I like to occasionally refresh memories and acquaint newcomers of just what it is we are talking about when we refer to panic disorder and agoraphobia. I’ll give my quick definitions and then go over the basic brain science that tells you why you have what you have and how you can get out of it.
My definition of panic disorder is the general state of anxiousness that results from having had one too many panic attacks. Agoraphobia describes the avoidance one employs to feel safe. After only one PA, your amygdala starts to work against you in a bizarre and not at all helpful way. The guard at the gate for your brain is where all data enters your sensory ports (5 in the norm). That most primitive part of the central nervous system must begin the sorting process for everything that happens to you – each sound, each new image in your eye, each word spoken, read or thought, each thing touched, etc.
Traffic is dispatched to various parts of the brain as amygdala and its memory-making compatriot hippocampus make the crucial choices that make you behave the way you behave by reacting the way you react to any given stimuli.
The amygdala process is nearly instantaneous. If cave dwelling you were out on the savannah gathering nuts and berries and saw a human-eating beast of some sort, you would be in full sprint just like that. Stimulus=Response=Survival (or not). Your amygdala would have shouted (by sending adrenaline) to all systems and when the amygdala shouts, your systems listen because they could die if they didn’t. You are now essentially a primitive beast with momentary power, speed, strength and will to do things you could not ordinarily do. There are witnessed, documented incidences of ordinary people lifting cars off people while in full adrenaline fury.
That’s what’s happening to you when you have a panic attack. You are scared to death. Period. After you have a panic attack your amygdala undergoes neural activity to increase its capability to detect future danger. That activity is what we call “anxiety.” Gray matter builds in the area providing more and more guards to spread the word if that dangerous thing happens again. This is like military preparedness, where a country (you) sends armies by the thousands to a certain area to protect against threats. Everybody’s pacing about and anxiously perseverating about the enemy. Only there’s no enemy.
I was age 10 when something I don’t recall startled me one night, sending me into my first horrible panic flight. The unexplained and unexplainable incident left me feeling anxious most of the time for probably six months or so. That was the effect of my amygdala having gone into high alert. My high alert state was, unfortunately, making it more likely I’d have another panic attack.
I had another attack cycle at age 12, again at age 14 and 16, and just after my 19th birthday had a panic attack that made me agoraphobic for the next 30 years. I returned to being fearless a few months after each of the childhood panic cycles, but the one at 19, while on a road trip, was the final straw. I yielded to the power of my muscular amygdala and from then on had to be close to whatever constituted “safety.”
The word “irony” seems almost lame to describe what is happening to a person with panic disorder. Your amygdala thinks that your panic attack was a grizzly bear attacking you and is now “protecting” you by putting all systems on alert for another one of those…those…. Let’s let Amygdala explain away what it was that caused your most recent panic attack: “It must have been a huge bear of some kind because I was really really scared and opened the flood gates. The heart was beating like a jack hammer and the lungs were going in and out like a bellows and all the muscles were pumped up and the brain was whirling with activity. Gosh it was exciting! Did anyone see where the bear went?”
Here’s where you take your first step in your recovery from panic disorder and agoraphobia. You grab the amygdala around the throat and scream, “It wasn’t a Bear you Idiot! It was nothing!! You terrified me for NOTHING!!
After you let the amygdala know that you know what’s up, you can begin in my book Un-Agoraphobic the daily activities, studies and practices that will create new neural pathways working for you instead of against you. After a period of time of regular and vigorous work sessions as laid out in my recovery program, you will achieve a state of mind that makes it seems like you’re in a safe place. The amygdala can now walk the perimeters of your awareness and announce, “The place seems pretty secure. I don’t see any bears, so I guess I can start laying off some guards.
That will be your happy day