Friday, January 24, 2020

A New/Old? Mental Health Issue... Really?!

So... I'm working on a document and in it, I'm describing some of the mental health issues I had when I was in my early 20s. I thought one condition I had was called agoraphobia but I get all of the phobias' names mixed up so I decided to research it to make sure.

Some background... My panic disorder started at that age (or my late teens, I can't remember exactly). It got so bad that I developed a mild version of agoraphobia. I would leave my house only to go to work and to church but wouldn't go anywhere else. Even work and church were difficult but my sense of responsibility somehow prevailed during those times.

As many of us with mental or physical health issues do, I was a good actress and acted like I was okay when I was away from home, but I was a basket-case otherwise. Looking back, I was already displaying signs of both my addictive-prone personality as well as bipolar disorder, but then I had no clue mental health was really the issue.

You probably think, "How could she NOT think that mental health was the issue with panic disorder and agoraphobia?" The times were very different then. Most people didn't believe you if you had major depressive or anxiety disorders (which I also had) - they thought you just needed to think more positively or "just let go and let God."

Actually, I guess times haven't changed that much, as many people still believe those things about mental illness. But there are many who are learning about it and there are so many more systems to help now than there were then (mid- to late-80s) - from counselors, to medical professionals, to support groups, to online publications and communities.

During that time, I was diagnosed with Mitral Valve Prolapse (MVP) which is greatly associated with two conditions - a form of dysautonomia and panic attacks. It was treated much more from a medical (physical health) viewpoint than a mental health perspective. I took meds to help regulate my heartbeat. I drank lots of water with electrolytes to raise my blood volume (another issue with these conditions). I also tried to find patterns on when I usually had panic attacks - which for me were too little sleep and/or too much caffeine.

Once I did those things, the panic attacks didn't go away, but they lessened in frequency and severity. No one told me that I needed to get to the root of the problem, which was my anxiety disorder. But the agoraphobia got better as the panic attacks lessened and I assumed that I no longer had agoraphobia because I was again able to leave my house without too many issues.

Jump to this week and my realization... When I looked up what agoraphobia was, just to confirm it was the phobia that deals with not leaving the house, I found it was so much more.

Mayo Clinic's website defines it as "a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless, or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd." (https://www.mayoclinic.org/diseases-conditions/agoraphobia/symptoms-causes/syc-20355987) That alone answered my question about it being the correct term, but that last line nudged me to look more into it.

What I discovered blew my mind... My go-to medical site, WebMD has lists of causes and symptoms.  (https://www.webmd.com/anxiety-panic/agoraphobia#1)
Their site states:
               "With agoraphobia, you might worry when you are in:
                        - Public transportation (buses, trains, ships or planes)
                        - Large, open spaces (parking lots, bridges)
                        - Closed-in spaces (stores, movie theaters)
                        - Crowds or being in line
                        - Being outside of your home alone
              Symptoms may include:
                        - Fast, pounding heart
                        - Sweating, trembling, shaking
                        - Breathing problems
                        - Feeling hot or cold
                        - Nausea or diarrhea
                        - Chest pain
                        - Problems swallowing
                        - Dizziness or feeling faint
                        - Fear of dying"

I still have this! I can't stand crowds and avoid them at all costs. I have to sit on the end of the aisle or the front row when in an audience, and I need space between me and the next person (not always possible, which freaks me out). Online shopping was a God-send for me because I can't stand going into stores. I always try to sit where I can see the door and/or most of the room at a restaurant or event where we sit at tables. I will wait if there is a line (I try to be either first or last) and don't go to areas like amusement parks on days they will be crowded, both because of the crowds and because of the lines.

I have attributed all of these things to other issues, such as social anxiety disorder, generalized anxiety disorder, panic disorder, major depressive disorder, and bipolar disorder. Where one starts and another stops is a mystery. I'm not even sure if a person can technically have all of these disorders or if everything would actually fit into one - like my bipolar disorder.

In my research, I found out that agoraphobia is one type of anxiety disorder, with some of the others being social anxiety disorder and panic disorder (https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders) I did also find out that a person can be diagnosed with more than one anxiety disorder (https://www.rand.org/pubs/research_briefs/RB9525.html) but I'm still not sure how that fits with the bipolar.

It really doesn't matter in practical terms, though. Anxiety disorders all have very similar symptoms and treatment options. The reason I'm glad I came to this realization, though, is that it explains more of the behavior that has become so much a part of me that I didn't even realize it needed to be addressed. Now that I know that it didn't "just go away" when I was young and I'm still dealing with it at times, I can bring it up in counseling and maybe one day the fears I have that are associated with this disorder will be much more manageable and I can live a better life, with a few less fears.

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