Agoraphobia and Panic Attacks

There is phobia that is linked to the experience of panic attacks, and that is agoraphobia. Agoraphobia is the fear of open spaces or of being in crowded, public places such as shopping markets. It is a fear associated with leaving a safe zone, such as the home.

Because of a feeling of being vulnerable, people who experience this fear often suffer from panic attacks in these “open” situations. It is true to say many people who have regular panic attacks experience different degrees of agoraphobia. Some have a lingering background anxiety about being away from home should they experience a panic attack. Other people are so immobilized by this fear that they find it very difficult to leave their home for even a short period.

The thinking behind agoraphobia usually follows the line that were a panic attack to occur, who would look after the person, how would he or she get the assistance and reassurance they needed? The vulnerability grows from the feeling that once victims of agoraphobia are caught in the anxiety, they are suddenly unable to look after themselves and are therefore at the mercy of the place they find themselves in and the strangers around them. In its extreme form, agoraphobia and panic attacks can lead to a situation where people become housebound for numerous years. Please note, this is by no means a hopeless situation, and I always need to reinforce the fact that something only becomes hopeless once the person really believes that to be the case.

To begin with, the primary issue that needs to be addressed is the belief in the safe zone. To clarify, when I talk about safe zone, I am referring to the zone where the person believes panic attacks do not occur, or at least occur infrequently. As comfort is found there, it is where the person tends to spend more and more time. The safe zone of anxiety is a myth sustained by the mind. The mind has developed a habit of thinking that dictates that being inside the safe zone is the only place to feel secure and avoid agoraphobia and panic attacks. If agoraphobia is an issue for you, watch as your mind comes up with reasons why it believes only a certain area is safe and another is not. Those reasons range from being near the phone or people you trust to having familiar physical surroundings to reassure you.

The reality of anxiety is that there is no such thing as a safe zone. There is nothing life threatening about a panic attack, and therefore sitting at home is the same as sitting under the stars on a desert island. Of course, your mind will immediately rush to tell you that a desert island is a ridiculous place to be as there are no hospitals, no tranquillisers, no doctors, NO SAFETY.

You need to review your previous experiences of panic attacks. Aren’t you still here, alive and well, after all those attacks during which you were convinced you were going to die?

It may be that on occasions you have been driven to the hospital where they did medicate you to calm you down, but do you really believe that you would not have survived were it not for the drugs? You would have. If the same bout of anxiety had occurred on this desert island, it too would have passed, even if you were all alone. Yes, when it comes to conditions that need medical attention such as asthma, diabetes, and a whole litany or other conditions, then having medical aid nearby is a big asset, but no doctor in the world would tell someone with anxiety that there are only specific safe zones in which she or he can move.

As I know more than anyone how terrifying it can feel to move out of your safe zone as the feeling of fear is welling up inside, I do not wish to sound harsh. This course is not about chastising people for their behaviours. It is a way of looking together at solutions and seeing through the myths that form prison walls. The goal is to enable you to return to a richer and more meaningful life and ultimately defeat your agoraphobia and panic attacks. I also realize that people around you cannot understand why a trip to shops would cause you such discomfort. You will have to forgive them and try not to be upset by their lack of understanding of your problem.

If an individual such as a partner or family member has not had a similar anxiety issue, that person may often find it hard to understand and empathize with what you are going through. I am sure you have been dragged out of the house numerous times against your will, kicking and screaming. This can then lead to tensions and arguments and is upsetting as it can make you feel less understood by those around you. People around agoraphobics are often simply trying what they feel is best. If you can see that their intentions are well meaning (although often misguided), then you will be able to relate to them better and help sooth any potential conflicts.

There is one thing I am sure you will agree with, and that is that the only person who will get you out of agoraphobic thinking is yourself. These are your thoughts, and only you can begin to change that pattern. Dealing with long term agoraphobia and panic attacks is a slow process to begin with, but once the results start happening, it moves faster and faster until you reach a point where you will find it hard to believe that going out was such a difficult task.

