Written by Stephanie Gear, Australia
How many people think to themselves, “I won’t walk in the park today because I might poop myself”, “I won’t drive the car because I might pass out behind the wheel” “I won’t drink coffee because I might shake so violently that I can’t sit upright”?
It’s not an allergic reaction, not the result of trauma or abuse, not drug-induced, and not imaginary. It’s just fear. Or to be more specific, it’s a form of anxiety diagnosed as “agoraphobia”, which means “fear of the marketplace”.
How it all began
I’ve had agoraphobia ever since I was a kid, though I had no idea that it was a medical condition. Throughout primary and secondary school, it presented itself as a more generalised form of anxiety, like opening-night jitters whenever I had to do something new. I remember it happening before a school play, or going on the bus for an excursion. Other people got nervous too, how was I to know that my “nerves” were any different? Even going to the airport; I’d get a sore tummy. A trip or two to the bathroom usually fixed that and off I’d go—if not entirely better, at least feeling able to cope. Mum took me to the doctor, who treated me for parasitic infection. Nothing changed.
In my late teens, it disappeared completely. I was capable, independent, and unstoppable. I was travelling overseas alone, studying, working, socialising—flourishing.
At 24, it came back with a vengeance. I was newly married, working full-time and had just started a small catering business. There were times where I had to do errands on the other side of the city. Regular things most adults do. No big deal.
But that day in the car as I was driving, I felt a bit queasy. Then, I was very queasy. Then, it was like the worst case of food poisoning ever. I looked vainly for places I could pull over that might have a toilet, finally parking near a large café. I must have looked dreadful because the barista pointed to the bathroom immediately! Sweating like mad, with my heart pounding, I sat there with my head against the cool wall praying I wouldn’t pass out in a public restroom as I endured a terrible bout of diarrhoea.
From then on it escalated. What was an occasional occurrence started becoming a regularity over the next few months. It always happened when I visited unfamiliar places, and often in familiar places too. It ruined picnics and concerts and shopping trips and parties. It was always this same sweating and light-headedness. Diarrhoea and stomach pain followed by chills and fatigue. Finding myself once again on a toilet somewhere, leaning against the wall, praying I would stay conscious. I was unable to enjoy life because I was afraid of living it.
Fear of the next episode compounded the problem itself. My sister had to rescue me from Melbourne’s Queen Victoria Market (a really lovely place for fresh food and crafts) because I couldn’t drive home alone. I quit my job managing a café in a busy suburb because I was so exhausted. My small business staggered on, and sometimes I’d have to cancel at a moment’s notice “due to illness”. What made it all the more horrible was that I didn’t know when it would happen again, though the answer to that became “always”. The very thought of the experience was enough to trigger symptoms.
Using my hospitality training and common sense, I ruled out all the physical causes I could think of: Gluten intolerance? Lactose intolerance? Viral infection? Bacterial infection? No other symptoms of Diabetes or Crohn’s or Irritable Bowel Syndrome.
These constant heart-racing, stomach-churning, brain-fogging episodes made me sick of myself—of the terrified, insular person I could see I was becoming. It became an everyday occurrence, intrinsic to my very being. Any reason to go out the front door required so much mental and physical strength.
I was trapped inside my house and myself, and I felt so sorry for my husband. I was no longer the fun, capable person he’d married. I was a burden in every sense—emotional, financial, sometimes even physical, like when I would shake so much I needed his support and warmth to leave a place and get to the car.
Diagnosing the issue
It was only after a routine pap smear with my general practitioner, when she asked how I was going generally that it came up (I was very good at putting on a brave face). She asked questions about my lifestyle and weekly habits, then suggested panic attacks as a possible cause. She recommended a few websites for further reading, to see if that diagnosis resonated with my experience, and a follow-up appointment.
The more I read, the more I felt vindicated. I wasn’t a hypochondriac, a mental case, or a failure as an adult. It was simply a medical condition where my brain went a little haywire for reasons, as yet, unknown. And the more I read, the more it made sense! The panic attacks sent my adrenaline response into overdrive, which then plummeted as soon as I felt safe. This caused exhaustion, making me susceptible to further panic attacks in future. It was a vicious cycle I couldn’t get out of on my own.
Having a diagnosis was a big step, but that didn’t fix the problem. I could hardly get through the whole day. Showering and dressing were enough to tire me—the very thought of going out of the apartment could renew that whole cycle of panicked adrenaline followed by crashing exhaustion. I was in no position to make significant medical decisions on my own. I needed help.
There were lots of options for improvement, and I wanted to be better—to go back to being me. With my husband’s help, we evaluated the pros and cons of the two main treatment methods:
- Depression medication & GP review: very effective quickly but also had addictive side effects. Relatively inexpensive.
