agoraphobia, it is important to take note of the past six months. Try to plot your episodes, take note of the intensity, and the symptoms. This would definitely be of help once you consult with an expert. You may also look at your family tree, and find ancestors or relatives who have the same case.

Now, let us go to the case of panic disorder. Before a certain case is validated as a disorder, the episodes should be re-current, intense, and it can cease the pursuant of an individual’s daily routine. The usual symptoms for panic are: difficulty of breathing, palpitations, profuse sweating, and dizziness. Sometimes, there are people who feel that they are going crazy or depersonalization.

For the panic disorder, there can be different triggers for this episode to surface. It does not necessarily mean that they are afraid of crowded spaces, or an area where it would be difficult to escape. For some, public speaking is a huge deal, and nervousness usually sets in before they talk in front of the audience. Some maybe caused by fear of spider, this one is called arachnophobia.

Hence, Panic Disorder and Agoraphobia is not vice versa. It does not necessarily mean that if you have panic disorder, that you automatically have agoraphobia. On the other hand, agoraphobics may have panic disorder. There are some patients who actually develop panic disorder due to agoraphobia.

For these two, the treatments are quite similar. I will be giving some simple tips that could actually lessen the cycle of your episodes. First, let’s go to your diet. If you are consuming too much sugar and caffeine, you are attracting another panic attack. These ingredients are uppers, making you vulnerable to anxiety. Consequently, cut out the sodas, sweets, chocolates, and coffee. You may also do substitutions. Like replacing your sugar with sweeteners, sweets with fruits, and decaffeinated coffee in replacement for your usual espresso.

Another substance that you have to avoid would be nicotine. So, if you are smoking you have to kick the habit. This, like sugar and caffeine, is also an upper. What we are doing here, is to lessen the triggers of your attack. As of now, experts haven’t found of an overnight solution for panic attacks. The treatment is in sessions, and would take a lot of time and effort from your end.

During the attack, there is simple breathing exercise you could do. According to doctors, people tend to lose oxygen and gain carbon dioxide during an attack. Hence, you must extend out breathe to release the carbon dioxide. To do this, you may simple hum or count, then inhale.

Also, you may distract yourself because concentrating on your agoraphobia and panic disorder would only make things worse. You may open the television or pop in your favourite cd, anything that would remove your focus on your symptoms.