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What is Anxiety and Agoraphobia?


ANXIETY is a normal response when we find ourselves in situations we perceive to be threatening or stressful. For an acute problem and in an emergency, this is a healthy reaction. The amygdala, a small organ in our brain, triggers the release of cortisol and adrenaline which makes us more alert and able to react quicker. When the threat is passed, our body winds down to normal again.


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If we are constantly worried about our finances, there is a never-ending stress at work, or we have a difficult relationship with a spouse or between a parent and child, then the amygdala is working more than it is resting. The result is that the amygdala is on all the time, instead of its normal resting state. In this condition we become more sensitive, and events that we might normally hardly notice, now set our “fight or flight” responses on alert.


This can lead to an anxiety attack, also called a panic attack. After the panic attack there is the fear of another panic attack in a place where the person does not feel safe, such as in a supermarket or at a social event. There is also the fear of making a fool of oneself. At this point there is a risk that instead of a fear of something, there is now a fear of the fear itself.


AGORAPHOBIA is when the person starts to be anxious about something, like having panic attacks in a place the person does not feel safe. The person then avoids anything which can trigger a panic attack. Originally the agoraphobia definition was the fear of being outside one's home, but now it is defined as a phobic avoidance. The agoraphobic person avoids anything which may trigger anxiety.


Anxiety disorders affects about 18% of the population in the United States, at some time in their life.


Anxiety disorder is an emotional disturbance, a complex emotional interrelationship between mind and body. It can be in extreme cases a 24/7 permanent condition, when the person is awake or asleep. Usually however there are respites from the feeling, although there may be periods of weeks when anxiety does manifest itself constantly and the person is agitated, restless and irritable.


Anxiety is based on a perceived present danger and a future threat. Anxiety cannot be fully understood apart from strong emotions. The experience of a panic attack is a traumatic experience, physically and mentally. The physical feelings are paralysing. In the fight or flight situation the body is primed to respond quickly. In anxiety, the body and mind are so worn down and exhausted by the constant tension, that the panic attack has the opposite effect to the fight or flight response. the body closes down.


The panic attack is real, even if the fear is irrational. The person might even be aware that there is no threat, yet is unable to control the feelings inside. It is common for anxiety sufferers to say that they are afraid of losing their sanity. The physical feelings are really an extreme self-defence mechanism to protect the system from overload.


In a panic attack, there are usually several of these symptoms: a feeling of terror, rapid heartbeat, chest pains, sweating, feeling dizzy or faint, shortness of breath, weakness, feeling cold, a tingling in hands or over the whole body, nausea, numbness and confusion. There may be a sense of unreality, like an “out of the body” experience, a fear that one is about to die (e.g. heart attack) and a sense of loosing control.


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In Agoraphobia this feeling of losing control is one of the major stimuli for the agoraphobia. Strangely having a fear of doing something embarrassing is also a self-defence mechanism, as it relieves the worry causing the anxiety, and focuses on something the person can control. Even if there is a fear of embarrassment, the person will not do that, and so it is a safe thing to worry about. The worry, out of the person's control, has thereby been replaced by a worry within the person's control.


A panic attack is a terrifying experience. The sufferer starts dreading the next attack, which can come at any time, even in asleep, when the person wakes up in the attack.


Often there are other problems accompanying anxiety and panic disorders, such as alcohol, drugs including prescription medicines, and other mental problems such as depression. Depression especially, can complicate diagnosis, as the physician may easily misdiagnose anxiety as depression as there is an overlap of symptoms as well as the patient having both anxiety and depression. Some physicians try and diagnose one or the other, not understanding that both can coexist.


Some of the antidepressant medications are also anti-anxiety medications. As depression is routinely treated with drugs as a first choice, many anxiety sufferers are not aware of their main condition. Antidepressants and anti-anxiety medication does not treat the cause of the condition, but the symptoms, thus masking the true condition. If the cause of the anxiety disappears during treatment, for example a financial crisis for the family is resolved, then it will appear as if the medication did the trick. however the person is still susceptible to an anxiety attack again if a trigger presents itself.


A long lasting cure lies in changing the person's perceptions and thoughts. This is done through some form of Cognitive Behavioral Therapy. Anxiety disorders are among the most treatable mental disorders. However the earlier the treatment is started the easier it is for the patient and the patient's family. There are variations of Cognitive Behavioural Treatment, which can be specifically tailored to the patient's personality and specific condition. These treatments even include Neuro Linguistic Programming. Every case is unique as every person worries in a different way, therefore every person needs treatment tailored to them. Relaxation Techniques is often a crucial part of anxiety attack treatments, as well asanxiety support from the family.


There are a number of anxiety disorders:

  • Generalized Anxiety Disorder (GAD)
  • Panic Disorder with Agoraphobia
  • Panic Disorder without Agoraphobia
  • Panic Attack
  • Post Traumatic Stress Disorder (PTSD)
  • Social Anxiety Disorder or Social Phobia
  • Obsessive Compulsive Disorder (OCD)

There is an overlap of the symptoms, but all anxiety disorders have excessive dread and irrational fear at their base.


Anxiety can strike anyone. Once intense anxiety becomes the normal state for that person, and that person is unabile to perform everyday tasks, then competent professional help is needed. Cognitive Therapy resets the thoughts and restores normality. A person suffering from anxiety needs an understanding family and work colleagues, to support and encourage them through the therapy time.



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