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It is often observed that many people’s top ranking fear is not death but having to speak in public. The joke is that these people would rather be lying in the casket at the funeral than giving the eulogy. Public speaking for people who suffer from panic attacks or general anxiety often becomes a major source of worry weeks or even months before the speaking event is to occur.

These speaking engagements do not necessarily have to be the traditional “on a podium” events but can be as simple as an office meeting where the individual is expected to express an opinion or give verbal feedback. The fear of public speaking and panic attacks in this case centers on having an attack while speaking. The individual fears being incapacitated by the anxiety and hence unable to complete what he or she is saying. The person imagines fleeing the spotlight and having to make all kinds of excuses later for their undignified departure out the office window….

This differs slightly from the majority of people who fear public speaking because their fear tends to revolve around going blank while speaking or feeling uncomfortable under the spotlight of their peers. The jitters or nerves of speaking in public are of course a problem for this group as well, but they are unfamiliar with that debilitating threat which is the panic attack, as they most likely have not experienced one before.

So how should a person with an anxiety issue tackle public speaking?

Stage one is accepting that all these bizarre and quite frankly unnerving sensations are not going to go away overnight. In fact, you are not even going to concern yourself with getting rid of them for your next talk. When they arrive during a speech/meeting, you are going to approach them in a new manner. What we need to do is build your confidence back to where it used to be before any of these sensations ever occurred. This time you will approach it in a unique, empowering manner, allowing you to feel your confidence again. It is said that most of the top speakers are riddled with anxiety before speaking, but they somehow use this nervousness to enhance their speech. I am going to show you exactly how to do this, although I know that right now if you suffer from public speaking and panic attacks you may find it difficult to believe you can ever overcome it.

My first point is this and it is important. The average healthy person can experience an extreme array of anxiety and very uncomfortable sensations while giving a speech and is in no danger of ever losing control, or even appearing slightly anxious to the audience. No matter how tough it gets, you will always finish your piece, even if at the outset it feels very uncomfortable to go on. You will not become incapacitated in any way.

The real breakthrough for if you suffer from public speaking and panic attacks happens when you fully believe that you are not in danger and that the sensations will pass.

“I realize you (the anxiety) hold no threat over me.”

What keeps a panic attack coming again and again is the fear of the fear—the fear that the next one will really knock your socks off and you feel you were lucky to have made it past the last one unscathed. As they were so unnerving and scary, it is your confidence that has been damaged by previous anxiety episodes. Once you fully understand you are not under any threat, then you can have a new response to the anxiety as it arises while speaking.

Defeating public speaking and panic attacks…

There is always a turning point when a person moves from general anxiety into a panic attack, and that happens with public speaking when you think to yourself:

“I won’t be able to handle this in front of these people.”

That split second of self-doubt leads to a rush of adrenaline, and the extreme anxiety arrives in a wave like format. If, however, when you feel the initial anxiety and you react with confidence that this is not a threat to you, you will move out of the anxiety rapidly. Using this new approach is a powerful ally because it means it is okay to feel scared and feel the anxiety when speaking–that is fine; you are going to feel it and move with and through the sensations in your body and out the other side. Because he or she is feeling very anxious, often before the talk has begun, that person may feel they have already let themselves down. Now, you can relax on that point. It is perfectly natural to feel the anxiety. Take for example the worst of the sensations you have ever experienced in this situation—be it general unease to loss of breath. You will have an initial automatic reaction that says:

“Danger–I’m going to have an episode of anxiety here and I really can’t afford that to happen.”

At this point most people react to that idea and confirm it must be true because of all of the unusual feelings they are experiencing. This is where your thinking can lead you down a train of thought that creates a cycle of anxiety that produces a negative impact on your overall presenting skills.

