Mental Illness out of the shadows: Agoraphobia

[scottcsmith]

I've written of my struggles with mental illness a couple of times here at DU, and I wanted to talk about another mental illness I have, Agoraphobia, and explain what it is.

As I type this, I still feel ashamed of myself, as if my mental illnesses were an indicator of defects in my character. That's the stigma of mental illness: it's a subject that our entire culture views with suspicion, and those of us that have it, get the message our entire lives that something is "wrong" with us. And while part of me feels the shame I mentioned, I do know that nothing is "wrong" with me. The brain is an organ that is susceptible to disease like any other organ in the human body.

I know many people have heard of Agoraphobia, but most people do not know what it is. If you ask someone, chances are they will respond with, "Isn't that when you do not want to go outside?"

The answer is, no, that's not what Agoraphobia is. Agoraphobia is simply a fear of losing control. It's really a fear based on the anticipation that something bad will happen, or that you will be put into a situation where something will happen that you cannot control.

For me, Agoraphobia manifests itself in two distinct areas: driving and social interaction.

When I drive my car, there are certain areas I will not drive to, and when I drive, I tend to use the same route. I always drive in a linear fashion. If I have to do a lot of shopping, I plan out the route in advance in such a way that my last stop shopping is the place closest to where I live.

The Agoraphobia I experience is the fear of having a panic attack while I drive. That fear is so strong that in most situations, I will get a ride from someone, rather than drive to the place that causes anxiety. For instance, it is very difficult for me to drive to the airport. I live about 13 miles west of Portland, OR, in a city called Beaverton. I tend to avoid driving into Portland; it's one of my trigger zones. Driving causes anxiety, and when I'm driving, I fear having a panic attack, and not being able to do anything about it, which leads to the fear that I will crash my car and injure or kill myself.

I experienced this fear last night, when I drove into Portland to see Chris Rock. I wanted my wife to drive me, but I knew it would be a big hassle for her to do so, and I decided to drive myself to the show.

Getting to my destination wasn't much of a problem. I parked and enjoyed the show. But when it was time to drive home, that's when I had a massive attack of anxiety.

It just got worse as I continued to drive. I took a wrong turn somewhere and was lost for a short time. I finally got onto a familiar road, but I could barely see anything due to poor night vision. It was also raining. I clutched the steering wheel and tried not to think about what I was doing.

When I got home, I had a major panic attack. I haven't had one in a while, and this one was pretty bad. I was shaking and I couldn't breathe right and I was in hysterics.

I also fight Agoraphobia in social situations. I dread meeting a new group of people, and I'm convinced that they will know something is "wrong" with me, or that the subject of my mental illness will come up. Again, the fear is based upon anticipation of something happening. In most cases nothing happens, but it's still hard for me to meet strangers. Really crowded public places tend to set off panic attacks. I do okay in theaters and on airplanes. But for something like an outdoor concert with lots of people, you would have a difficult time getting me to go.

The symptoms of Agoraphobia are helped with medication, and behavioral modification also helps. I'm at a point now where I can do more without having a panic attack, but it's an issue I still struggle with.

[Droopy]

1. I used to have similar difficulties

when I was in the throes of a mental illness known as schizoaffective disorder. I was afraid of people. I spent as much time as possible at my home.

Now that I'm being treated for the illnes, that symptom has disappeared, thankfully. I'm still not what one would consider a socialite, but I no longer have the paralyzing anxiety that I used to have around people.

I hope you find a way to rid yourself of this illness. I know how tough it can be.

[sendero]

2. I once...

... suffered from panic attacks. I've probably had a total of 10 in my life. The last one was over 10 years ago so I don't worry about them any more.

People who have not experienced this have not a glimmer of a clue how horrible they are. Literally, for me - I'd be gripped with terror for several long minutes, and then after the acute part subsided, would feel strange for almost a day. Very unpleasant.

After I while, I did learn to feel one coming one and I learned that if I could get my mind on something else quickly, I could avert them.

I'm sure everyone is different, and that your experience is unique. Best of luck in learning to live with and manage it.

[wysi]

3. I can understand that...

I used to have panic attacks fairly frequently, particularly in the supermarket and when travelling (not driving but flying or taking the bus somewhere). I still get very edgy in these situations but have not had a full-on attack in some time, though I've not sought any treatment for it.

I'm also quite wary of crowds in general and meeting new people.

