Question:
I used to believe my agoraphobia developed subsequent to having 4 or
5 spontaneous panic attacks per day for several months.
But I've been thinking about my history lately because there is
currently a topic at ASAP concerning "dizziness" which helped me to
recollect some of the things I experienced prior to the onset of my
panic disorder.
I suspect if I had seen a doctor when all I had was dizziness, fear of
fainting, and avoidance of certain locations, my diagnosis would have
been "agoraphobia without panic disorder". However, because I didn't see
a doctor untill after the onset of the panic attacks, I was given the
diagnosis "panic disorder with secondary agoraphobia".
When a doctor sees the patient, the diagnosis reflects what the doctor
observes at the time he sees the patient. If he had seen me 10 years
BEFORE, my diagnosis might have been "fearfull child", "afraid to be
away from parents".
If the doctor had seen me 10 years AFTER the onset of my panic attacks,
the diagnosis would be "major depression, recurrant" and "PD with
secondary agoraphobia".
Has anyone else developed agoraphobia (or some
restriction in their activities due to "some uncomfortable feelings")
PRIOR to the onset of their "full blown" panic attacks?
Answer:
I didn't and I suspect you didn't develop anything like *agoraphobia
without PD* either. You developed agoraphobia after what I would call
*limited symptom attacks*. These are part of PD. PD can present changing
symptoms in the course of times. I don't believe that there is anything
like *agoraphobia without PD* (whatever the DSM IV may say). I believe
if you dig deep enough or ask the right questions you'll always find
that PD comes first. In your case I have no doubt. I am not a doctor
(would be bad for patients anyway) nor would I want to be one, but if I
were one I think I would have diagnosed you as having an anxiety
disorder, probably PD w/agoraphobia if you presented situational
dizziness only. I know this doesn't help ;))
Chip-don't see a doctor after your dead or recovered it will confuse him.
Almost all folks suffering form agorophobia and pa have a lot of personality
traits in common. As you can see from the posts. What came first the chicken or
the egg? It's like the nature nurture issue it is not a dichotomy. You are a
sensitive person who concentrates on your feelings both physical and
emotional-if these feelings scare you your anxiety increases, if it increases
still it becomes panic, if you panic at the barbers you associate the panic
with that situation and you avoid it-the avoidence fuels the anxiety and keeps
you stuck in this irrational no win avoidence avoidence schema. You know your
not afraid of the barber(maybe the haircut he gives) but you are afraid of
FEAR. I'll bet when you were a wee boy you had all kinds of worries-
agorophobia is the natural progression of panic if your main defense of dealing
with the anxiety is to avoid exposure and experiencing it. Your dizzy feelings
are a construct of anxiety your allreadyv tense and worrying about what if I
faint? Then the pervasive worry leads to worry about worrying and it escalates
into panic. There are spontaneous panic attacks but usually there is a
percursor a thought a vision an idea a memory some trigger that sets it off.
You may never be aware of what that trigger is it may be elusive but it's
there. Your panic and agorophobia are logical reactions, given your
circumstances and personality and how you became sensitized to it. Secondary
primary target symptoms yada yada--it's all for your docs convenience you know
your diagnosis you know your anxiety better then he(she)does it's yours. Sorry
I do carry on.