So let that initial “oh dear, not now” thought pass by, and follow it up immediately with the attitude of:

“There you are–I’ve been wondering when you would arrive. I’ve been expecting you to show up—by the way, I am not in the least threatened by any of the strange sensations you are creating—I am completely safe here.”

The key to controlling your fear of public speaking and panic attacks is that instead of pushing the emotional energy and excitement down into your stomach, you are moving out through it. Your body is in a slightly excited state, exactly as it should be while giving a speech, so release that energy in your self-expression. Push it out through your presentation not down into your stomach. You push it out by expressing yourself more forcefully. In this way you turn the anxiety to your advantage by using it to deliver a speech where you come across more alive, energetic and in the present moment. When you notice the anxiety drop as it does when you willingly move into it. Fire a quick thought off when you get a momentary break (as I am sure you have between pieces), asking it for “more.” You want more of its intense feelings as you are interested in them and are absolutely not threatened by them.

It seems like a lot of things to be thinking about while talking to a group of people, but it is not really. You’d be amazed how many different non-related thoughts you can have while speaking. This approach is about adopting a new attitude of confidence to what you might have deemed a serious threat up until now. This tactic will truly help you with fear of public speaking and panic attacks you have associated with them.

If your predominant fear of the speaking engagement is driven by a feeling of being trapped, then I would suggest factoring in some mental releases that can be prepared before the event. For example, some meetings/speeches allow for you to turn the attention back to the room to get feedback etc. from the group.

If possible, you might want to prepare such opportunities in your own mind before the engagements. This is not to say you have to ever use them, but people in this situation often remark that just having small opportunities where attention can be diverted for the briefest of moments can make the task seem less daunting. It my even be something as simple as having people introduce themselves or opening the floor to questions. I realize these diversions are not always possible and depend on the situation, but anything you can factor in that makes you feel less trapped or under the spotlight is worth the effort and can help alleviate fear of public speaking and panic attacks.

Joe Barry is an international panic disorder coach. His informative site on all issues related to panic and anxiety attacks can be found here:

http://www.panicportal.com

This article is copywritten material

Click here to learn more about the Panic Away course by Joe Barry

If you suffer from…

* Palpitations

* a pounding heart, or an accelerated heart rate

* Sweating

* Trembling or shaking

* Shortness of breath

* A choking sensation

* Chest pain or discomfort

* Nausea or stomach cramps

* Derealization (a feeling of unreality)

* Fear of losing control or going crazy

* Fear of dying Numbness or a tingling sensation

* Chills or hot flashes

…then you’ve experienced firsthand some of the possible symptoms of a panic or anxiety attack. If you are reading this page because a loved one suffers from these symptoms and you are trying to understand or help, it’s hard to appreciate what they go through.

Just try to imagine what it feels like to experience one, if you can.

Here is a typical example:

Standing in a supermarket queue, it’s been a long wait but only one customer to go before you make it to the cashier. Wait, what was that sensation? An unpleasant feeling forms in your throat, your chest feels tighter, now a sudden shortness of breath, and what do you know—your heart skips a beat. “Please, God, not here.”

A quick scan of the territory—is it threatening? Four unfriendly faces queue behind, one person in front. Pins and needles seem to prick you through your left arm, you feel slightly dizzy, and then the explosion of fear as you dread the worst. You are about to have a panic attack.

There is no doubt in your mind now that this is going to be a big one. Okay, focus: Remember what you have been taught, and it is time now to apply the coping techniques. Begin the deep breathing exercise your doctor recommended. In through the nose, out through the mouth.

Think relaxing thoughts, and again, while breathing in, think “Relax,” and then breathe out. But it doesn’t seem to be having any positive effect; in fact, just concentrating on breathing is making you feel self-conscious and more uptight.

Okay, coping technique 2:

Gradual muscle relaxation. Tense both shoulders, hold for 10 seconds, then release. Try it again. No; still no difference. The anxiety is getting worse and the very fact that you are out of coping techniques worsens your panic. If only you were surrounded by your family, or a close friend were beside you so you could feel more confident in dealing with this situation.