I suspect, as you say, that these are all related to control issues (i.e. situations in which one is likely to have less control can trigger them) and there are those of us who are generally disposed to this sort of thing (we psychologists like to call them the 'defensive high-anxious types, which refers to the combination of responses to a couple of questionnaires). The good news is that oftentimes these individuals are quite proactive in protecting their health (better diet, more exercise, etc).

Best of luck.

[junker]

4. An alternate view of Universe would suggest a 'ki' sensitivity.

Many people have the inability to cope with, or lack the skills to cope with, the intrusion of other persons' 'ki' or chi or prana or life force within their own ki sphere.

While I am in no way suggesting that your understanding of yourself is incorrect (like I know squat), I would suggest that a nice, do-no-harm, experiment might be to take a ki course at your local aikido dojo.

THE prime directive within aikido, is respect, so fear no belittlement nor undesired exposure. Every dojo I have ever seen or attended has a 'sit in' policy where anyone is welcome to sit in and observe. What I am suggesting is not necessiarily the martial art of aikido, but rather the ki skills that many dojo's offer as separate instruction. Of course, aikido too is applicable with a life of balance and growth, but you need not even consider it. The ki arts come in very very handy.

Just an alternate view of Universe.
Bon chance' mon ami.

[Taeger]

6. Aikido is cool ...

But I think that people take "ki" and turn it into things that it simply IS NOT. Ki has been turned into the explanation for everything and nothing. People use the term so much that it becomes unusable. When everything in the universe can be explained in terms of ki, you know it has a LOT of bogus uses.

One can certainly claim that all kinds of therapy including Aikido can be beneficial for relieving symptoms. But trying to explain a particular mental disorder in terms of a "magical ki sphere" is just kinda ridiculous in my opinion.

[Malva Zebrina]

5. diabetics experience panic attacks also

and no one knows why.

I once could not drive over the George Washington bridge. I had four kids in my car--two of my own and two of my brother's.

I simply could not breathe the closer I got to the bridge. I pulled over to a side street and sat there trying to muster up the courage or the calmness to drive over that bridge.

The kids were wondering what was the matter also and I think they were also scared.

Finally, I managed to get up on that bridge, and seemed to me I was holding my breath the entire time and made it over--complete panic ,m hysteria and out of control

I have not had an episode like that now for at least ten years.

I also went through a period of panic during a lightning and thunderstorm.

I would dread it if I perceived a storm coming. It was to the point where I was refusing to go on canoe trips because there may be a sudden squall and then what would I do if I were on the water. So if there were clouds in the sky I would not go

I got fed up with that one--I would sit with a blanket over my head and not on the couch because it was a hide a bed with a metal frame

Finally, one day, ]there was a real bad thunderstorm and i got so fed up with myself that I threw all caution to the wind, opened the back patio doors and confronted the lightning and thunder--ever since then, I have not had that phobia.

WE are such vulnerable human beings. There is a lot to our chemistry that we do not understand.

Hang in there--you are a valuable human being

[flamingyouth]

7. I'm agoraphobic as well

I've also dealt with panic attacks most of my life. There was a time when I was too afraid to leave my apartment and go downstairs to get my mail - it was that bad. I made quite a few behavior modifications and even changed my diet. Eliminating caffeine and limiting alcohol especially helped me. It is a scary and horrible thing, and I feel for anyone dealing with it. Sounds like you are doing quite well, though, and I'm proud of you.

I too get really panicky driving alone at night, especially if I get lost. It happened to me about 10 days ago, and I too had a bad attack when I got home.

Keep up the good work. You know you've got support here if you ever need it. :hi:

[Nikia]

8. I get panic attacks

I am alright going anywhere with my husband now but I get nervous when I am alone sometimes. For a while, it was difficult to even go to the grocery store. Now after group therapy, beta blockers, and Xanax wheneve I need it, which thankfully is relatively rare, I am usually alright. Going out to eat is probably the worst for me.

[Pithlet]

9. I have a fear

of running into my neighbors if I step outside the door. It isn't specific to anyone; I've always been that way, wherever I've lived, since I've been out on my own. It was worse in apartment buildings, but even now that I have my own home, I'll only go outside with the kids if I know my neighbors are not outside. The idea of interacting with them fills me with dread, and I'm not looking forward to the weather getting warmer, when everyone spends more time outdoors. They do probably think it is odd that they rarely see me. All other social situations I'm cool with. It's just neighbors.

I hate the stigmatization of mental health issues. You have nothing to feel ashamed about.

