Agoraphobia is a fairly well-defined cluster of phobias embracing fears of leaving home, entering shops, crowds and public places, or travelling alone in trains,
buses or planes. Panic disorder is a frequent feature of both present and past episodes. Depressive and obsessional symptoms and social phobias are also commonly present as subsidiary features. Avoidance of the phobic situation is often prominent, and some agoraphobics experience little anxiety because they are able to avoid their phobic situations.
Although I have suffered from agoraphobia for three decades now, I refuse to allow the condition to define me. If I describe myself as an agoraphobic, I become my illness. I am more than my condition. I am a person who led a normal life with the same dreams, goals and ambitions that most of us are aspire to. Although I developed a generalized anxiety disorder in my twenties, it did not stop me from functioning. In the early stages, it limited my ability to work, but with time and rest, I was able to resume what for most is considered a full and challenging life. Normal is a relative term defined culturally.
It is difficult to say what triggers the condition which is a global crisis that continues to rise. While the mean age for the onset of the illness was at one time 18 – 24, it is now becoming more common in adolescents. For me, it was a case of accumulated stress and traumas which were not acknowledged much less treated. The WHO has indicated that generalized anxiety disorders are fast becoming a huge burden of disease not only for developed nations, but also for developing ones. The cost in terms of lost productivity and health care is high and will only increase. The human cost cannot be measured in metric evaluations nor in monetary costs. It is a life sentence and a living prison.
The Beginning of My Life long Struggle
The plane was cruising at 33,000 feet transatlantic almost four hours into the flight from Zurich to Toronto via Montreal when I sensed an odd feeling. I was reading the flight specs at the time when the odd feeling morphed into a sudden surge of panic. There was no reason. It seemed to have come out of the blue. My brain was attempting to make sense of what was happening when the realization struck that the cabin was getting warmer . I placed my hand over the small control that allowed one to adjust the level of airflow and temperature of the overhead air conditioning. Nothing was coming out. That was when the panic struck so hard that I had to get out of my seat and seek out the flight crew.
As I approached the back of the aircraft, the flight attendants were busy preparing in flight meals .I remember looking at their calm demeanor and thinking that all must be well ,otherwise there would be some indication of a problem. That didn’t seem to comfort me nor do anything to mitigate the unsettling symptoms. I sought out the flight attendant closest to me and told her that I was having an anxiety attack. It was conveyed in such a calm and controlled manner that she told me to take my seat and she would check on me later. At this point, I lost it literally. I lost my composure, I began to cry and pleaded to be let off the aircraft. Horrified at the sight in front of her, she went to get the chief purser. At first I was struck by how handsome the man was and how much he resembled a younger and better looking Tom Selleck, the actor. I was beginning to feel slightly better until he asked what was wrong, at which point the panic struck with a vengeance.
I HAD to get out of the aircraft. I felt a sense of doom, of suffocation, of wanting and needing to open a window My vision was blurry, I began to feel dizzy and nauseous and my palms were sweaty. I could barely swallow, much less talk. In halted sentences, I expressed all of this and more to the purser who tried in vain to calm me even as I was approaching a state of hysteria. Panic is driven by thoughts which become physiological events – a storm of biochemical reactions. I barely heard what he was saying. His voice seemed to come from a cavernous distance. He made a valid point in asserting that I should look around at the other passengers.
I nodded in agreement even as my body began to tremble. Every passenger appeared normal, except for me . When I pointed out that the air in the cabin was warm and that it felt as if we were getting less of it ,he explained that some passengers had complained about the cold in the cabin and the crew decided to turn down the thermostat . One part of my mind knew this was a rational and plausible response given that no one else was in a state of distress but my mind had unleashed a torrent of terrifying scenarios which included dying due to suffocation and lack of air. My mind was so convinced of this that the only recourse was to get out.
My body was thrust into a biochemical storm of adrenaline which was both debilitating and in turn caused more panic by pumping out more adrenaline and cortisol. I again pleaded, almost demanded – that he open the cabin door and let me off. At this stage, all rationality was gone as was my sense of control. Being told that I could not get off only served to make things worse. I understood how insane that sounded but I was gasping for air and opening a door was the only thing that my panicked mind could conceive of. I continued to plead as the fear continued to escalate. I would not go back to my seat and finally, from my now faint recollection, I asked for cold water or ice.
Quite possibly, I may have sat or laid on the cabin floor. Tom Selleck kept me engaged. He offered to take me to the cockpit, something that was not allowed by International Aviation Law even back in the 1980’s. Whatever happened at the back of that Swiss Air flight cabin during my physical and emotional storm allowed me to regain a modicum of composure and agree to the offer to visit the cockpit. Once there, I was introduced to the three flight crew members, all of whom were having a glass of wine. I was offered a glass which I accepted only to find that following a sip of the red wine, the anxiety began to escalate yet once again. Despite being on the flight deck, it was so claustrophobic and unnerving to watch the plane slicing through the clouds, that I thanked all but decided to go back to my seat. Once there, a coffee was brought to me along with little games and dolls for children. I was mortified. The coffee was a bad choice adding to the adrenaline spikes. I was tense, anxious, embarrassed, struggling to breathe and still hoping to find a way to get off the aircraft.
