BOOKS by Ellen
"Coexisting With Agoraphobia, Anxiety and Panic Attacks"
"If all of life
What is AGORAPHOBIA anyway?
I have heard and read many descriptions of what agoraphobia is, but I think the best one I have ever read was recently ( July 2013) written in an article by Nathan Daniels. It goes like this:
“At a grocery store, my vision rebels against me. The lights are far too bright all of a sudden. The isles seem impossibly long and are twisting and warping before me. The people become horrible reflections in a funhouse mirror. I’m dizzy and disoriented, sweaty and shaking. I’m reacting physically to my irrational terror. I want to vomit. My heart is beating way to fast… way to hard. I think I can actually see it kicking against my chest! Paralyzed, I want to run, but I can’t.”
—Excerpt from Surviving the Fourth Cycle
What, exactly, is Agoraphobia?
Agoraphobia is an anxiety disorder characterized by avoiding situations or places that might cause panic or one might feel trapped, embarrassed, or helpless if they do panic. This widely misunderstood and complicated disorder affects approximately 2% of adults in the United States, and about twice as many women as men.
The name itself comes from two Greek words… fear and marketplace.
There is evidence suggesting many possible causes, including genetic inheritance, though some research suggests it’s more likely a predisposition to general anxiety people are born with, which may increase their chances of developing Panic Disorders or Agoraphobia later in life.
There are even studies that could prove physical origins in some cases.
A weak vestibular system can cause one to rely on visual and tactile signals alone. In wide-open spaces, where these signals are few and far between or in crowded environments, where these signals are overwhelming, a person with this defect can become dizzy and disoriented. This strange and confusing sensation could very well lead to fear and avoidance of these situations or Agoraphobia.
It’s also notable that almost half of the people diagnosed with Agoraphobia have experienced some kind of trauma in their life, like sexual abuse or the death of a loved one.
Most experts agree, however, that suffering severe panic attacks and developing a continuous fear of having these attacks is the direct cause. In fact, Agoraphobia where there is no history of panic attacks is extremely rare… but does occur.
Panic attacks invite a list of frightening symptoms including accelerated heart rates, tremors, and shortness of breath. Severe attacks can often feel like you’re dying or going insane, as your body releases massive amounts of epinephrine to fuel a primal “fight or flight” response. These attacks are exhausting and terrifying events… I experience them on a daily basis.
I am not alone.
Famous southern cook, Paula Deen suffered with this illness for twenty years, resulting in a fear of death she developed after losing her father when she was nineteen years old. She describes her experience as pure hell.
Actress Kim Bassinger went public about her battle with Agoraphobia, admitting that it kept her homebound for extended periods, and caused her to live in confusion and shed tears on a daily basis.
Ironically, it’s been reported that the most noteworthy person of fame who lived with Agoraphobia was Sigmund Freud. This is something to consider if you’re one to believe the stigma, that someone can just “snap out of it” or “it’s all in your head.” Surely, the most quoted psychologist in history had a vast understanding of the disorder, but that’s obviously not enough to alleviate one’s symptoms.
What does Agoraphobia feel like?
Imagine standing in front of a door that you needed to pass through. Now… picture a blazing inferno or a psychopath with a shotgun and an itchy trigger finger on the other side. Imagine, what you’d feel, physically, knowing you still had to go through that door. You’d feel terror, desperation, and panic. You’d experience an accelerated heart rate, shaking, sweating, nausea, dizziness, shortness of breath… perhaps even paralysis or loss of consciousness.
Would you be able to reach for the knob? Would you be able to go through that door?
I face this fear on a daily basis. I even beat it more often than not, with teeth clenched and shaking legs, I’m usually able to make it through that door and function, even if it is on a limited basis —even if I do need a hood over my head, sunglasses, and possibly earplugs.
Now if you can accept the fact that Miss Bassinger, Dr. Freud, and I aren’t mentally weak imbeciles and our physical symptoms are real regardless of what’s actually on the other side of the metaphorical door, then you can grasp the reality of living with Agoraphobia.
If someone really charged through a doorway with foreboding danger on the other side, depending on the circumstances, they’d probably be considered a hero… brave and strong. Chances are, most people will never have to face that kind of terror. With severe Agoraphobia, I have to summon that same exact intestinal fortitude on a daily basis.
It’s a hard way to live.
