Adventures in Psychiatry : Agoraphobia

In part one I talked about my first panic attack and how I was brought to the attention of the mental health team a lot faster than originally intended. The natural progression of this is to talk about what happened next.

As the title suggests; I developed agoraphobia. In psycho-babble it was noted down/diagnosed as 'Panic Disorder with Agoraphobia'. It really is a living hell and if you are coping with or have lived with this condition, my god, I offer you all the love and support in the world.

Agoraphobia is fairly well known amongst the general population, but there are varying degrees of how limited you may be. Before I explain more, I want to touch on 'panic disorder' because the two feed into each other and panic disorder is it's own condition with a set of criteria, distinguishing it from the less extreme anxiety disorders.

Panic disorder will push sufferers to the limits of their sanity. Essentially, you're living in fear of fear itself. It is a hellish cycle of what feels like endless panic attacks. Having just one will ruin your whole day, so imagine what having upwards of 5 or even 10 would feel like? For weeks on end. It makes me feel sick to even think about those dark times.

This disorder is characterised by sudden and unexplainable onsets of panic. It only has to happen to you a few times before you become scared of panic attacks. This state of living in constant fear and hyper-vigilance creates an ideal environment for adrenaline and the 'fight-or-flight' reflex that is buried in the back of all our brains to take the reins and make a real freaking mess.

That part of our brains is what got us to where we are today. It kept our ancestors alive and away from danger, so it's obviously pretty darn good when it needs to do it's thing. The problem is we don't live in caves anymore and danger isn't exactly around every corner, we don't have to fear every noise or shadow, or smell. Sure, if we were on an amazing safari holiday in Africa and there happens to be a lion charging at you, those panic attack feelings would suddenly make a whole lot of sense and you'd be able to beat Usain Bolt rather than being on the floor in a heap and contemplating if straight-jackets are still used in modern psychiatry.

Without getting too geeky on you; one of my GPs explained panic disorder and my system becoming overly sensitive to adrenaline and cortisol, and that whenever these levels rise in my blood past a certain point there is a part of my brain that suddenly thinks there is a 10ft tarantula coming at me and lets the cave-woman in me loose. It is a very real, physical problem.

Agoraphobia is a fear of being in spaces or places which may trigger, or have triggered, your anxiety and/or panic; from which there is no easy 'escape' without feeling embarrassed, ashamed or judged. This leads to avoidance of these places or situations. Over time, the cage becomes smaller and smaller until the only place you feel safe is your own home. It is a complex phobia, much more than just "being scared of going outside".

So. If you have panic disorder you're pretty much perpetually scared, but if you're having a 'good day' and decide to venture out into the outside world to have a *decaf* coffee or maybe just sit on the beach and panic decides to hit you, those places will instantly become write-offs. Once bitten, twice shy.

I became housebound and agoraphobic very quickly after panic disorder developed. How could I fathom going outside when being in a room smaller than a prison cell was terrifying? I was stuck in a room that was 6ft by 7ft. Prisoners get an extra foot of room. I remember having to really psych myself up to walk the 15ft to get to the bathroom. The hallway looked like something out of a horror film, when they do that camera trick that makes it seem never-ending. I seriously considered just peeing in my bin.

Oh, just to add more fuel to this perfect **** storm of psychological torture, I was sharing this space with my then boyfriend, who flat out refused to leave. We hadn't even been together a year but I knew something was wrong with the dynamic building in our 'relationship' and needed to end it but I was so broken I couldn't. I had absolutely no fight left in me and I think he could tell. I'm not totally ready or sure how to approach this side of my 'story' but a whole other tsunami of **** entered my life and it took 2 and a half years to finally break free.

How did I do it? Sloooooooooooooooooowly. I lived in a ground floor flat with a garden for a while which helped a lot, despite it being right next to the train line. People always say to take 'baby steps' when you're working on recovery, and that's literally how I got out the door. One baby step at a time. On my own. I took a step, counted to 10 and then took another. Gradually I built up my tolerance to 'low-level' anxiety and just got further away each time. 

Online support communities were absolutely vital in making progress too. I felt like an absolute freak of nature until I saw just how many other people were going through the exact same thing. It's a very comforting feeling. You gain support, advice and friends.

Books are important too!! I'm not a fan of the Kindle. Books cannot be allowed to die. If you have panic attacks, I really recommend "Panic Attacks" by Christine Ingham. It was my bible for the longest time. There is also a book on panic and agoraphobia in the "Overcoming" series. Mindfulness seems to be coming into mainstream society now, and my GP recommended "Full Catastrophe Living" by Jon Kabat-Zinn to me. It's a heavy book, but the chapters are small and I'd say go into it with an open mind. He offers a different way of thinking to which is probably the complete opposite you've been surviving in!

My agoraphobia consists of a set of 'safe places' I am able to go to on my own without much problem, places I can go to but I need to be with someone when I get to the destination, places I can go to but need support the entire time, and places that are impossible.

Addiction plays a part in this story but that needs it's own discussion so I will leave that alone for now or we'll be here all night!! 

It has taken a long time to get to this point in my recovery, and I have my amazing boyfriend to thank for expanding my horizons to the stage we're at now. There is no way I could have gotten to this point with anyone else. I have to take an almighty 160mg propranolol a day to keep panic disorder in check and for the most part, it does it's job nicely. I can skirt on the edge of a panic attack without going over the edge, so I can't ask for more really! Venlafaxine is also used to treat panic disorder, so I'm on a pretty good cocktail right now!

I'm almost certain I've missed vital information out here, so please ask away and I'll fill in the gaps.

Until next time <3

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