There is no clear answer to what causes panic attacks, but theories abound. When we are startled or alarmed by something that turns out not to be dangerous, our ancestor-tainted fight-or-flight response system can be misled into believing there is a full-scale emergency. As a result, adrenaline floods through our system and blood flows to the muscles, making the body ready for action when there is no action to be had. Pulse, breathing rate, and blood pressure rise for naught.

The overwhelming feeling of fear is real, but there is nothing real to fear. This constitutes a panic attack. It seems clear that some people have an elevated susceptibility to being startled and therefore could be the type to unwittingly throw gasoline on the tiny spark of something as harmless as a sudden noise.

I surmise that both learned behavior and genetic brain chemistry are involved in making one person likely to easily recover from being startled and another person more easily misled and unable to halt the fight-or-flight response to a mere startle.

False Alarm?

Think of an occasion when you were surprised or startled by something that caused you to either freeze or quickly move out of the way. The something could have been as harmless to most people as a honeybee, or it could have been an ax-wielding maniac. If the bee wandered off in another direction and disappeared, a “normal” person would return to normal. If the ax maniac persisted, a “normal” person would continue evading or fighting back with the elevated strength and speed provided by a flood of adrenaline.

Someone with panic disorder does not know how to turn off the false alarm process once it gets going and must endure a terrifying experience of unknown duration, even if there is nothing apparent to fear.

The truth is, unfortunately, some people have alarm systems that need to be reprogrammed. We all take in squintillions of units of information daily; nearly every time you turn your head, you see changes. Our brains have to filter data so that we can conduct some what rational lives without being overwhelmed. The aforementioned amygdala and hippocampus team up to provide our data filter.

Try to imagine how many mixed messages have been transmitted from one part of your brain to another and back when things once scary or misinterpreted changed status a few times from scary to friendly to indifferent and back again— something as simple as a particular person at school, for example. Multiply that example by millions of experiences and changes in perception, and we wonder how we ever learn to be afraid of the appropriate things and make the correct response to any given stimuli.

It’s not hard for me to understand how a child who is nervous (by nature or circumstance) could be subconsciously telling the information-sorting part of her brain to fear many more sorts of things than a less nervous child might fear. I’ve spoken to several agoraphobic people who reported troublesome anxiety as youngsters, and my own story is no different. The more things a child decides to fear—and it really is a decision—the more likely the child is to end up in a situation that creates a fearful response.

How Do You Cure It?

The agoraphobic person will recover by tricking herself into not fearing panic attacks. Once she stops fearing panic attacks, she will never have another.

Briefly, an agoraphobic person needs to do heavy lifting in the following areas: willingness to change, letting go, communication skills, confidence, self-respect, self-knowledge, self-love, knowledge about agoraphobia, and courage.

Recovery requires diligent work, creative actions, and self-learned tactics. A therapist who specializes in panic and anxiety disorder can greatly assist recovery, and there are some medications that can help if used prudently.

Is PTSD Different from Agoraphobia?

Post-traumatic stress disorder (PTSD) is a condition created by severe trauma that causes feelings of extreme fearfulness. When the fear forces the victim into a restricted area, the effect is nearly identical to agoraphobia brought on by panic disorder. There are other paths to agoraphobia, which I’ll explain briefly.

Whether it’s a single event like a catastrophe or an ongoing stressor like abuse, these kinds of traumas can create PTSD. Unfortunately, a significant number of military people suffer tremendous mental torture because of their experiences in warzones. PTSD causes many of them to isolate and avoid.

The condition of agoraphobia can also be the result of a terrible physical illness or health condition. Most sufferers of PTSD require therapy to help them work their way through the emotional effects of the traumatic event or illness.

Two Other Anxiety Disorders That Limit Mobility

There are two other anxiety disorders that can cause one to limit mobility. Obsessive compulsive disorder results in avoidance of feared things, limiting the sufferer to certain territories. People suffering from social anxiety disorder can become nearly homebound in worst cases in trying to avoid intimacy.

Some people develop phobic avoidant behaviors because of emetophobia, fear of vomiting, especially in public. Other people have been shown to be prisoners of a certain territory because of falsely held beliefs.

There is another route to panic attacks with the tongue-twitching name of labyrinthitis. A search of Harvard Medical School’s website for psychiatric studies revealed a strong correlation between people who develop the inner ear infection called “labyrinthitis” and anxiety leading to panic attacks. Briefly, the researchers noted a similarity between the neural signal associated with labyrinthitis and the neural signals alerting a person to extreme danger. They noted that both the onset of a panic attack and an attack of labyrinthitis, which can cause extreme vertigo, happen instantaneously and without warning. I can confirm that personally. They theorize that the correlation between labyrinthitis and panic attacks is the similarity of the triggers—they appear so much the same that the amygdala might misread the inner ear signals and put out a call to action (panic attack).

