While many things can trigger panic attacks, one of the most common causes is agoraphobia. Agoraphobia is often thought of as being a fear of open spaces but as we will see it is actually somewhat more complicated than that. Here we will look at what agoraphobia is, how it relates to panic attacks and at how you can treat the condition.
Panic disorder is a condition which causes an individual to experience bouts of anxiety called panic attacks. Panic attacks are characterized by an increased heart rate and blood pressure, shaking, negative thought patterns and sweating among other things. Essentially, these are caused by the 'fight or flight' response which is the body producing adrenaline, dopamine and other hormones to increase awareness and alertness in case of some kind of confrontation. If you have ever had to give a speech or gotten into an argument and found yourself shaking, then you'll be familiar with the fight or flight response. A panic attack is similar but far more pronounced and often 'out of context'.
Often panic attacks are so severe as to be mistaken for heart attacks (due to the rapid heart rate and chest pain) which ultimately leads to the individual becoming even more stressed. Ultimately this can lead to hyperventilation, dizziness and fainting.
In cases of panic disorder with agoraphobia, the cause of this response will consistently be agoraphobia. On the face of it, agoraphobia is thought of as a phobia of wide open spaces. In fact though, it can be triggered by many things including travelling on public transport, going shopping or even leaving the house. Generally, many sufferers express that their agoraphobia is actually a fear of being in a situation where they wouldn't be able to get immediate help if something went wrong, or where they might be unable to 'escape'.
The fear is often actually that they will have a panic attack in public, causing them to faint in a situation where they wouldn't be able to get away and where they might be at risk of being trampled. Almost ironically then, it is a fear of having a panic attack that then causes the panic attack and that thus causes the agoraphobia itself. In other cases, a fear of something else going wrong in public (being attacked, falling over, being sick) will then cause the individual to have the attack.
There are fortunately a number of different methods you can use to treat the condition and to manage it.
For immediate relief, one option is to use benzodiazepines or other medications. Benzodiazepines are antianxiety medications that work by increasing the amount of GABA in the brain. GABA is an inhibitory neurotransmitter meaning that it suppresses the firing of neurons and thereby reduces brain activity and anxiety. GABA will often make us feel groggy and tired while at the same time reducing anxious ruminations.
Benzodiazepines shouldn't be used too frequently as they can have negative side effects and are potentially addictive due to processes called 'tolerance' and 'dependence'. Fortunately, these medications work very quickly and so can be used only when the early symptoms of a panic attack emerge. This way, a sufferer can then stop a panic attack in its tracks and prevent it from fully developing.
A more long-term solution is to get treatment in the form of therapy. The best forms of therapy for treating panic disorder with agoraphobia are cognitive behavioral therapy and exposure therapy – which can be used in combination to great effect.
Cognitive behavioral therapy focusses on an individual's thought patterns and looks at what it is they may be thinking in order to cause the anxiety. In this case, they might be thinking things like 'I'm going to faint and get trampled'. The goal is then to remove these thoughts and to replace them with more positive and realistic ones.
Exposure therapy meanwhile means exposing yourself to the thing you're afraid of. In this case, that means purposefully going outside of your 'safety zone' and gradually increasing your exposure to situations you would find stressful while breathing and trying to remain calm.
While it may take time, therapy can be very effective in treating panic disorder with agoraphobia so is well worth seeking out.