[scottcsmith]

12. Me too

That's a strange one, isn't it? I'm so bad that if I see a neighbor heading for our mail box I'll wait until the neighbor is done before I go to the mail box. I rarely walk anywhere out of fear of having to pass someone. Even as a teenager this was an issue for me. When I did have to walk I always plugged myself into a Walkman and tried not to make eye contact. I hate public transportation and the idea of sitting on a bus fills me with so much dread that I rarely ever do it.

[maveric]

20. I too avoided neighbors.

Fearing that I'd have a dysfluent episode and they'd think that I was retarded or drunk/drugged.
You'd be surprised of the ignorance when it come to stuttering.

[maveric]

10. I know that stigma. I'm a stutterer with social anxiety disorder.

I was painfully shy and feared social situations so much that i would have severe anxiety attacks.

Throughout school, as a kid, I would be so terrified by oral reports and the likes that I would freeze up and wouldn't be able to utter a discernible sound. When we had to stand up and speak in class I would pray that they would skip over me for when I was told to do so I would stutter so bad that the whole class, including many of my teachers, would laugh and torment me. Many times I would ask to use the restroom, sit in a stall shaking with fear,have cold sweats and would cry and pray for the situation to go away. This was real blow to my self esteem and for many years(and sometimes even now), I wallowed in self loathing and self destructive behavior. I would avoid social situations as much as I could, and when I couldn't escape them I would freeze up and have sever anxiety attacks.

So all through my school years I shirked off my oral reports and took dumbed down classes that didn't require public speaking. This brought out hatred for language related activities and to this day, I still have somewhat of a grammatical and vocabularic retardation. Its my own fault for not being strong enough to not let things get to me and I'm kicking myself in the ass to this day for handling things as I did. I basically deprived myself of the education that I always wanted and needed.

Later on when I got married and was so happy that I found someone patient enough to tolerate my dysfluency. For 18 years she gave me the impression that she was OK with it and accepted it. I later found out, when she was leaving me, that she couldn't stand the stuttering and avoidances and was always embarrassed of me when it came to social situations and was waiting for the right time to rid herself of me and my curse. This really killed my self esteem.

I now have adopted a new perspective and have sort of a "Fuck It' attitude about the possibility of embarrassment in those social situation. I have accepted the fact that I have a mental illness and have no control over it at times. So now when people chuckle when I'm having a dysfluent spell, I stop, look them in the eye and ask them if they think that its funny. Fuck em!

I feel your pain my friend and perhaps you may try my approach and sometimes even laugh at yourself. It seems to take the edge off for me. Just tell yourself that at times you have no control over things not to your own fault. Try the serenity prayer if wish.

My heart goes out to you. Hang in there.

[Droopy]

11. I don't think you have any grammatical or vocabularic

dysfunctions at all. You express yourself very well using the written word. I know it's different in social situations, but I really think you've got a lot going for you.

[scottcsmith]

13. Thanks

Writing for me has always been an outlet for my anger, depression or psychosis. When I was in my late teens I wrote lots of poetry of the very black, depressed variety. Back then I dressed in black and walked around with a "Joy Division" T-Shirt.

I use my web site as an outlet for my political anger. I tend not to discuss politics when I'm with friends, so having my domain is a very healthy way to work out that frustration.

[RobinA]

19. Have You Tried Treatment?

Stuttering is treatable in many cases.

[maveric]

21. I went to the best speech therapists in Boston for 10 years, as a kid.

Nothing good ever came out of it and my parents couldn't afford it anymore. Then after I was engaged and at the request of my fiance, I went to these group sessions at San Diego State. As it turned out the group was all for the benefit of the grad students who watched us from behind the 2-way mirror. Didn't help much much to her disappointment. I've tried TM, yoga, and was even prescribed barbiturates. Nothing worked and it made me feel totally inferior and hopeless.

So after years of shame, rejection and avoidance I just said "Fuck It", and dint put the energy into worrying about being dysfluent. I still stutter at times but I dint take it so seriously as I once did.

[curse10]

14. I have Agoraphobia and Enochlophobia

fear of crowds. I am now on medication, which helps a great deal. But the panic attacks still come sometimes.

It's very hard to explain to people why you are crying and freaking out in the middle of the zoo because a group of children came into the gorilla house.

I can't do theaters on a weekend anymore. I can't go to concerts at all. I avoid street fairs and the such like the plague.

Crowded bars are the worst. The loud music. So many people. And they often bump into you.

Parties can be excrutiating.

Most people don't understand. Friends have gotten mad because I need to leave places early.

I often feel like I'm missing out on great things- like concerts, and such. My friends want to go down to watch the fireworks on the 4th of July and I can't go. My boyfriend has a concert in a crowded club and I can't go.

I know exactly how you feel.

