Agoraphobia....my thoughts

I am copying and pasting a post I made in a thread about agoraphobia.  I thought this one was a good one to hang on to, for anyone who needs to learn more about it...or gain understanding for a loved one...etc.


I will share with you what *I* know about agoraphobia.  Once I found out what I was suffering from (and that it was actually part of my disorder)...I wanted to learn all about it...so I dove into books and spent MANY a therapy sessions simply discussing that...I asked a million questions.

Before I start babbling..there is a book I would personally HIGHLY recommend for anyone with agoraphobia...it's called "Helping your Loved One Overcome Agoraphobia" by Karen William.  It is meant for the loved ones...but *I* got a LOT out of it...b/c I related so much to it....I felt as if *I* could have written it myself....and it made me feel not so alone.  After I read it (in mere hours)....I passed it around among my family members.  Great book.

I learned that agoraphobia technically means "fear of the marketplace/open places"...but what it boils down to is extreme avoidant behavior due to tha anticipatory anxiety of having a panic attack (or severe anxiety in GAD and other disorders).  My therapist told me that the percentage of anxiety disorder patients that have suffered from one level of agoraphobia or another is ASTOUNDING.  Agoraphobia is ESPECIALLY prevalent in panic disorder.  It usually starts vaguely...often even un-noticed by the sufferer.  I gave some examples before...but for instance, if a person has their first major devastating panic disorder in a grocery store....all of a sudden, that person finds it impossible to return there....because they have convinced themselves it will happen again if they go back there. In our minds, we relate the PA TO the location.  Agoraphobia isn't always related to locations either...it can be related to situations (ie...another poster mentioned an interview)...or even a time of the day....a person has a very bad PA at bedtime...and before you know it...the person relates the attack TO that time of day (and we see a lot of posts like that).  Obviously, though...with THAT kind of scenario...we can't actually AVOID a timeframe, so instead we just FILL ourselves with an unbelievable amt of anticipatory anxiety.

Sooo, the grocery store situation.  The person starts to avoid going there.  Next, that person has a PA at the library...so they stop going there as well.  This kind of thing balloons until basically the "safe zone" (which most people's "safe place" is their home) becomes smaller and smaller and smaller.  Like JS said...and I have experienced in talking with fellow PD'ers....some people cannot even go to their mailbox it is so severe.  The more we avoid, the worse it becomes.  I liken it almost to a PTSD scenario.  Certainly if I was present during a violent bank robbery...I would have a VERY hard time going back to that bank.  Same thing with panic attack induced agoraphobia, only the "danger" is perceived, not actual.

Another BIG component of agoraphobia is anticipatory anxiety.  This is where we literally make ourselves SICK with worry and anxiety before something we have to do.  Some things are unavoidable.  Example--One HAS to go to the doctor...but yet...as soon as the appt is made...the worry starts.  We "what if" ourselves into a frenzy..."What IF I get stuck in traffic and have a PA?"...."What IF my car breaks down and I have a panic attack?"..."What IF I get stuck in the elevator at the medical office building and have a PA?".  And so the cycle goes...the more we "what if"...the more anxious we become...and of course the anticipatory anxiety gets worse the closer the outing gets.  A LOT of people with agoraphobia cancel plans at the last minute...often making excuses because they are too embarassed to admit and to try to explain that they are afraid to basically leave their home.  They are embarassed by it because it is hard to explain to someone without an anxiety disorder...and because we can rationally tell ourselves that there IS no real reason to be afraid.  That's also when we often add depression to our laundry list of suffering.  We feel SO guilty for disappointing our family and friends who we let down by cancelling.  We feel inadequate that we can't even go to the gas station to fill our car.  Our loved ones most likely are unaware of the REAL reason behind our cancelling events...and therefore they assume we are being rude, irresponsible, etc etc.  So, that adds even more stress.  I personally am the most depressed when I am suffering with bad agoraphobia.  Like I said...it is an awful cycle...and it is hard to break.  Basically...like someone who fell off a horse...you have to get back on....and slowly start increasing that "safe zone"...as hard as it may be.

THAT is where CBT is very helpful.  A lot of therapists who do CBT actually do outings....starting small...and getting more intense.  I had a friend who was in CBT...her first outing involved her therapist picking her up in the car and driving WITH the patient as a passenger a mile down the road.  Her last session a year later....my friend was driving herself in her own vehicle on routes especially chosen with challenges...bridges, traffic, tunnels, etc.....to meet the therapist at least 60 miles away (and actually that last session included a ride on a subway as well...as that was a big fear for her).  But, she made progress....she came a LONG way.  

I will get into my own personal experiences with agoraphobia shortly....and to relate to what I just said...my most recent struggle involved a nasty PA in the middle of traffic on a busy highway.  That route is STILL incredibly hard for me to face..but I make myself do it at least once a month...even if I do not HAVE to go into town.

So...this is PART I of MY feelings about agoraphobia.  Like so many of you...I have suffered with it at various different degrees...but also, I have competely overcome it on 2 seperate occasions...working on my third.

I also wanted to address something barfer said about phobias.  That is another very common aspect of any anxiety disorder.  Most of us have one, if not several phobias...some very severe...others just sort of fleeting.  It's all part of the anxiety disorder...the cycle...the classic "what iffing"...basically a cruddy package deal of sorts.  My OWN personal phobias are....travel phobia (again a form of agoraphobia...nothing scarier for an agoraphobic to go REALLY far away from our "safe place".)...."poopy pants phobia" (self explanatory..I don't think I'll get too much into that right now...lol)...and driving phobia (again.....part of the agoraphobia).  But....as we've seen sooo often here....some of the more common phobias that anxiety sufferers deal with are health phobias, death phobias, exercise phobias, fear of vomiting, fear of going crazy, flying, driving, tunnels, bridges (anywhere we feel there is no easy "escape").