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Agoraphobia can be the core problem in fear of flying, fear of public speaking, social anxiety, fear of driving, fear of crowds, fear of elevators and many other dreaded or avoided situations.

Most of the individuals who tell me they have a fear of flying do not have true aerophobia ( a fear that the plane will malfunction, crash ). Rather, they fear getting on the plane and having a panic attack while trapped and unable to get off the plane. They see themselves out of control in an embarrassing or physically dangerous way ( high blood pressure, cardiac symptoms, fainting to name a few).

Fear of public speaking can be fear of having a panic attack during the talk. The people who avoid public speaking truly eve believe they will not be able to continue a presentation or, if they do manage to complete the presentation, they will be so noticeably anxious they will embarrass themselves and lose the respect of those who are present. This one I know well because it is the anxiety disorder I suffered from for years. I made many presentations while having such high anxiety I later could only partially recall the presentation. Even speaking up in a class by the time I was on my third degree ( for my doctorate ) was excruciating.

The others I mentioned in the opening paragraph are the same as the two I have described: fear of having a panic attack and not being able to leave the situation.

The stories vary a lot but they are basically the same: a panic episode that changes one’s life. To help you, I have taken a few verbatim accounts from my practice.

Here are some of those verbatim descriptions:

“ I was driving on a busy street when I became dizzy and light headed. My hands and feet began to tingle. My right foot and leg felt “dead”, totally numb. I wasn’t sure my foot was on the excellerator. I thought, Oh my goodness, I’m going to wreck this car. I’ve got to get off this street now. I pulled over shaking and breathless and full of terror.”

“ I had been under a lot of stress. I was working lots of hours and my husband was having a real difficult time with his career, too. I was already beginning to know I was a wreck most of the time but I was managing to keep going. One night I was at work and closing up. I was in the small room where the receipts and money were placed. I locked the door as always. When I went to the door to unlock it, the fixture was stuck and when I pulled on it, it broke and I couldn’t get the door open. I started to panic. I beat on the door and yelled for someone to get me out. Another employee came to the door but couldn’t get it open. I became hysterical. I thought I couldn’t breathe. I had the sense to call my husband and he calmed me down while someone called a locksmith to get me out. Almost overnight simple things became impossible. I thought I was losing my mind. I couldn’t even go to the movies, something I used to love to do.”

ldquo; I was on an airplane. I was traveling all over the country, so busy I hardly got off one plane before I got on another one. On one trip, I had this awful shortness of breath, shakiness and chest tightness. My heart was palpitating so hard I thought it would jump out of my chest. I began to perspire. I told the attendant I thought I was having a heart attack. The plane made an unscheduled stop and I was rushed to the emergency room. An examination found that nothing was wrong with my heart. From then on I dreaded having a panic attack. I kept going because I had to. I had a family to support even though I was having attacks several times a week.”

“My first attack happened when I was in a restaurant eating with a business associate. I didn’t know what hit me. I got lightheaded and sort of sick. I felt so strange, so terrified, that I had to get out of there. I told the person that I was ill and had to go. The next four years saw me rapidly get more city bound. My life was home, office and the road connecting the two. My family had to get use to going without daddy. It was so hard on all of us.”

“ I had been anxious for much of my adult life. I became so used to feeling anxious and to avoiding things that, as I look back I was really more dead than alive, at least psychologically speaking. I really got to the point that I was so used to being depressed and anxious that I did not know how bad off I was. Things began to come to a head when a fear of choking caused me to not eat solid food for two years. I was hospitalized for anorexia even though so much of that diagnosis did not fit me. Now that I look back on it, I see that driving, going to the store, even answering the door was something I dreaded.”

Agoraphobics are often strikingly energetic, intelligent. and take charge individuals. They are sensitive, conscientious and well liked. They also tend to expect a lot of themselves and often place unrealistic demands upon themselves. Also, before the first panic or anxiety attacks occur, they have typically gone through a period of generalized, psychological stress. In about 80 to 90 percent of the cases, development of agoraphobia can be traced to the type of stress that cannot be "fixed”: loss through divorce or death, a move, job or career problems, financial crises, an irreversible change such as marriage, the birth of a first child or graduation from high school.

The person, in response to stress, develops panic or anxiety attacks. The phobia develops as the person tries to circumvent a panic attack by avoiding any given situation where an attack has occurred or might occur.

The panic prone individual is not afraid of the' grocery store, or the car, or the mall, he is afraid of the feelings or sensations that happen to him when he is in those situations, and he is afraid the anxiety, if not stopped will kill him, cause him to go crazy or to lose control in some horrible way.

Agoraphobia Quiz

Check the symptoms you experience:

Rapid, shallow breathing___
Racing, pounding heart _____
Faintness, dizziness, lightheadedness_____
Weak “jelly legs”_____
Chest tightness_____
Tingling and numbness in parts of your body_____
Blurred vision_____
Feeling of non-reality_____
Flushing of face and/or neck_____
Swallowing difficulty_____
Nausea and/or diarrhea_____

Do you also have intense fear? yes/no

Have you been examined by a doctor? yes/no

Have you begun to dread or avoid certain situations? yes/no

Do you have safe places or a boundary of safety? yes/no

Are you afraid to do things without a support person? yes/no

Do avoid being alone? yes/no

Do you avoid open spaces? yes/no

Do you avoid situations from which escape could be

(1) delayed (2) embarrassing (3) blocked yes /no

Do you fear the extreme symptoms of panic could cause

(1) death (2) passing out (3) going crazy? (4) losing control yes/no