"Far from being the dependent type, agoraphobics show courage and determination of their independence, fighting their symptoms and fears, often with little help and unfortunately without adequate understanding". Dr. Claire Weekes M.B.E., M.B., D.Sc., M.R.A.C.P.

Agoraphobia symptoms are herein discussed, but a sufferer is to check any physical problems with their medical practitioner first, and any new symptoms, to be sure there is not a physical cause producing them.

This is a simple explanation of the physical symptoms suffered by an agoraphobic. This knowledge is a vital main step on the track to recovery. Knowing and understanding the physical symptoms will help you to know yourself and once you have this knowledge, you will learn to accept the symptoms and it will reduce worry and fear (anxiety) and aid your recovery.

Lack of knowledge on the subject of the physical symptoms accompanying agoraphobia, bring bewilderment and fear which prolong sensitisation and keep it sever. Knowing and understanding your physical body and it's reaction to stress will reduce and can remove the panic attacks.
The following diagram is the human body's reaction to fright that happens to all human beings. While alive, each of us feels symptoms of stress from time to time. An agoraphobic so often think that recovery means a peaceful body at all times. Recovery means reduction to a normal sensitivity of intensity, not the absence of all nervous sensations.

THE HUMAN BODY'S FRIGHT REACTION SYMPTOMS DIAG 1 1. Danger! car braking in front. 2. Alarm button 3. Automatic Nervous System 4. Adrenal gland pumps out extra power effecting:- blood vessels, heart racing, head, arm muscles, stomach upset, sweat glands, fast breathing, legs, bladder. DIAG 11 1. Bad memories, pressures, fear of public speaking etc., of work time, walking in the dark. 2. Positive thoughts 3. Negative thoughts 4. Alarm button 5. Automatic Nervous System 6. Adrenal gland pumps out extra power to the arm muscles, stomach, sweat glands, breathing, respiration faster, leg muscles, blood vessels, heart, head.

If any person ignored a classical conditioned fear reaction and kept going out, the fear would gradually fade away. WHY DOES THIS NOT HAPPEN TO AGORAPHOBICS?
The main reason is that the natural reaction to feelings of panic you cannot understand or reason with, is to avoid the places where they happen. Unfortunately this seems to have the effect of actually strengthening the fear - the longer the avoidance goes on the stronger it can become.

When you are frightened by real danger, your mind is occupied with doing something about it. In the case of agoraphobia, the same feeling of fear seem to come and keep coming on for no reason at all, and often so many times without being able to do anything about it ! FOR THIS REASON THERE IS A GREAT TENDENCY TO NOTICE THESE FEELINGS OFTEN - AGAIN THIS MAKES IT WORSE !

WORRYING ABOUT THESE FEELINGS TEND TO GET THE SYMPTOMS MORE FIRMLY FIXED AND WORRYING ABOUT IT CONSTANTLY BRINGS IT LIKENED TO A HABIT.

IT IS ONLY TOO EASY TO GET INTO THE VICIOUS CIRCLE OF WORRYING AND BEING AFRAID OF FEELINGS OF FEAR THEMSELVES.

Some people think they might make a fool of themselves in public, faint or vomit, perhaps physically collapse or think of going insane through BEWILDERMENT.

THINK ABOUT THE NEXT STATEMENT. THIS IS SO TRUE, THESE EXPERIENCES CAN HAPPEN TO ANYONE, ANYTIME, ANYWHERE. TODAY THERE IS SUPPORT AND INFORMATION TO HELP IN OVERCOMING AGORAPHOBIA. AGORAPHOBICS ALSO ADD EXTRA PRESSURE AS WHEN PHYSICALLY ILL, IT TAKES A LONG TIME TO GIVE IN AND GO TO A DOCTOR FOR TREATMENT OF PHYSICAL ILLNESS.

TO TREAT AGORAPHOBIA, NOT ONLY THE THERAPIST WHO INSTRUCTS ON THIS, BUT THE SUFFERER THEMSELVES MUST UNDERSTAND SENSITISATION BECAUSE THE MOST LASTING DESENSITISATION IS SELF-DESENSITISATION !

Diagram showing beginning and progression of severe anxiety state, developing into the condition of agoraphobia.

STUDY THE DIAGRAM AND UNDERSTAND THE CONTINUAL STRESS CIRCLE.

KNOWLEDGE REDUCES FEAR AND AIDS RECOVERY !

Sensitisation is a state in which emotional and body sensory nerves react to stress with unusual intensity and sometimes with disconcerting swiftness - mild anxiety becomes acute. Agoraphobia drains off mental energy that could be used for productive purposes. Recognising and understanding the effects of emotional fatigue is a key for recovery. Fatigue and it's secondary symptoms are difficult to identify and add to bewilderment. PRESENT SENSATION MUST BE REMOVED - if the original cause is not known you still can recover, it is not that necessary, but if you can do something about it, recovery comes much quicker. The conditioned fear now is the main concern.

