Laura L. Smith - Anxiety For Dummies

The agoraphobic may start with one fear, such as being in a crowd, but in many cases the feared situations multiply to the point that the person fears even leaving home. As agoraphobia teams up with panic, the double-barreled fears of not getting help and of feeling entombed with no way out can lead to paralyzing isolation.

You or someone you love may struggle with agoraphobia if

You worry about being somewhere where you can’t get out or can’t get help in case something bad happens, like a panic attack.

You tremble over everyday things like leaving home, being in large groups of people, or traveling.

Because of your anxiety, you avoid the places that you fear so much that it takes over your life, and you become a prisoner of your fear.

You may have concerns about feeling trapped or have anxiety about crowds and leaving home. Many people do. But if your life goes on without major changes or constraints, you’re probably not agoraphobic.

For example, imagine that you quake at the thought of entering large sports stadiums. You see images of crowds pushing and shoving, causing you to fall over the railing, landing below, only to be trampled by the mob as you cry out. You may be able to live an entire blissful life avoiding sports stadiums. On the other hand, if you love watching live sports events, or you just got a job as a sports reporter, this fear could be really bad.

Luciana’s story, which follows, demonstrates the overwhelming anxiety that often traps agoraphobics.

Luciana celebrates her 40th birthday without having experienced significant emotional problems. She has gone through the usual bumps in the road of life like losing a parent, her child having a learning disability, and a divorce ten years earlier. She prides herself in coping with whatever cards life deals her.

Lately, she feels stressed when shopping at the mall on weekends because of the crowds. She finds a parking spot at the end of a row. As she enters the mall, her sweaty hands leave a smudge on the revolving glass door. She feels as though the crowd of shoppers is crushing in on her, and she feels trapped. She worries she might faint, and no one would be there to help her. She’s so scared that she flees the store.

Over the next few months, her fears spread. Although they started at the mall, fear and anxiety now overwhelm her in crowded grocery stores as well. Later, simply driving in traffic scares her. Luciana suffers from agoraphobia. More and more she feels like staying in her house.

Many times, panic, agoraphobia, and anxiety strike people who are otherwise devoid of serious, deep-seated emotional problems. So, if you suffer from anxiety, it doesn’t necessarily mean you’ll need years of psychotherapy. You may not like the anxiety, but you don’t have to think you’re nuts!

Many fears appear to be hard-wired into the human brain. Cave men and women had good reasons to fear snakes, strangers, heights, darkness, open spaces, and the sight of blood — snakes could be poisonous, strangers could be enemies, a person could fall from a height, darkness could harbor unknown hazards, open spaces could leave a primitive tribe vulnerable to attack from all sides, and the sight of blood could signal a crisis, even potential death. Fear fuels caution and avoidance of harm. Those with these fears had a better chance of survival than the naively brave.

That’s why many of the most common fears today reflect the dangers of the world thousands of years ago. Even today, it makes sense to cautiously identify a spider before you pick it up. However, sometimes fears rise to a disabling level. You may have a phobia if

You have an exaggerated fear of a specific situation or object.

When you’re in a fearful situation, you experience excessive anxiety immediately. Your anxiety may include sweating, rapid heartbeat, a desire to flee, tightness in the chest or throat, or images of something awful happening.

You know the fear is unreasonable. However, kids with specific phobias don’t always know that their phobia is unreasonable. For example, they may really think that all dogs bite. (See Chapter 19for more on phobias in children.)

You avoid your feared object or situation as much as you possibly can.

Because your fear is so intense, you go so far as to change your day-to-day behavior at work, at home, or in relationships. Thus, your fear inconveniences you and perhaps others, and it restricts your life.

Almost two-thirds of people fear one thing or another. For the most part, those fears don’t significantly interfere with everyday life. For example, if you fear snakes but don’t run into too many snakes, then your fear can’t really be considered a phobia. However, if your snake fear makes it impossible for you to walk around in your neighborhood, go on a picnic, or enjoy other activities, then it may be a full-blown phobia.

The following description of Dylan’s life is a prime picture of what someone with a specific phobia goes through.

Dylan trudges up eight flights of stairs each morning to get to his office and tells everyone that he loves the exercise. When Dylan passes the elevators on the way to the stairwell, his heart pounds, and he feels a sense of doom. Dylan envisions being boxed inside the elevator — the doors slide shut, and there’s no escape. In his mind, the elevator box rises on rusty cables, makes sudden jerks up and down, falls freely, and crashes into the basement.

Dylan has never experienced anything like his fantasy, nor has anyone he knows had this experience. Dylan has never liked elevators, but he didn’t start avoiding them until the past few years. It seems that the longer he stays away from riding them, the stronger his fear grows. He used to feel okay on escalators, but now he finds himself avoiding those as well. Several weeks ago at the airport, he had no alternative but to take the escalator. He managed to get on but became so frightened that he had to sit down for a while after he reached the second floor.

One afternoon, Dylan rushed down the stairs after work, running late for an appointment. He slipped and fell, breaking his leg. Now in a cast, Dylan faces the challenge of his life — with a broken leg, he now must take the elevator to get to his office. Dylan has a phobia.

Dylan’s story illustrates how a phobia often starts out small and spreads. Such phobias gradually grow and affect one’s life increasingly over time.

A couple of anxiety symptoms that usually occur in children sometimes follow into adulthood. As with other symptom clusters of anxiety, they often manifest themselves along with some degree of worry, panic, social fears, and so on. Two interesting though rare disorders include

Separation anxiety disorder: People who feel terrified that someone they love will be killed, kidnapped, injured, or die from an illness and as a result, refuse to be separated from their loved one. When separated, they often feel panic, extreme distress, and despair. The technical diagnosis is called separation anxiety disorder.

Selective mutism: Although this pattern usually begins in childhood, some adults are almost unable to speak in a variety of anxiety-arousing situations. They may neglect to say basics like “thank you” or “hello,” not because of rudeness, but because of extreme fear. This form of anxiety can cause massive social and occupational limitations. This form of anxiety is technically known as selective mutism.