Many people who suffer from panic attacks go on to develop agoraphobia, a severely handicapping disorder that often prevents its victims from leaving their homes unless accompanied by a friend or relative–a “safe” person. The first panic attack may follow some stressful event, such as a serious illness or the death of a loved one. (The agoraphobic often doesn’t make this connection, though.) Fearing more attacks, the person develops a more-or-less continual state of anxiety, anticipating the next attack, avoiding situations where he would be helpless if a panic attack occurred. It is this avoidance behavior that distinguishes agoraphobia from panic disorder. Two different types of anxiety appear to afflict the person with agoraphobia–panic and the “anticipatory anxiety” engendered by expectations of future panic attacks.
If you have agoraphobia, chances are it developed something like this: One ordinary day, while tending to some chore, taking a walk, driving to work–in other words, just going about your usual business–you were suddenly struck by a wave of awful terror. Your heart started pounding, you trembled, you perspired profusely, and you had difficulty catching your breath. You became convinced that something terrible was happening to you, maybe you were going crazy, maybe you were having a heart attack, maybe you were about to die. You desperately sought safety, reassurance from your family, treatment at a clinic or emergency room. Your doctor could find nothing wrong with you, so you went about your business, until a panic attack struck again. As the attacks became more frequent, you spent more and more time thinking about them. You worried, watched for danger and waited with fear for the next one to hit.
You began to avoid situations where you had experienced an attack, then others where you would find it particularly difficult to cope with one–to escape and get help. You started by making minor adjustments in your habits–going to a supermarket at midnight, for example, rather than on the way home from work when the store tends to be crowded.
Gradually, you got to the point where you couldn’t venture outside your immediate neighborhood, couldn’t leave the house without your spouse, or maybe couldn’t leave at all. What started out as an inconvenience turned into a nightmare. Like a creature in a horror movie, fear expanded until it covered the entire screen of your life.
To the outside observer, a person with agoraphobia may look no different from one with a social phobia. Both may stay home from a party. But their reasons for doing so are different. While the social phobic is afraid of the scrutiny of other people, many investigators believe that the agoraphobic is afraid of his or her own internal cues. The agoraphobic is afraid of feeling the dreadful anxiety of a panic attack, afraid of losing control in a crowd. Minor physical sensations may be interpreted as the prelude to some catastrophic threat to life.
Agoraphobics may abuse alcohol in an effort to keep the anticipatory anxiety in check. Their pattern of abuse appears to be different from the binging characteristic of alcoholism, however. The agoraphobic usually takes small amounts of alcohol, avoiding loss of control. Other drugs may also be abused.
Agoraphobia typically begins during the late teens or twenties. Women are affected two to four times as often as men. The condition tends to run in families.
Recent surveys have found that many people are afraid to leave their homes. Most likely they are not all suffering from agoraphobia. Some people may stay confined because of depression, fear of street crime, or other reasons. These surveys also show, however, that many agoraphobics may have never suffered a panic attack. This finding suggests that their agoraphobia may have developed in ways different from that outlined above.
(Source: National Institute of Mental Health Useful Information On . . . Phobias and Panic.)
Panic Attack Symptoms:
Symptoms of a panic attack can include: Lightheadedness, dizziness, racing heartbeat, chills or warmth, numbness and tingling in the extremities, “jelly legs”, distorted vision, chest pain, feeling as though you may faint, sense of impending doom, fear of dying or going crazy, fear of losing control, feelings of unreality, a strong urge to run or flee.
Are Panic Attacks Dangerous?
Panic attacks are not considered dangerous; one does not die or go crazy as a result of a panic attack.
What is the Cause of Panic Attacks?
Just as there are differing opinions regarding the cause of panic, there are differing opinions as to the best treatment. Treatment options include cognitive/behavioral therapy and medication, among other modalities used today. Panic disorder and agoraphobia are considered highly treatable.
Are Panic Attacks Genetic?
Genetic studies are underway to determine if individuals have a hereditary predisposition to panic attacks.
How is Agoraphobia and Panic Disorder Connected?
Agoraphobia may occur without panic attacks although agoraphobia most often develops as an avoidance response to panic attacks and the feelings of anxiety. Agoraphobia is sometimes called the “fear of fear” since agoraphobics actually avoid places or situations where he/she fears a potential attack, particularly where he/she might feel “trapped” or less able to get quickly to their “safe place or safe person.”
Agoraphobics are not necessarily housebound. Limitations vary from person to person.
Who Might Become Agoraphobic?
Agoraphobics are said to share similar personality traits: people-pleasing behavior, difficulty in expressing anger, highly imaginative, creative, easily moved to emotion, perfectionistic, sensitive, and intelligent. Men and women both may develop panic and/or agoraphobia.
Counseling and/or special programs developed for agoraphobics can aid in developing appropriate assertive behavior, expression of emotions, greater self-esteem, and so forth, to better manage stress and anxiety.
(The above data is but a small portion of the available information on these subjects.)
Family Member With An Anxiety Disorder
Don’t make assumptions about what the affected person needs; ask them.
Be predictable; don’t surprise them.
Let the person with the disorder set the pace for recovery.
Find something positive in every experience. If the affected person is only able to go partway to a particular goal, such as a movie theater or party, consider that an achievement rather than a failure.
Don’t enable avoidance: negotiate with the person with panic disorder to take one step forward when he or she wants to avoid something.
Don’t sacrifice your own life and build resentments.
Don’t panic when the person with the disorder panics.
Remember that it’s all right to be anxious yourself; it’s natural for you to be concerned and even worried about the person with panic disorder.
Be patient and accepting, but don’t settle for the affected person being permanently disabled.
Say: “You can do it no matter how you feel. I am proud of you. Tell me what you need now. Breathe slow and low. Stay in the present. It’s not the place that’s bothering you, it’s the thought. I know that what you are feeling is painful, but it’s not dangerous. You are courageous.”