Now, the adrenaline is really pumping through your system, your body is tingling with uncomfortable sensations, and now the dreaded feeling of losing complete control engulfs your emotions. No one around you has any idea of the sheer terror you are experiencing. For them, it’s just a regular day and another frustratingly slow queue in the supermarket.

You are out of options. Time for Plan C.

The most basic coping skill of all is “fleeing.” Excuse yourself from the queue; you are slightly embarrassed as it is now that it is your turn to pay. The cashier is looking bewildered as you leave your shopping behind and stroll towards the door. There is no time for excuses—you need to be alone. You leave the supermarket and get into your car to ride it out alone. Could this be the big one? The one you fear will push you over the edge mentally and physically. Ten minutes later the panic subsides.

It’s 10:30 a.m. How are you going to make it through the rest of the day?

If you suffer from panic or anxiety attacks, the above scenerio probably sounds very familiar. It may have even induced feelings of anxiety and panic just reading it. The particular situations that trigger your panic and anxiety may differ; maybe the bodily sensations are a little different. Or maybe it happened to you for the first time on a plane, in the dentist chair, or even at home, while doing nothing in particular.

If you have ever had what has become known as a “panic attack,” take comfort in the fact that you are by no means alone.

A panic attack always comes with the acute sense of impending doom. You feel you are either about to lose your mind or one of your vital bodily functions is about to cease functioning and you will end your days right there among the canned goods and frozen food.

You are by no means alone; you’re not even one in a million. In America, it is estimated that almost 5% of the population suffer from some form of anxiety disorder. For some, it may be the infrequent panic attacks that only crop up in particular situations-like when having to speak in front of others, while, for other people, it can be so frequent and recurring that it inhibits them from leaving their home. Frequent panic attacks often develop into what medical physicians refer to as an “anxiety disorder.”

One of the first steps to regaining control of your life is getting helpful information. This site will give you that, and more.

The beginning of your recovery starts here. What you will learn is that there is a very good chance you are about to end the cycle of panic attacks in your life. You will learn not only to regain the carefree life you remember once having, but will also gain new confidence in living. Your answer to living free from “panic” or “anxiety attacks” is at hand.

This site demonstrates that the panic and anxiety that you have experienced will be the very key to your courage and success.

Begin the road to recovery by browsing through the site. While many of you may have read almost everything you can possibly read relating to panic and anxiety I assure you this site offers something very effective.

Did you know…?

The key difference between someone who is cured of panic attacks and those who are not is really very simple. The people who are cured no longer fear panic attacks. I’ll try to show you how to be one of these people as well.

What if I told you the trick to ending panic and anxiety attacks is to want to have one. That sounds strange, even contradictory, but let me explain.

The trick to panic attacks is wanting to have one-the wanting pushes it away. Can you have a panic attack in this very second? No!

You know the saying that “what you resist, persists.” Well that saying applies perfectly to fear. If you resist a situation out of fear, the fear around that issue will persist. How do you stop resisting–you move directly into it, into the path of the anxiety, and by doing so it cannot persist.

In essence what this means is that if you daily voluntarily seek to have a panic attack, you cannot have one. Try in this very moment to have a panic attack and I will guarantee you cannot. You may not realize it but you have always decided to panic. You make the choice by saying this is beyond my control.

Another way to appreciate this is to imagine having a panic attack as like standing on a cliff’s edge. The anxiety seemingly pushes you closer to falling over the edge.

To be rid of the fear you must metaphorically jump. You must jump off the cliff edge and into the anxiety and fear and all the things that you fear most.

How do you jump? You jump by wanting to have a panic attack. You go about your day asking for anxiety and panic attacks to appear.

Your real safety is the fact that a panic attack will never harm you. That is medical fact. You are safe, the sensations are wild but no harm will come to you. Your heart is racing but no harm will come to you. The jump becomes nothing more than a two foot drop! Perfectly safe.

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