Tuesday, February 27, 2007

Alas, some more Agoraphobia

I walk into the dining hall, just like every day, to sit down and eat my peaceful solitary lunch. I turn the corner and BAM. Like a freight train! Half the baseball team standing there like frightened deer. I freeze up. I can't breathe. My hands start to shake. I stutter some incoherent syllables before I turn more red than a kid from NC State and duck away from them as fast as I can. This, my friends, is mere shyness. The only ballplayer I've ever even spoken too did not let me know that he was a ballplayer until we were already well acquainted. How he escaped my notice I'll never know. But there are people in the world with such an acute sensitivity to being in society that they can barely even leave their homes without experiencing debilitating fear and oftentimes severe panic attacks. These poor people suffer, not from my baseball-shyness but from a condition known as agoraphobia.

“Agoraphobia” sounds horribly frightening, doesn’t it? Well, once this condition gets to a point where it’s actually called agoraphobia it becomes a daily terror to the people who experience it. Essentially, someone with agoraphobia would probably be called “shy,” yet the disorder is pretty much shyness on steroids. There are two types of agoraphobia recognized by psychology professionals. The first is associated with panic attacks and is the most highly diagnosed type of agoraphobia simply because the symptoms are more easily recognized as an issue. Agoraphobia without accompanying panic disorders is a hotly debated topic in the field of psychological health. The article in Behavior Modification entitled “Anxiety Sensitivity: A Missing Piece of the Agoraphobia-without-panic puzzle” explores many of the reasons why the condition is so rarely diagnosed and why many professionals believe that it doesn’t even exist.

The main argument of the article focuses on the way that “panic attack” is defined. Essentially, most people diagnosed with any kind of agoraphobia have such debilitating panic attacks that they tend to pass out in any kind of social situation. Hayward and Wilson, the authors of my article, cite numerous sources that claim that most people diagnosed with agoraphobia-without-panic are actually misdiagnosed and have other disorders (usually phobias of certain and specific things such as people, or germs). Agoraphobia is generally thought of as panic disorders that originate from within a person rather than from outside stimuli. The argument put forward here is that the definitions of many of the terms regarding agoraphobia are either too vague or too broad in their meaning. The authors seek to address that discrepancy.

The general distinction that the author makes between Agoraphobia with panic attacks and Agoraphobia without panic attacks is that those without panic attacks rarely even leave their houses in order to not feel the anxiety that comes to them in public situation. Essentially, Agoraphobia without panic attacks is only lacking the attacks because the people are so frightened that they don’t even leave their houses. There is also the concept of “anxiety sensitivity” thrown into the mix which basically says that some people are (surprise!) more sensitive to anxiety and therefore more prone to attacks.

Essentially, both conditions are debilitating in a social situation and further complicate the victim’s life by causing further embarrassment on top of the anxiety and shyness that they already feel. The most successful way to treat agoraphobia is called “systematic desensitization” which involves gradual exposure to the situations that cause intense fear, thus desensitizing the patient of their severe anxiety.

Granted, some psychologist could probably do a lifelong case study on my daily activities which are a mixture of superstition and baseball obsession, but I can tell you one thing that would not end up on my chart: agoraphobia. What I want you to come away from this with is that, come on guys, all people have feelings. If you make fun of a shy person *cough* then they will become increasingly more shy until it reaches the point of some strange hysteria, culminating in the person become an agoraphobic cat lady who never leaves her house. Friends, don't let friends tease nerds.

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