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

First published in 2014 by Weiser Books

Red Wheel/Weiser, LLC

With offices at:

665 Third Street, Suite 400

San Francisco, CA 94107

www.redwheelweiser.com

Copyright 2014 by Hal Mathew

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from Red Wheel/Weiser, LLC. Reviewers may quote brief passages.

Mathew, Hal.

Un-agoraphobic : overcome anxiety, panic attacks, and agoraphobia for good : a step-by-step plan / Hal Mathew.

pages cm

Summary: A wonderfully comprehensive, step-by-step self-help program for overcoming agoraphobia and panic attacks-- Provided by publisher.

ISBN 978-1-57324-639-2 (paperback)

1. Agoraphobia--Treatment--Popular works. 2. Panic attacks--Treatment-Popular works. 3. Anxiety--Treatment--Popular works. I. Title.

RC552.A44M377 2014

616.85'225--dc23

2014023658

Cover design by Jim Warner

Interior by Jane Hagaman

Typeset in Sabon

Printed in the United States of America.

EBM

10 9 8 7 6 5 4 3 2 1

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To Krissie and to Christy
and to all my pals living with
and working with mental illness

How did you get here, deep in the clutches of this #@!&%*! curse known as agoraphobia? Were you born with it? Choose it? Conditioned by your environment? No one seems to be certain what causes panic attacks, or why some people who suffer from panic attacks become agoraphobic. I've developed theories, and you will no doubt develop some more. We know it starts with a panic attack, then turns into panic disorder, which I define as fear of fear, causing avoidance. The avoidance, in turn, becomes agoraphobia. Once you have a couple of panic attacks and the indescribable fear they bring, you live in dread that you might have another, at any moment and with no warning. This keeps you on edge and, therefore, more likely to have another panic attack. It's a cruel, consuming cycle.

Let's get down to basics. You want your life back. Life. You can't get any more basic than that. How much longer are you going to let this panic creature rule? Why does it get to constrain your life, your essence, your days and nights, in a dark dungeon of despair? Isn't it about time for you to rule? You can free yourself from your prison. You can, and you will! Here's where we cue the cheers and wild applause. Go ahead, bask in it.

How do I know you can do this? Because I did.

What's more, there really are no big mysteries you need to crack, or secrets you need to know, to free yourself. Your cure will come from persistent hard work, creative thinking, and a loving change of attitude about your misdirected fear-response system, all under the careful (and sometimes zany) guidance of the book you are holding right now. The book says hello, by the way, it's a pleasure to meet you.

What was your first one like? Most people who end up agoraphobic can recall vivid details from the first time the train ran over them. Life is so palpable, so vibrant, so intense at the onset of a panic attack that the experience is seared into your brain as if with a red-hot branding iron. This is one of life's crueler realizations: you suddenly discover that your body came equipped with a kick-ass, state-of-the-art alarm system, but you can't find any instructions on how to turn the screeching thing off.

You find yourself in the middle of some sort of blast zone. You are acutely aware, but you're not sure of what. The not knowing makes the experience even more frightening.

In a matter of seconds, you went from being a normal person having a normal day to becoming the most desperate creature on the planet. You don't know what's happening to you, and you certainly don't know what to do about it. How or why the emergency started is a mystery. The thought slams into your brain: Run! But where? The thought of running makes you more scared. You need a safe place now! This is quickly getting out of hand. You can't control your thoughts, and you can't even draw a full breath. You look around for something or someone to save you, but everything is foreign and unfamiliar. The whole world seems chaotic and threatening, and you are far from any safe place.

You don't dare start screaming. Do you? Your limbs tremble as you move about with increasing urgency, but there is still no help anywhere in sight. Your hands are tingling and shaking, and sweat gathers on your face. Your terrible dilemma seems to be worsening by the second. Frantic, you consider desperate measures like injuring yourself and calling for an ambulance so you can get to a hospital and be anesthetized. Help!!!

That one blood-curdling experience led to another, and another, which led to your present status of being constantly in fear. Who wouldn't be afraid of a monster that leaps out in front of you without warning, sinks its teeth and claws into your flesh, and viciously shakes your body and soul until you're afraid you will die, and then slinks off to its sulfurous hiding place, leaving you in a frightened and battered heap, afraid you might not die? Who wouldn't be afraid of that?

This sucks. All you know for certain is you never, ever want to have one of those again. From now on, each time you venture out, you have to be constantly alert to this gruesome new threat. You begin to avoid places or circumstances that might cause another panic attack, but the attacks persist. You continue to eliminate possible triggers, and finally there are places you can no longer go and things you can no longer do.

Anxiety is constant, like a heavy, scratchy overcoat you can't remove. You're such a good person, you intone, why should you be a helpless victim of whatever this is? You hate to go to bed because, first, you can't sleep and, second, there's the horrifying prospect of waking up terrified at three a.m. with no help, madly trying to think of someone you can call. And then you hate to wake up in the morning because you are instantly jangled by the noise and demands of the chaotic world.

Once you're up, you fixate on developing strategies to somehow keep yourself together for another day without having a you-know-what. You try to eat breakfast while reading the paper (aka The Daily Struggle), but everything you read and hear seems jarring and your throat closes so tightly that swallowing is difficult.

What now?

So here we are. Your automatic fear-response system is now on overload, hyperdrive, totally malfunctioning. And it's all your fault. Why? Through only the best intentionstrying to protect yourself from another attackyou have given the fear-response apparatus in your brain too many jobs to do, too many things to be on alert for. Meet your amygdala: the decision-making center of the brain, the on switch for floods of adrenaline coursing through your panicked veins. Your amygdala is on high alert. Left unchecked, it has lumped any possible trigger or fear-ful sensation into one big pile. And the sign near the pile says Extreme Danger. The amygdala is an integral part of the brain; without it we wouldn't survive because we wouldn't have anything to alert us to (truly) extreme danger. But puhlease! There seems to be some misunderstanding here about what constitutes extreme danger. A flickering fluorescent light?! A long bridge??!! A