Archive for October 2013

agoraphobiaSince I’ve moved back to school, I’ve found that my agoraphobia has been hardly ever present. I had such great support during my time back home that I’ve been able to overcome many of the fears that plagued me. I have very little “floating” anxiety, I rarely think of panic attacks anymore, and I’m perfectly comfortable going out and doing things.

So it came as a surprise to me the other day when I started panicking before my first midterm. I’ve never been one to get much test anxiety; I naturally test well, and I was well prepared for this exam, so I had nothing concrete to worry about. It took me some time to realize I wasn’t feeling test anxiety at all. I was feeling agoraphobia.

Many people see agoraphobia as a fear of leaving the house, but in fact it’s more complicated than that. As per the DSM criteria, agoraphobia is a fear of situations that are perceived to be dangerous or unfamiliar, or where there is a lack of control. For some people, simply leaving the house may elicit agoraphobic fear. But for many, agoraphobia manifests as a fear of certain types of situations, like taking public transport or shopping at big grocery stores.

I have a particular fear of situations where escape isn’t immediately possible. Luckily for me, those sorts of situations don’t occur too frequently in my daily life. I’m still not quite able to get onto a long-distance bus (e.g. to travel from Montreal to Toronto), and I’m even a bit squeamish when I have to take local buses around town. I don’t really travel much, so that isn’t much of a problem for me.

Sitting through an exam is another good example of a seemingly inescapable situation. Once you enter the exam room and write your name on the paper, you really can’t leave (barring certain extreme situations). There’s even a warning at the beginning of most exams: “If you’re sick, get up and leave now, or else you’re locked into the exam.” For a student that takes his grades pretty seriously, the thought of failing a class because I was too anxious to stay in the exam room is just not an option. Hence the “inescapable” feeling.

I’m sure I could talk to the student disability service on campus and get special arrangements, but I really don’t want this agoraphobia to stick around any longer, so I’d prefer to take direct action. So I’ve come up with some techniques that work well for me. I got through my first exam in one piece, and the second one was even easier.

Here’s how I tackle my agoraphobia:

Before the agoraphobic situation

  • Visualize yourself in the situation. What are you feeling? What is making you anxious? What’s the worst that could happen? In most cases, the worst case scenario is really not that bad. In my case, I have a panic attack during the exam and I have to leave the room for a little while. I actually have had a panic attack during an exam, and I managed to stick around long enough to finish the exam and run off. Maybe you’re afraid of elevators. Worst case scenario? The elevator breaks down and you’re stuck for a little while.
  • Intellectualize. Take your worst case scenario and explain to yourself why it’s not really that scary. In the elevator example, you know that there’s nothing that’s going to hurt you. You’ll be stuck in a small space for maybe a half-hour, until someone comes and rescues you. It may sound terrifying, but really, you’re in no danger. Maybe you’ll be late for an appointment or meeting, but at least you’ll have an interesting story to tell!
  • Take a few deep breaths

During the situation. 

  • Take a few more deep breaths. 
  • Tell someone about your anxiety. This may not always be possible, but if you’re really worried about panicking, it can be very helpful to let someone know. If I thought I was really going to panic during an exam, I might tell my professor at the onset. “I may have to run out of the room if that’s okay. But I’ll be back.” If you can’t tell someone who is with you, maybe call someone or send a text letting a close friend or family member know you’re in a situation that makes you anxious and you have to stay there. Just acknowledging to the outside world that you’re anxious is sometimes enough to calm down.
  • Take note of escape routes or other sources of comfort. It’s not a good thing to become reliant on this (because really, it’s a safety behavior), but we’re talking about baby steps here! In my exam situation, I take note of the exits, the closest bathrooms I can run to, and I make sure to get an aisle seat for quick escape. I’ve never had to actually act on these safety behaviors, but I know they’re there. (Eventually I’ll start phasing these behaviors out as my anxiety decreases.)
  • Focus on something other than your anxiety. For me, it’s easy: I have an exam in front of me. I’ve spent hours upon hours studying. Once the exam starts, my anxiety usually melts away as I enter a deep focus. For you, it may be more difficult. If you’re afraid of public transport, try taking some word puzzles or sudoku to keep your mind occupied.

After the situation. 

  • Pat yourself on the back: You did it! Every time you make it through an anxiety-provoking situation, you’ve make a great step in the right direction. Take note of the things you did well, and also the things you can improve on. Maybe next exam I’ll sit farther from the exit. Eventually I could start sitting in the middle of a row. Baby steps.

How do you deal with your agoraphobia? Let me know in the comments!

photo by: dcJohn