By Elaine Ryan
Agoraphobia can develop from having panic attacks. This page is to explain what you can do to prevent it from happening, if you are already having panic attacks. It will also discuss what to do if you already have agoraphobia, to help you to recover.
What is agoraphobia
People often think that agoraphobia is having a fear of being outside, in large spaces. I find it more useful to think of it as a fear of situations where you believe you might have a panic attack or not be able to escape from. Somewhere where you do not feel safe, and every part of you wants to return to where you think you will feel safe.
It is this fear that eventually causes avoidance. Over time, you can start to avoid more and more situations until you are afraid to leave your home and may even feel unsafe if you are at home alone.
What causes agoraphobia? Signs and symptoms
It often starts with panic attacks. If the attacks are not treated and become more frequent, you might begin to live in fear of the next attack, which might result in panic disorder, which in turn may turn into panic disorder with agoraphobia.
The first panic attack.
Often comes out of the blue. One minute you are feeling ok, and the next, your heart is pounding, you are finding it difficult to breathe, shaking, sweating, your pulse is racing and you are terrified. Often, finding out that what you have just experienced was a panic attack, may not give you the reassurance you need, especially if you start to experience frequent panic attacks. Pretty soon your headspace if full of thoughts relating to panic.
- Am I going crazy
- Other people can see what is happening to me
- When will it happen again
- Why is this happening
- Will I die
- How do I know it is just a panic attack?
Even though some part of you can start to accept that the physical symptoms you are experiencing is part of a panic attack, it is almost impossible to think this during an attack. Your whole life can be quickly turned upside coping with attacks as they happen, and living in fear of the next one.
It is very difficult to “get out of your head” with panic disorder as the symptoms are so severe and naturally worry you. It can seem such a roller coaster ride, that you try to make sense of what is happening.
You start looking for triggers, something that can help you understand what caused the last panic attack.
If you notice that you have had several panic attacks in the shopping mall, it makes sense that you might be fearful of returning to the mall. What happens if it happens again there?
The start of avoidance
You might decide to return to the mall and as soon as you go inside you quickly scan the building to make sure you know how to get out, in case you need to.
Going into shops may cause you feel anxious and you are no longer concentrating on what there is for sale as your head is more concerned with what you are starting to feel in your body.
You can feel panic starting and rather than face that again, you quickly leave and return home.
Once home, your anxiety starts to calm down. Your brain is quick to note this.
- Shopping mall = Panic
- Home = Safe
Even the thought of the mall makes you anxious and afraid. Next time you need something, you might go to the local store instead of the mall.
This is the start of avoidance and the development of an anxious mind
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People with agoraphobia may avoid
- Going outside
- Public transport, cars
- Being alone
- Restaurants; eating in public
- Walking outside, going to the gym, exercise
- Shopping malls
- Sunlight and heat.
- Using public restrooms
Our brain works to protect us from danger. The brain might notice similarities in the shopping mall and the local store. Your thoughts might quickly turn to worrying if something might happen in the smaller store.
This is enough to send alarm bells ringing in your brain that something is wrong and you get a stress response. You start to panic again.
Over time, you might start to notice that there are fewer places where you feel safe. Fewer places where you do not panic, until the only place that you feel comfortable is at home. This is agoraphobia.
If you have an attack at home, it can be more bearable as you do not have to have to contend with worrying what other people are thinking of you, or how to get out of where you are.
If agoraphobia is left untreated, you may start to feel unsafe if you are at home alone.
Having someone around means you have help at hand if you need it, or someone to help to distract you from what you are feeling in your body and mind.
Having agoraphobia can take up a lot of your headspace.
If you have had anxiety, panic or agoraphobia for a long time, you may hardly notice how much of your headspace can be taken up with planning. For example, let’s say you have run out of milk, you might not be able to just pop out and get some. You might have to ask someone else to get it.
If you do decide to go yourself, you may need to get someone to come with you. You need to plan when to leave, what store to go to, what to do if you panic, how you will get out and back to the safety of your home as quickly as possible. For many people with agoraphobia, you may not be able to go to store, as the only place that you may feel safe, is your home.
Our thought processes can change with anxiety. To help you see what I mean, think back to life before agoraphobia.
Were your thought processes similar to how they are now? You probably see that things that take up your headspace now and create anxiety symptoms in your body, would not have caused you a thought before you became anxious.
Treatment for agoraphobia therefore needs to look at how you are thinking, as it is thought processes that can actually keep the anxiety going. Your thoughts relating to panic and fear can now fire in your brain and create fear in your body. All of this happens without your knowledge, it is automatic. You can learn to take control and make your brain respond in a more helpful way.
Treatment for agoraphobia
One of the biggest problems for people wishing to receive agoraphobia treatment is; having agoraphobia.
It can be extremely difficult to get out of the house to go to receive help. With this in mind, I have produced an online program to help you to recover.
If you have not already read about me on my site, I am a Doctor of Psychology and specialize in anxiety disorders.
Treatment needs to address several things.
Change your anxious brain.
Agoraphobia normally develops from having panic attacks and out of fear of another one happening.
We need to look at what is happening in the brain to create the anxiety in the first place.
This is key to the treatment I provide.
Many people, maybe even you, have tried different things and do well for a while, only to slip right back into agoraphobia.
This is more than likely due to you not being taught about how your brain can be helpful or hurtful to you. Your mind has developed patterns, that it will quickly fall back in to.
The good news is – You can retrain your brain to work in a more helpful way.
Find out more about my Mind Body Approach to Anxiety to help you get your life back.