Agoraphobia

While not all people who develop an Anxiety Disorder will develop agoraphobia, many of us do. This in turn complicates our experience and adds to the stress and anxiety many of us feel.

In the past, as we have said, Agoraphobia was known as the fear of open spaces. Now it is recognised as a fear of having a panic attack in which we feel escape or help may be difficult or we will make a fool of ourselves or embarrass ourselves in some way. It is not a fear of situations and/or places. It is the fear of having a panic attack which motivates us to avoid situations and places.

The avoidance behaviour is one way we use to avoid further panic/anxiety attacks. Sometimes it is successful, sometimes it is not.

When we use the term 'Agoraphobia' we may think this indicates someone who is 'housebound'. While there are people who can become housebound through their disorder, the avoidance behaviour can present in many different ways and for a number of different reasons.

• The avoidance behaviour can be categorised in a number of ways:
  As an overall defence against ongoing panic and anxiety. We have 'boundaries' of where we can and can't go. Sometimes these boundaries may mean we can't leave the house or perhaps even one room.

• We may have had a panic attack or panic like symptoms in a particular situation or place and start to avoid going back into the situation or place just in case we have another one.

• Anticipatory anxiety . This means we know we have to go into a certain situation or place but are fearful of having a panic attack when we go there. The 'What ifs' create a spiral of anxiety and we may then avoid going into the situations and/or place because of the spiral of anxiety.

• This reason is quite obvious but not generally acknowledged. With ongoing panic attacks and anxiety we simply do not feel well. Besides the symptoms of anxiety and panic many of us develop ongoing sinus or ear problems. We do feel unwell and we do not want to do what we need to do because of how unwell we feel.

Agoraphobia does not have to be a life sentence. As we learn to manage our panic attacks and anxiety we can then begin to practice going back into situations and places we have been avoiding by practising our skills in managing our thoughts.

ASHA

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