Without added stress, sensitisation heals itself; agoraphobics rarely understand what is happening and adds further stress, bewilderment and fear to the stress - and are trapped in a SENSITISATION - BEWILDERMENT - FEAR - more sensitised CYCLE . Indecision leads to loss of confidence, also with no inner self from which to seek direction, emotional energy spent in bewilderment brings severe mental fatigue.

The agoraphobic rarely stops to rest from 'studying' the state of bewilderment they are in, and fail to recognise their mental fatigue. (Any student suffers mental fatigue, but allows time for rest ). Because the agoraphobic remembers so vividly of past attacks, they have to unlearn WRONG REACTION - READINESS TO RIGHT REACTION - READINESS. This means to rehearse how to meet stressful situations in reality. (Graded exposure} right reaction - readiness.

After understanding the explanation of sensitisation and its treatment, also the explanation of self-desensitisation, this alone can cure or reduce this continuous sudden shock to the nervous system.

In the right circumstances, this is a normal body reaction.

Humankind needs this reaction to protect us and warn us of danger. It is very necessary. An agoraphobic body is kept constantly alert and ready to act and defend itself by RUNNING OR FIGHTING. This action of running and fighting is the correct function and response to these signals.

Our bodies are conditioned to run from the memory of panic attacks. Our bodies are conditioned to fight this memory also.

So agoraphobics have to learn to control this reaction as we get physically and mentally fatigued.RUNNING - FIGHTING - RUNNING - 'A SUBCONSCIOUS PHYSICAL HABIT'

Instead of the normal reaction to these hormones we have to learn to control it - THE COMPLETE OPPOSITE to its normal function !

We have to STOP running and fighting -GIVE UP - SURRENDER to this action., instead of trying to attack it.

RELAX - TRY TO REMEMBER YOU CANNOT PHYSICALLY FIGHT A PROGRAMMED MEMORY (PAST PANICS). ACCEPT THE PHOBIA AND ITS PHYSICAL SYMPTOMS AND UNDERSTAND THEM SO THAT MUCH FEAR AND STRESS IS REDUCED.

WE HAVE HAD THESE STRESS SIGNALS SO LONG, WE FEEL AS THOUGH THEY WILL NEVER LEAVE ! Our body is simple responding to what we think and remember ! Panic attacks although alarming are nerves highly sensitised, BUT also understand that nerves can be desensitised. The habit has ben a long time in your mind, giving it a collection of bad memories and a tired mind easily forgets the advice given.

NO TRUST IN ONESELF An agoraphobic has tried so many different ways to recover, before trying again. We think it won't work. Trust the advice given, even if you do not trust yourself - your body will act on the advice we give it. This happens automatically once we have understood what to do.

PANIC ATTACKS ARE SO STRONG WE THINK WE HAVE GIVEN UP. We believer it's impossible to think when a panic strikes, but you DO THINK. The thoughts are "I must get out of the shop ", even though it is the wrong thought, YOU DO HAVE TIME TO THINK. Here is where to start changing your thinking to 'Rest in a quiet place' and start to react against tension with relaxation and with the correct attitude.

WE FEEL EMOTIONALLY THE FIRST STEPS ARE TOO MUCH This is based on lack of confidence in what our bodies CANNOT DO. You will be very surprised that we CAN RELY on our body to function correctly if we give it the chance. Understanding that thinking inwardly is natural in the circumstance right now. An agoraphobic has been CLASSICALLY CONDITIONED.

REMEMBER IT IS THE PHYSICAL SYMPTOMS ALSO THAT MAKE US FEEL TOO EMBARRASSED ABOUT OUR REACTIONS.

THE BRAIN IS THE MASTER ORGAN OF THE BODY. IT IS MORE COMPLICATED AND MORE WONDERFUL THAN ANY MACHINE EVER BUILT. The brain controls everything we do, say and think. Certain areas of the brain control the functions of different parts of our body, other areas control activities such as appetite, emotions, memory and temperature regulation. The brain also controls our emotions. It also stores information from past experiences, also our sense glands.

OUR BRAIN HELPS US TO LEARN not just remember. Our brain combines messages from memories and emotions to form our various thoughts and reactions.

THE PITUITARY GLAND IS THE MASTER GLAND OF THE HUMAN BODY. It controls the activity of the other glands including control of the adrenal gland.

