Agoraphobia

Agoraphobia can be a problematic aspect of anxiety.  When a person goes out of his way to avoid certain places, situations or activities because  he is afraid of having a panic attack, he is said to have agoraphobia.  Like most people who suffer from this condition, it probably started after you experienced your first panic attack.  It was so terrifying that you began avoiding places and situations in the hope of avoiding another panic episode.   For example, you may have gone to a ball game and – – out of the blue – – had a panic attack there.  So now, you stay away from stadiums or other large venues you fear might trigger another panic attack.

Because a panic attack scares the living daylights out of you, it’s understandable that you’ll do almost anything to try and prevent another one.  Unfortunately,  your avoidance has the exact opposite effect:  it keeps anxiety and panic coming back!  Not only that, avoidance has a way of spreading to more and more situations, limiting more and more aspects of your life.  As you give up more “turf” to anxiety, the activities and pleasures you used to enjoy shrink.

Safe Havens

One way that people with agoraphobia give up turf (to anxiety) is by limiting the distance they are willing to go from their home.  If this describes you, you probably fear that if you stray outside your “Safe Haven” you won’t be able to cope or get help if you have a panic attack. You think that somehow, by staying in close proximity to your home or within your safe borders you will be free of anxiety and, therefore, won’t experience a panic attack.  But I imagine that you’re reading this because this strategy isn’t working so well.

Your Safe Haven may be geographic, meaning that if you go too far from home you feel terrified.  Or your Safe Haven may be always knowing where your “Safety People” are  in case you need them.  Another way you may conceptualize your Safe Haven is by avoiding any situation that makes you feel trapped.  What you’re afraid of is not being able to exit quickly and unobtrusively if you should have a panic attack.  I don’t need to tell you how many aspects of everyday life can be affected by your agoraphobia; you’re probably an expert on this subject.  Driving, traffic jams, freeways, flying, being inside large stores, movie theaters, getting through checkout lines, being in meetings, elevators – – all are, in your mind, potential triggers for panic.  And so, you avoid them – – or “white knuckle” your way through them.  Either way, you are – – without realizing it – – perpetuating the anxiety/panic cycle.

Overcoming Agoraphobia

Fortunately, there is proven, effective treatment for agoraphobia.  You CAN reclaim the “turf” you lost to anxiety and take your life back.  Overcoming agoraphobia entails 4 steps.

The first step is understanding how your brain reacts when it receives a signal from you – – (that you’re not conscious of) – – that a situation, (like getting stuck in a check-out line) is “dangerous.”  In order for you to respond differently to anxiety once it’s triggered, it helps immeasurably to have a scientific perspective about what’s happening in your body. This knowledge will help you respond in a new way to fear and anxiety in order to overcome your pattern of avoiding (or fleeing the scene) that is maintaining the problem.

The second step in overcoming agoraphobia is to be able to tolerate the uncomfortable, scary physical sensations of anxiety and panic – –  (like rapid heartbeat, dizziness, shortness of breath or whatever bodily symptoms concern you).  You don’t have to like feeling these sensations.  (Who does?)  You just have to tolerate them and learn how to react to them differently to overcoming your fear.

The third step to beating agoraphobia is becoming aware and letting go of the “tricks”,  (therapists call them “Safety Behaviors”), you use to “protect” yourself from a panic attack.  Some Safety Behaviors are obvious:  avoiding situations out right. . . or fleeing the situation if you get triggered.  But other Safety Behaviors are subtle:  always knowing where your “safety people” are, having your cell phone handy, keeping Xanax in your purse or a water bottle in your car.  One problem with Safety Behaviors is that they keep you from learning that you can manage a panic attack without these gimmicks.

The fourth step in overcoming your fear entails approaching, facing the situations and places you have been avoiding.  This work is called Exposure Therapy  and, frankly, there’s no substitute for it if you want to get your life back.  Numerous scientific studies have demonstrated the efficacy of Exposure Therapy to overcome fear and avoidance.  The key is doing it the right way.  There are some principles you need to know to do exposure correctly and gain the therapeutic benefits from it.  Done incorrectly, Exposure Therapy can backfire, reinforcing your fear and avoidance.   Done properly, it’s a powerful, effective method to conquer your fear.  There are a number of excellent self-help books on the market that walk you through these tasks.  Or you can do the work with a therapist who has expertise in Cognitive Behavioral Therapy and Exposure Therapy.