A Is For Agoraphobia

This year my family is planning a cruise together for Christmas. Fun, right? And yet, after we bought the tickets a couple of months ago, and as I lay awake for the 3rd night straight with sweaty palms and a racing heart, I finally had to admit that I have a real problem.

A problem called agoraphobia.

I only know that word thanks to one of you readers - the one who suggested in the comments once that my "escape anxiety," as I called it, was actually something called agoraphobia. At the time I did a quick Google search for the definition, agreed with the commenter, and moved on. Having a fancy name for my peculiar flavor of anxiety just didn't seem all that helpful, to be honest. I mean, most folks don't even know what agoraphobia is, so what good is it having a label?

But as it turns out, it can be a whole lot of good.

As it turns out, understanding that "label" could very well be the key to understanding my anxiety, to mastering my panic, and - at the risk of sounding overly dramatic - to getting my life back.

You see, I've let my fear bully my life away. I've been telling myself I was fine missing out, that I was happy always staying home, waiting in the gift shop, taking the stairs, skipping the show. I never dared let myself wish I could have it all back some day.

But today, dangit, I dare.

So now I'm going to tell you what agoraphobia is. I'm going to tell you what it looks like, so you can watch out for the signs in yourself or your loved ones. And I'm going to tell you what I'm doing right now to try to undo the damage I've done to myself - damage that I *thought* was actually helping.

First, what the heck is agoraphobia? Here's what The Anxiety And Phobia Workbook has to say:

"The word agoraphobia means fear of open spaces; however, the essence of agoraphobia is a fear of panic attacks. If you suffer from agoraphobia, you are afraid of being in situations from which escape might be difficult - or in which help might be unavailable - if you suddenly had a panic attack."

Many people associate agoraphobia with housebound shut-ins, but that only happens in the most extreme cases. Most agoraphobics can leave the house, but almost all will avoid things like elevators, airplanes, sitting up front, driving alone or in heavy traffic, and other hard-to-escape situations.

Seven years ago I developed a panic disorder, literally overnight, but no one told me that's what it was. Four days in the hospital, countless tests, doctor visits, trips to cardiologists & kidney specialists, and not a single health professional ever uttered the words "panic disorder" or "anxiety attack." NOT ONE.

Looking back, I'm kinda irked about that.

And since no one mentioned anxiety, of course I also wasn't warned about the very real danger of agoraphobia. I wasn't told that more than 30% of people with panic disorder will develop agoraphobia, or that it strikes far more women than men. (About 80% of agoraphobics are women.) I wasn't told what to look for or how to combat it, or that catching the fear early on can be crucial.

The trouble is it starts out so very logically: if going to church makes you have a panic attack, then stop going to church. And hey, since panic is all about adrenaline and over-stimulation, it just makes sense to avoid loud environments like theaters or concerts, right? That's just taking good care of yourself!

As avoiding those situations rewards you with fewer panic attacks, you may start to think you've really got a handle on this whole anxiety thing. To keep up your "winning streak," you might start avoiding any situation that gives you even a twinge of discomfort. Elevators, public transportation, tunnels, crowds, long trips, theme park rides, shopping or driving alone, rush hour. Before you know it, your world has shrunk down to a carefully regulated "safe zone," and so long as you don't try to leave that zone, you feel pretty good!

But then, say, your family schedules a Caribbean cruise, and that fragile house of cards can come tumbling down.

To clarify, being uncomfortable in confined situations doesn't necessarily make you agoraphobic. It's only when you start avoiding situations because of that fear that the phobia truly begins. And the more you avoid - and are consequently rewarded with fewer panic attacks - the more entrenched that fear can become.

Funny, isn't it? How something that feels so healthy - less stress and panic - can actually be so damaging?

There is good news, though, and it's this: Agoraphobia can be reversed. You - WE - can get our lives back. It's not easy, and the process kinda sucks, to be honest, but knowing there's a light at the end of this tunnel helps more than I can say.

So this is what I've done so far:

First, I ordered several books on treating panic and agoraphobia in particular. So far I've made it through The Anxiety and Phobia Workbook, and I'm working on Master Your Panic now.