THE ADRENAL GLAND is an important organ in the human body. Our bodies have two, one on top of each kidney. The inner core of these organs is the part which produce adrenalin and nor-adrenalin into the blood to adjust to sudden stress. For example the heartbeat increases and much blood is pumped from the digestive organs to the muscles, large amounts of sugar empty into the blood stream, the breathing rate increases. We will get further into the adrenal gland later. (AT LEAST WE CAN KNOW FOR SURE THIS GLAND IS IN PERFECT WORKING ORDER !!!) This gland receives the messages in seconds.

RESPIRATION All humans breath in oxygen and breath out carbon dioxide, it is A REFLEX ACTION, AUTOMATICALLY - A person can try and hold his breath for a while, but soon he reaches a point where he can no longer do so. Automatically, rhythmic breathing starts again. Nature was not so foolish as to give us the full responsibility of breathing - otherwise how could we breath when we are asleep or under anaesthetic?

BREATHING is controlled by the brain and is regulated by the brain. A group of cells form the respiratory centre. Agoraphobics pant quickly; shallow breathing and deep breathing causes unpleasant feelings, and irregulates the respiritory centre point. BREATHING is automatically controlled. When we ourselves make it irregular we have to watch our normal breathing when the situations arise.

WE BREATH IN OXYGEN AND BREATH OUR CARBON DIOXIDE. PLANTS TAKE IN CARBON DIOXIDE AND GIVE OFF OXYGEN.

THE AUTONOMIC NERVOUS SYSTEM A person has no direct control, that is why they are termed INVOLUNTARY !

THEY REGULATE THE INTERNAL ORGANS AND BLOOD VESSELS. This system is chiefly automatic, and it is strongly influenced by an individual's emotion. These nerves are connected to the central nervous system and are termed 'involuntary', are connected to the central nervous system and are regulated at the subconscious lever. This system consists of two parts. 1. sympathetic and 2. para-sympathetic, eg. a nerve from one system can speed up the heart and the other nerve can slow it down. When emotional - afraid, agitated, angry, excited - the sympathetic usually dominates the other and makes you aware of bodily functions.
IN A PEACEFUL UNSENSITIZED BODY THESE TWO HOLD EACH OTHER IN CHECK. After a sensory nerve has been stimulated, the impulses may pass up to the brain and send messages to the motor nerves. Some impulses do not go to the brain, they go straight to make contact with the motor nerve. The motor nerve sends messages of pain to muscles which produce an involuntary jerk of the body, causing them to respond and act. REFLEX ACTIONS TO EMOTIONS THAT ARE STIMULATED, INCLUDE CHANGES IN HEART BEATS AND RESPIRATION (and it does not always have to be fear) LEARNING NEW BEHAVIOUR HABITS INVOLVES CHANGES IN THE NERVOUS SYSTEM. (THE CHANGE IS FOR THE BETTER) TO BE CURED, YOU SHOULD UNDERSTAND THIS, AND TO DO SO, IT IS ESSENTIAL TO KNOW HOW YOUR NERVES NORMALLY FUNCTION, AND HOW YOU CAN HELP WITH YOUR CHANGE OF ATTITUDE.

AGORAPHOBIA IS A CLASSICAL CONDITIONED EMOTIONAL REACTION LET US LOOK AT EMOTIONS BEFORE GOING INTO WHAT THE BODY IS DOING DURING A PANIC ATTACK - REMEMBER WE HAVE BEEN BLUFFED BECAUSE WE DID NOT KNOW ENOUGH ABOUT THEM BEFORE, BUT BECAUSE OF THEIR CONSTANT REQUEST FOR ATTENTION WE HAVE AGREED TO SEE WHAT THEY HAVE TO TELL US ABOUT THEMSELVES. INTRODUCING THE EMOTIONS.

EVERYONE HAS ALL THESE EMOTIONS, NOT JUST AGORAPHOBICS. YES, EVERYONE HAS POSITIVE AND NEGATIVE EMOTIONS.

Agoraphobics have been classically conditioned to the emotion fear, (NOT BY CHOICE). Some of our positive emotions have taken second place. The fear emotion causes parts of the nervous system to send signals to glands and organs. The glands and organs get prepared to defend the body. In fear the Adrenal gland empties a hormone called adrenalin and nor-adrenalin into the blood stream. These hormones cause a series of changes in the body. THESE EMERGENCY MEASURES GIVE THE BODY ENERGY TO FACE CRISES. This explains why a face becomes hot then pale, mouth dry when anyone has a fright. EVERYBODY HAS THESE SAME FEELINGS BUT AGORAPHOBICS ALWAYS PUT THEM INTO THE PHOBIC SITUATION, TRANSFERRING THEM OVER MAKING IT AND KEEPING IT A HIGHLY SENSITISED SECOND STAGE FEAR

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