Interestingly, I was plagued by labyrinthitis attacks at about the same time I had my first panic attack at age ten. There was no apparent correlation between the two, though. I did not experience a panic attack the few times I had sudden attacks of what is also called “vestibular dysfunction,” nor was I suffering inner ear infection symptoms on any of the occasions I had panic attacks. When the inner ear thing happened, I would become instantly so dizzy I couldn’t stand; everything whirled around me. Other symptoms were light sensitivity, nausea, and a nasty sinus-like headache.

The only thing that seemed to help was to lie in a dark room with a cool washcloth on my forehead. Later I figured out that Dramamine and antihistamines relieved the dizziness symptoms. I had my last attack of labyrinthitis when I was nineteen, the same year I became agoraphobic. I don’t really know what to make of any of that; the result was still the same—agoraphobia.

There are a number of websites regarding “labyrinthitis and anxiety,” and reading the postings indicates the phenomena is fairly common amongst vertigo sufferers. One posting was from a woman who said her vertigo diminished as her mental health improved.

If you have panic disorder and ever had or are suffering from labyrinthitis, please send an email to our website—This email address is being protected from spambots. You need JavaScript enabled to view it.—describing your experience. If we get enough people with these cross diagnoses, we can send our anecdotal information on to Harvard Medical’s psychiatry department. I’m sure every little bit helps as the medical community strives to provide better care for our particular mental illness.

For Friends and Supporters Asking: How Can I Help?

Agoraphobic people recover more easily when they have friends or partners who understand the condition and are supportive. Help beyond that depends on many variables.

An important thing to comprehend is that you cannot have expectations about time of recovery. Too many variables. Do not use any kind of pressure if your partner is working on a Recovery Program. Outside pressure is almost always counterproductive. Communication is important, so plan regular conferences.

As a mental health social worker, I saw many families and relationships torn apart or at least negatively affected by mental illness. I, therefore, advise you to take all steps necessary to preserve your well-being. Doing so could include dramatic changes or even separation from the relationship. This is the hard part, but if you don’t take care of yourself, you cannot be of help to anyone else. Agoraphobic people are hypersensitive, and if your participation is not clear and pure and from the heart, you will make matters worse.

Ask what things your friend needs help with, and then be honest with yourself about how much you are willing and able to do. You may be able to help find others inclined to give rides and provide some services. You can also help by coordinating assistance from friends, family members, and neighbors as well as public assistance agencies if necessary.

If your friend is going through a homebound phase, you can get extra Saint points by helping to survive it. Help in this case would include bringing in outside necessities, running errands, and being available to assist with baby-step trips outside the safe confines. The dramatic increase in fear that forces an agoraphobe into a corner is demoralizing. Moral support is important during this time. Do what you can.

Here’s one bit of agoratrivia that may help you: the circumstances of the initial, panic-inducing event don’t really matter because when fear of and avoidance of any one circumstance starts, dominoes fall. Panic attacks in a crowded mall lead a person to avoid not just malls but also any other crowded place. Travel more than a short distance from a safe place can become difficult.

Having panic attacks keeps the agoraphobic person on high alert all the time, making it more likely that a panic attack will occur. Yes, while guarding against the feared panic attack, agoraphobes subconsciously create the perfect circumstances for a panic attack. It’s complicated.

I hope this explanation helps you more fully understand the person you are close to as well as gives insight to the work involved in changing and redirecting some thought processes in order to get out of the terrible prison of agoraphobia.

©2014 by Hal Mathew. All rights reserved.
Reprinted with permission of the publisher, Conari Press,
an imprint of Red Wheel/Weiser, LLC. www.redwheelweiser.com.

Article Source:

Un-Agoraphobic: Overcome Anxiety, Panic Attacks, and Agoraphobia for Good: A Step-by-Step Plan
by Hal Mathew.

Click here for more info and/or to order this book.

About the Author

Hal Mathew was born and raised in Billings, MT. He began his writing and editing career at The Billings Gazette. Despite being plagued by panic disorder and agoraphobia, his journalism career included several other newspapers and a wire service. With Un-Agoraphobic he has created a way for those suffering with continual anxiety and panic attacks to reclaim their lives. He makes pottery, gardens, and writes in his adopted home of Salem, Oregon. Visit Hal online at www.unagoraphobic.com.