Agoraphobia

While not all people who develop an Anxiety Disorder will develop agoraphobia, many of us do. This in turn complicates our experience and adds to the stress and anxiety many of us feel.

In the past, as we have said, Agoraphobia was known as the fear of open spaces or the marketplace. Now it is recognized as a fear of having a panic attack in which we feel help or escape may be difficult, or we will make a fool of ourselves or embarrass ourselves in some way. It is not a fear of situations and/or places. It is the fear of having a panic attack or panic-like symptoms which motivates us to avoid situations and places.

The avoidance behavior is one way we use to avoid further panic/ anxiety attacks. Sometimes it is successful, sometimes it is not.

When we use the term 'Agoraphobia' we may think this indicates someone who is 'housebound'. While there are people who can become this disabled through their Disorder, the avoidance behavior can present in many different ways and for a number of different reasons.

The avoidance behavior can be categorized in a number of ways:

1. As an overall defense against ongoing panic and anxiety. We have 'boundaries' of where we can and can't go. Sometimes these boundaries may mean we can't leave the house or perhaps even one room.
2. We may have had a panic attack or panic-like symptoms in a particular situation or place and start to avoid going back into the situation or place just in case we have another one.
3. Anticipatory anxiet . This means we know we have to go into a certain situation or place but are fearful of having a panic or panic-like symptoms there. The 'What ifs' create a spiral of anxiety and we may then avoid going into the situations and/or place because of the spiral of anxiety.
4. This reason is quite obvious but not generally acknowledged. With ongoing panic attacks and anxiety we simply do not feel well. Besides the symptoms of anxiety and panic, many of us develop ongoing sinus or ear problems. We do feel unwell and we do not want to do what we need to do because of how unwell we feel.

Agoraphobia does not have to be a life sentence. As we learn to manage our panic attacks and anxiety, we can then begin to practice going back into situations and places we have been avoiding by practising our skills in managing our thoughts.

A recent study that we conducted investigating the Treatment Needs of people with an Anxiety Disorder revealed that out of 518 people diagnosed with an Anxiety Disorder, 335 (or 65%) of those participants went on to develop Agoraphobia. When asked if they felt that this avoidance/ Agoraphobia had developed as a result of the Anxiety Disorder, 95% responded yes.

Other

DEPRESSION: sometimes it is difficult for people to discern if the Depression is the primary diagnosis, or if the Anxiety Disorder is the primary diagnosis. Depression can be a secondary condition of an Anxiety Disorder. In our study, 278 (or 54%) participants reported that they experienced Major Depression. When asked if they felt that the Depression had developed as a result of the Anxiety Disorder, the participants responded yes. In addition to Major Depression, 221 (or 43%) participants reported having suicidal thoughts while 21 (or 4%) had actually attempted suicide.

NOTE: If you feel deeply depressed or suicidal, contact your doctor, local counselling centre, or hospital immediately. Reach out and get some a assistance. As someone who has been there, I know that it is crucial to help yourself and seek assistance. There is help you can receive.

PRESCRIBED DRUG DEPENDENCE: many people do develop a prescribed drug dependence as a result of taking medication for the Anxiety Disorder. 163 (or 32%) of our study Anxiety Disorder participants had gone on to develop a prescribed drug dependence. No one knows who will develop a dependence and who won't. Certainly, withdrawal from a prescribed medication can be (in people's own words) "..worse than the Anxiety Disorder itself."

DO NOT STOP TAKING YOUR MEDICATION. CONSULT YOUR DOCTOR OR DRUG/ALCOHOL UNIT FOR ADVICE.

ALCOHOL DEPENDENCE: As a way of trying to deal with the devastating effects of the Anxiety Disorder, many people turn to alcohol as a way of trying to deal with it. This, of course, is no solution. As Bronwyn often says, "how do you know the difference between a hang-over and the Anxiety symptoms?" The alcohol will tend to reinforce the physical symptoms and then we interpret them as increasing Anxiety levels. The spiral continues.

Kenneth was a man's man ...one of the boys. It was devastating for him when he developed an Anxiety Disorder. How could he explain what he was experiencing? Especially to his mates. He would be humiliated, the butt of all their jokes. Unfortunately, Kenneth had also bought into the stereotype of Anxiety Disorders - that it was a woman's problem (akin to PMS). His way of coping with the "problem" was to avoid situations where he might have a panic attack - this especially included down the pub with the boys. "Imagine," he thought, "the shame. I'd make a fool out of myself."

His friends started to inquire why they weren't seeing him anymore. No answer. Kenneth found a "solution" to the situation - he drank-and-drank until he was drunk BEFORE going down to the pub to meet with his mates. It was of course, no solution.

In our study, 58 (or 11%) of the Anxiety Disorder participants had developed an alcohol dependence as a result of their Anxiety Disorder.

CONTACT YOUR DRUG/ALCOHOL UNIT OR ALCOHOL ANONYMOUS (AA) IN YOUR CITY.

next: The Role Thoughts Play in Anxiety and Panic