Unfortunately, most people in my world look down upon me for suffering with this affliction and view me as weak and pathetic. Many think it’s a “fake” disorder and I’m just “lazy.” This stigma and lack of understanding from society in general, needs to change.
The exhaustion from trying to justify and explain the things you’re feeling, combined with the hopelessness of not having the reality accepted, can lead to crippling loneliness and social isolation. These are the most horrible aspects of living with mental illness, because they are completely unnecessary and inflicted upon us from external sources… sometimes by our own friends and family.
I find comfort in reminding myself that the ignorance is, “all in their heads.” Perhaps they’ll, “snap out of it.”
How does one recover?
To the best of my knowledge, there is no definitive cure for Agoraphobia. There are, however, a number of treatment options that can help alleviate the symptoms or, at least, make them more manageable.
Typical medications prescribed for this disorder usually include a combination of anti-depressants like; Selective Serotonin Reuptake Inhibitors (SSRIs), Monoamine Oxidase Inhibitors (MAOs), or Tricyclic Antidepressants along with anti-anxiety medications, also called benzodiazepines.
Cognitive Behavioral Therapy (CBT) has proven to be an effective form of psychotherapy for those diagnosed with Agoraphobia. This involves educating yourself with facts and understanding the nature of the disorder, while carefully and patiently increasing your exposure to places and situations that potentially trigger attacks.
Due to the nature of this illness, it might be difficult or even impossible to leave your home at times for therapy… especially in the beginning. Personally, I can only make it to my therapy sessions with my girlfriend’s assistance, and I have to reschedule if she’s not available to bring me.
It’s still a challenge, even with a companion you trust completely. I hold her hand and keep my head down. I wear a hood to reduce my peripheral vision… grit my teeth and bare it. If you don’t have a companion that can help you get to your appointments, or having one simply doesn’t help, don’t fret.
Good therapists understand the complexities of the Agoraphobia, and most will be cooperative in making alternative methods of therapy available. Options might include starting out with over-the-phone or email sessions, meeting at your home, or secondary location where you might feel safer.
Even non-conventional forms of therapy like; yoga, meditation, and hypnosis can help by teaching you relaxation and stress relief techniques that, with practice, can help you learn to manage your symptoms and expand your comfort zone.
Support is crucial too, when learning to live with Agoraphobia. I’m lucky to have a very supportive and understanding partner, but I also belong to several online support groups. Facebook has a couple good ones, and it’s comforting and helpful to chat with others who can relate to my daily struggles.
Agoraphobia and me.
Ever since I started writing extensively about my past relationship with my parents, I can’t help wondering if I may have genetically inherited some of the psychological disorders I live with today. More specifically, I wonder if my mom lived with an undiagnosed case of Agoraphobia, and if this disorder might run in our family.
For reasons unknown to me, my mother stopped driving when I was quite young. She never had a job as long as I knew her, even when there was a need and nothing obvious standing in the way. She had no friends to speak of, and I remember her having great difficulty communicating in public most of the time. As I got older, she often had me speak on her behalf.
Symptoms that I experience as a result of Agoraphobia and other ailments often prevent me from driving, currently prevent me from working outside my home, limit my friendships to online communication, and I need my girlfriend to do the majority of my speaking when I venture out into the real world… It’s all too familiar.
I will most likely have to deal with this disorder, on some level, for the rest of my life. My mother’s past lifestyle strongly suggests that, if one can be genetically predisposed to this diagnosis, that’s likely the case with me.
I endured devastating forms of emotional, verbal, physical, and sexual abuse during my childhood. I also experienced the deaths of my grandfather, mother, and father… all in the space of three months, when I was a teenager. Any one of these situations can lead to the development of Agoraphobia.
My life seems like a series of events, specifically designed to induce this complex illness.
In spite of all this, I have immense confidence that I’ll consistently improve the overall quality of my life, and lessen the burden of my symptoms. I’ll do this by continuing to educate myself on my disorder, speaking openly and honestly about it, employing new and healthy coping skills as I learn them, maintaining my therapy and medication, knowing my limits, being patient with myself, and always seeking help when I need it.
I dream of a day, when I won’t even notice this disorder anymore, and my symptoms are all but gone. I know I’ll get there, and I’ll do everything in my power to help others get there as well. We might have to live with Agoraphobia, but there’s no reason we can’t do it well and we shouldn’t have to do it alone.
Also by Nathan:
My terror rises, as I pace.
Other writings by Nathan Daniels
copyright 2013 Ellen Isaksen