A Journey from Fear to Freedom

Everyone feels anxious and under stress from time to time. Situations such as meeting tight deadlines, important social obligations or driving in heavy traffic, often bring about anxious feelings. Such mild anxiety may help make you alert and focused on facing threatening or challenging circumstances. On the other hand, anxiety disorders are an exaggerated response to stressors and are characterized by creating anxious feelings where they are not warranted. The frequency and intensity of anxiety is often debilitating.



Agoraphobia
Most people fear having another panic attack and restrict their activities to avoid the possibility of another one. Agoraphobia is this cycle of anticipatory fear of panic and subsequent avoidance of situations where escape seems difficult, or help & safety are perceived to be unavailable such as being away from home or being alone. According to research, there are no particular personality differences between agoraphobics and members of the general population. Agoraphobia affects around 1.5% of the general population. More detailed stats are available here.

Agoraphobia onset is often preceded by a large number of adverse life events in the year or so before the condition is recognized but there is little evidence that a sudden trauma can cause it. Once present for about a year, the condition may persist for decades unless it is treated. Once the panic attacks have started, these episodes become the ongoing stress, even when other more obvious pressures have diminished. This sets up a "feedback condition" which generally leads to increased numbers of panic attacks and, for some people, an increase in the situations or events which can produce panicky feelings.

Typical Phobic Situations:
Typical "phobic situations" might include driving, shopping, crowded places, traveling, standing in line, being alone, personal or business meetings and social gatherings. Or simply anywhere away from home where 'escape' or immediate access to help is not possible. They will probably also fear standing in queues, going on bridges or sitting in any place where they feel 'trapped', such as at a hairdresser's or dentists. A companion for outings is often sought and rapidly becomes essential.

There can also be additional fears, predominantly 'social' ones such as a fear of blushing, trembling, talking eating or writing in front of people and of being stared at. (These latter fears can also be part of social phobia or separate specific phobias and don't necessarily mean that someone suffering in this way is agoraphobic.) There may also be obsessional and depressive symptoms. If the person becoming agoraphobic was significantly depressed before onset, which is more common when the problem appears later in life, this could be the disorder that is treated first.

Some Myths:
The common belief that agoraphobics fear 'open spaces' is, in general, untrue. So is the belief that a person must be totally incapable of doing any of the things mentioned above - or be totally consistent in their ability to do these things - before they can be designated agoraphobic.

Many agoraphobics are able to undertake certain activities under specific circumstances or when the need is great. This falls into the category that anyone should be able to understand when we make super-human efforts at times. For example, the documented case of a woman who lifted a car off her child. Anyone would understand that this was an incredible action fuelled by extreme need. However, the agoraphobic might be in much the same situation when heavily pressed to attend a family gathering or when faced with something that he or she desperately wants to do. This is about 'balance': the weight of need equalling the weight of ability and/or desire.

Because an onlooker cannot understand the particular balance involved, does not mean that the agoraphobic can be written off as: 's/he can do it if s/he wants to!' The contempt in this and the allied suspicion that the disability is not genuine stops a lot of agoraphobics from trying new things when they feel 'strong' and feeds in to a, possible, personal self-doubt and self-contempt. This is never useful and actively works against an agoraphobic's recovery.