- Holistic treatments & GP review: diet, exercise, Cognitive Behavioural Therapy, meditation, psychologist visits, etc. Costs ranged from low to very expensive.
We began down the holistic route, because the side effects were minimal. It’s better to be addicted to meditation than medication, right? If it didn’t work, medication was still a valid option. We talked to people, had books recommended, read, learned, and read some more. I started taking notes about what triggered panic episodes for me—public places, unfamiliar places, crowds. They were more likely to happen after caffeine and sugar, so there went those fun things from my diet. It made sense; they’re stimulants.
I joined a gym because exercise boosts serotonin and endorphins, which level out the fluctuating highs and lows. All I could do was walk on a treadmill—mundane, but safe; the loo was just around the corner. And I learned how we gravitate to places that our body considers to be “safe”. My safe place was home, where I could be me, warts and all. And toilets. They were a haven of privacy, hiding my irrationality. One of the more expensive treatments that seemed to help was Chiropractic adjustment. When your vertebrae are correctly aligned, your nervous system is enabled to work at its best. My nerves needed all the help they could get!
I became an expert at toilet-spotting. Fast-food chains all have one. As do petrol stations. Shopping centres. Large department stores. Entertainment venues. Large parks have public toilets. If I could identify a place of escape, I was more likely to cope.
Reconciling my faith with my anxiety
As a Christian, I also had to figure out how this experience fitted into my worldview. There are some who might say, like the Pharisees to Jesus regarding the blind man in John 9:2-4: “Who sinned; this man or his parents?”
But Jesus is very clear in His reply: “Neither this man nor his parents sinned but this happened so that the work of God might be displayed in his life.” So it was for me. Not only was I in the process of physically and mentally learning to live with and heal from crippling fear, but to understand that spiritually God was pleased to use that situation for His glory and the growth of His people. Romans 8:28 is a classic example: “And we know that in all things, God works for the good of those who love him, who have been called according to his purpose.” Scripture also teaches that we live in an imperfect world because of sin; both personal and original sin. Romans 5:12 also puts it well: “Therefore just as through one man [Adam] sin entered the world, and death through sin, and so death spread to all mankind because all sinned.”
So, the question for me became: What is God’s purpose in this illness? Is there something He wants me to learn? Is there a way this will help other people?
These are not necessarily small questions! Nor do they have small answers! I have learned that God’s purpose is often a mystery—it’s okay that I don’t know why everything happens, but He does, which is such a relief! I’ve learned that my life will never be a modern fairy tale— that I will never have an excellent career with a corner office, plus be a picture-perfect wife, mother, daughter and friend. Yes, I can do some to varying degrees, I just have to be wise in choosing the greater priorities.
I’ve also learned that mental illness is far, far more common than many assume. Some people experience it for a season, as a result of burnout or a particularly stressful period in their life. Others have a lifelong battle with it. It can be caused by environmental factors, like post-traumatic stress disorder (PTSD), or can be influenced by genetics, like bipolar disorder.
Other medications can play a role too. At that stage, I was on the contraceptive pill, and there is research to indicate that this can influence mental health in some women. As it alters the body’s hormonal control, it can make pre-existing anxiety better or worse, depending on the individual.
All this taught me to be more empathetic. Other people may feel just as hopeless and trapped as I did. Perhaps if they know my experience, they’ll feel more comfortable, and be encouraged.
Learning to live with my anxiety
Learning to cope with my anxiety has enabled me to resume everyday activities to some degree. In 2019, I spent 10 days in Paris. It was really out of my comfort zone. I learned how to use the Metro, and how to ask for directions to the toilet. I was on edge the entire time, but the experience stretched me. When I returned to Australia, I was more comfortable than I’d been in . . . forever, because my world had grown.
It’s been about 10 years now since I’ve had any really bad episodes. I’ve learned that panic disorder is more frequently diagnosed in women than men. That it is often tempered by the hormonal changes of pregnancy, which resonated with my experience. And that it is frequently a genetic predisposition. My grandma had it. As does my aunt. I’m keeping a wary eye out for it in my daughters.
In late 2020, I noticed the inklings of panic returning in the most everyday situations because of Covid-19. Being in Melbourne, much of my activity was legally limited to 5km from my home. My physical world was small again, and I became fearful that fear would submerge me again.
So I went back to the beginning, to the tools I first learned 15 years ago: breathing and exercise and to practice stretching my boundaries again. I had continued regular chiropractic visits, so maybe this helped too. This relapse has been a timely reminder that perfection will not be achieved in this world.
As a Christian, I look forward to the promise of heaven, where physical frailty and mental imperfection will not trouble me anymore.
*This story is a personal experience. Whilst I did not opt for medication, it may be appropriate for others to do so. Competent medical advice is invaluable, as is counselling.
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