[maveric]

18. My dad was Agoraphobic.

He couldn't be in crowds, drive over bridges, drive on freeways, attend functions such as little league or football games games, banquets or fly in planes. He was an esteemed news journalist in the Boston area (and a lifelong democrat), who could function well at work, attending many courtroom trials and political speeches, etc... but when he was off the clock he pretty much locked himself in the house.
For years he went to counseling to no avail and not until he was over 50 was he prescribed meds that seemed to work. He lived out the last 20 years of his life fully (except for the bridges), even taking many trips via planes.
I wish that the meds were available for him earlier. He always felt bad about his affliction. I would be alone at my little league/football games and banquets, and he even missed my wedding in CA due to the fear of flying.

[VOX]

15. I've been there, Scott, and I'll probably be there again...

And that is not a "down" attitude -- just the reality of the beast.

I have dealt with panic disorder and agoraphobia since I was 17 years old. It is exactly as you describe -- debilitating and confidence-sapping.

The outright attacks have diminished over time, but the "respect" for the kind of instant sickness they can cause is there. I always sit on an aisle or the end of a table. I have never been on an airplane (to date).

It comes and goes, and you just have to make a kind of peace with the beast. There is a genetic component to this, also.

Hang in there --

[Piperay]

16. I have panic attacks

that keep me from doing things that I would like to because the panic attacks can come out of nowhere and are so horrible that even when I don't have one the fear of having one is just as bad. I started having them about 8 years ago and they increased in frequency to the point that I couldn't even go to bed without having them. I started taking St. John's Wort a couple of years ago and they have lessened by about 75% but I worry that they may come back to what they had been or even more so that I can't function. :scared: I just take each day at a time, not much else I can do and hope for the best. :shrug:

[Lazpash]

17. Hi, I can't SWEAR this will help, but it won't HURT

And it's likely to help.

I've been researching this for about 6 years now.

I know and can back up the fact that ADD, ADHD, Bipolar, Depression, Alcoholism, Schizophrenia and many, many other diseases/disorders ARE caused by, an Omega 3 deficiency. And seeing as how 99% of the population IS deficient ... it kinda makes sense.

Get yourself some Nature's Bounty or Puritan's Pride brand flaxseed oil, then from one of those companies (Omega 3's are VERY fragile, heat, light or oxygen destroys them - makes them rancid - these companies are careful how they process the oils, plus they use organic flax and no chemicals) and get some DHA and EPA - take 1 gram of flaxseed oil and preferably 500mg/500mg mix of the other 2.

Take this once a day in the AM (as they CAN cause insomnia if taken too late in your day) and I'd bet $ you'll notice an improvement in 1-3 months. Most of the "mental illnesses" seem to partially resolve in this time frame. For a "full recovery, I'd expect you to be in the same boat as _I_ am, I have MS, it was VERY bad, now I figure I have 1-2 years and I'll be capable of going back to work. That'll be almost a 5 year recovery time. (Total) really MY full recovery likely won't be complete until April 2008 - but it'll be close enough for Gov't work in another year or two.

If you want to, email me on this, I'll answer any and all Q's. I could recite most of this stuff in my sleep. The reason I believe it WILL aid you, is it's a mental illness, and so far - most all mental illnesses they can't QUITE explain, seem to be the result of an Omega 3 deficiency. Also, I used to get either very agoraphobic, OR very claustrophobic (I believe I spelled those correctly) EITHER I'd have significant anxiety around open spaces, OR closed in spaces - also had problems w/crowds.

Thing is I haven't had any of these in the past 2-3/4 years that I can recall. That's also how long I've been on the Omega 3's. This was NOT a severe problem w/me, but it DID cause problems at least 2-3 months (cumulative) throughout the year - now none in 2.75 years? Co-incidence? I seriously doubt it.

I'll also look tomorrow & see if I can locate any actually "scientific" studies on "phobias" and Omega 3 supplementation ...AMA's Journal or the Annals of Psychiatry ought to have SOMETHING. If I find anything, I'll "link" it for you.

Oh - you SOUND young, but maybe you just "think" young. The only contraindications are if you are on blood thinning drugs, as Omega 3's prevent platelet aggregation (clotting) - so if you're a hemophiliac or are on blood thinners, talk to your doc first - but only blood thinning meds (lower BP, used in heart disease patients - like that) have "interactions" that are contraindicated.

Also 2 weeks before & after surgery, you should discontinue, as sticky platelets are typically a better thing than "slick" ones when they're cutting you open.

Good luck, I wish you well.

Kim