The chief purser who had brought me the toys attempted to keep me engaged and distracted. At one point, I heard a small voice ask me ” Is this your first time flying”. I looked up and saw a young girl and boy no older than 7 or 8 years of age. The boy had asked the question. I could barely respond with a no. The purser asked me my name and where I was from. My mouth was dry and my head was dizzy from all of the chemical warfare going on in my body. I couldn’t process the question, my cognitive processes were askew and no answer was immediately forthcoming. I fought hard to focus on the question – what is my name ? . I stared blankly thinking I know that one .. just give me a minute. Finally, I remembered my name and continued talking to the kids who, unbeknownst to me at the time, helped to distract me from the relentless onslaught of anxiety that led to the panic. I managed to calm down sufficiently in order to handle the remaining three hour flight to Montreal – while making a pact with the Universe. If God would allow me to live ,I promised myself never to get back on an aircraft. That was to be my last flight. My will to live at the time caused me to manifest an intention that was to rob me of traveling and of living my life as I had known it from that day forth.
I arrived home and allowed myself two weeks to recover from what had been a tiring and draining 40 day trip through Europe. Not much had gone right. I was on tour buses for much of the day, arriving late at most destinations, and slept no more than three hours per night. Despite the lack of sleep ,I would walk for 6 or 7 hours sightseeing, come back to the hotels to change and go back out in the evening. With little time in each city, I did not get to visit with my father, my friends in Austria nor my best friend in Belgrade.
I wanted to miss nothing and ultimately that was the beginning of my demise. By the time I arrived back in Toronto, my university courses in my master’ program had begun and my teaching assistant ship was approved. I allowed myself two weeks to recover from the trip and the panic at 33,000 feet. Without realizing that stress overload had triggered the panic, I threw myself into work, took on three part time teaching jobs, somehow found myself rescuing cats, and decided to buy a house – all at the same time.
One year later, my panic attacks returned. However, this time, they were severe and unrelenting to the point that I had attacks every day, all day, and most nights. Within six months of having purchased my new home, I was so severely crippled by my fear and the unremitting panic, that I became completely housebound. I could neither go out nor stay home alone. Life as I had known it ceased to exist. That was in 1984. It has been a roller coaster since then. I had separated from my husband, met someone else with whom I entered into a romantic relationship which initially gave me the impetus to go back out into the world. Those with agoraphobia seek out ‘safe’ people with whom to go out and get their needs met. As time went on, I divorced, my mother, grandmother, aunt, father and my significant other died. Once again, I regressed. I could not attend any funerals nor get to visit with my father whom I hadn’t seen since the mid 1970’s. I blamed myself constantly for not being able to overcome the fears. I was angry and depressed. I felt helpless and hopeless. Out of embarrassment, I invented excuses for not going out with friends. I would make and break commitments and appointments. I was so desperate to overcome the crippling disability that literally felt like a living prison that I set myself up for failure over and over until inevitably, I crashed and burned. I could not live up to my own expectations of success. Eventually, people stopped asking me out or including me in their plans. My life became much more solitary, restricted and joyless. I began to feel a sense of abandonment which only served to deepen my depression. Today, I continue to struggle with the fears and the phobias.
I know they are irrational, but that doesn’t alter how my body reacts to the underlying fears and the various triggers. Some days are better than others and I do manage to live a much more rewarding life, due in part to technology and the internet. I am able to do much more and have a wider scope of interests along with a network of support systems. I am more engaged politically and in issues of social justice. When possible, I go out and take part in recreational activities. It is not the live I had envisioned for myself, rather it is a life that found me. I continue to rise like the Phoenix out of the ashes in the hope that one day I may take flight again.
COPING WITH AGORAPHOBIA
For those who are living with this condition, my recommendation is to try anything and everything within reason. There is no cure and most who have agoraphobia do not fully recover. It is a lifelong condition that can be managed and one learns to cope. Some of the modalities that have shown promise are breathing exercises, visualization, relaxation, reiki, massage, exercise, acupuncture and meditation. Prescription medication is effective in the short term but eventually one habituates to the dose which needs to be increased. Natural remedies are available in the health food stores and I would advise everyone to research the products before taking them. Enlist the services of a naturopathic doctor and discuss your situation with your primary health care provider although expect that you will be given pharmaceuticals for what is perceived as a mental disorder as described in the DSM-V.
I believe that it is a neurological and biochemical disorder and that the psychological component is only one aspect of it. Seek counseling for coping with the stressors of life. Adopt a healthy lifestyle that includes getting sufficient sleep, eating nutritious foods and daily walks. Spend more time in nature. Follow a routine, structure your days, and find something to engage you that lifts your spirits and is life affirming. Living a stable life with purpose and minimizing stress can alter the course and progression of the illness and give some much needed respite and even challenge one to discover things that provide meaning and purpose. Open the doors to the prison and step out into a new way of being. Life is for the living. It is all we have and all we know. It takes work and is not without pain, but there are moments that give rise to renewed hope for better days.
By: Danielle Radicanin
Writer is an educational consultant in various areas of adult education and freelance writer.