The Workbook is huge and a bit daunting, and I was rolling my eyes a lot through some of the "inner child" and childhood history chapters, but I learned more there than I did in seven years of chasing diagnoses from doctors. (Apparently I'm the textbook personality type for panic disorder: a creative, people-pleasing, emotionally sensitive, conflict-avoiding control freak with a hefty streak of perfectionism. Who knew?)

Next, I went to my doctor for a check-up. (Ergo that Halloween blood draw.) Since this next step will undoubtedly cause me more anxiety, I need the peace of mind that comes from a current clean bill of health. Not only that, there are several deficiencies that can cause increased anxiety: deficiencies of magnesium, potassium (both of which were critically low for me in the past), B vitamins, and even calcium.

Once I get my test results back, I plan to get more aggressive with the treatment I've already begun: exposure therapy. The name says it all, but please don't run out and throw yourself into situations that make you panic; this is NOT an "all-in" approach. First you have to get comfortable with the proper techniques for managing a panic attack, most of which I already learned from Hope and Help for Your Nerves. (If you have panic attacks, read that book.)

Once you have the mental and breathing exercises down, then it's time to slowly start testing the limits of your safe zone. This is to be done incrementally, and though it only works if you feel some anxiety, you're never to push yourself so far that you have an actual attack. You have to build up your confidence, testing your ability to manage the anxiety as you go, until the things you fear become almost routine.

I know exposure therapy works, because I can take long trips in a car again. There was a time when just climbing into the passenger's seat caused me real fear, but now, for the most part, I can even look forward to day-long rides again. In fact, the other day I caught myself feeling bored - bored! - while in the car. Not gonna lie; after all the terror and avoidance and wishing I could just stop thinking about being in a car, that moment made the air a bit dusty.

With that said, I still have a long way to go. In fact, I didn't realize just how far until I tried to go to the store by myself the other week. John was sick in bed, I needed some eggs to make cupcakes for a friend's birthday, and I thought, "Hey, this is a great time for some exposure therapy! I haven't driven myself in months, and I haven't driven alone in years. IT'S PERFECT."

Or... not.

I wish I could tell you I struck a blow for independence and emotional health that day, but the truth is I started shaking the moment I walked through the door of the local 7-Eleven. The two-minute drive over had been fine, parking a breeze, and I even remembered my wallet. I was feeling pretty good! But then a lady looked at me as I opened the door. She made eye contact and smiled, and suddenly there was this "whooshing" sound in my brain. Over the roar, I thought, "What are you doing?! This is too much! This isn't just driving! You have to deal with PEOPLE! AAAAUGGGH!!"

I managed to stand in line with that carton of eggs for about 10 seconds, breathing and practicing my "floating" response. Then I shakily returned the eggs to the case, walked out the door, and drove home empty-handed. Once there, I shook for another 20 minutes.

But you know what? It wasn't defeat. It was progress.

Later that night I told John about my failed attempt, and I could tell he was shocked - as I had been - at just how far my agoraphobia had progressed. (If you never test that safe zone, then you'll never know!) Then he put his shoes on, handed me the car keys, and announced we were going to the grocery store. Once there, he also made me pay. Then I drove home again. And I did just fine.

That's how it has to be, I think. Step by step, little by little, I'm going to reclaim all the things I've let my anxiety steal from me. Some day I'm going to see a live play again. Some day I'm going to get on a plane again. And some day - one day - I'm going to go to Tokyo Disneyland. (Heck yeah!)

But 'til then, I'm ok with working on just buying eggs by myself.

For my Pinterest peeps:

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UPDATE: I wrote this post over the weekend. Last night, I went to a movie in a theater for the first time since 2010. Not only that, I went without the aid of Xanax or earplugs, and I did more than just endure it; I enjoyed it. (Big Hero 6. I recommend.)

Do you know what this means?! Thanks to the things I've learned about agoraphobia, and within just a month of deciding to try, I get to go to movies again. I can finally see Guardians of the Galaxy! (Er, assuming it's still in the cheap theaters.) 

My point is, any shame I might have felt over sharing this here is overshadowed by the hope that one of you might read this, and get to reclaim something joyous in your life, too. So please, guys, spread the word. Don't let someone you love be bullied by agoraphobia any longer.

Feel free to chime in in the comments; personal experiences & helpful tips are always welcome. (I know I could use the encouragement - maybe some of you could, too.)