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Anxiety disorders: agoraphobia—avoidance behaviour ANXIETY DISORDERS: AGORAPHOBIA—AVOIDANCE BEHAVIOUR
Agoraphobia is one such control. Developing agoraphobia has meant a lifetime of limitation for many people. Until the recognition of panic disorder as a separate condition in 1980, agoraphobia was considered to be a primary condition. Treatment was focused on it, instead of the disorder.
Agoraphobia used to be defined as fear of open spaces. In panic disorder, agoraphobia is now recognised as 'anxiety about being in situations or places from which escape might be difficult or embarrassing, or in which help may not be available in the event of having an uncued or situationally predisposed attack', and/or 'the situation is endured with marked distress or anxiety ... or may require the presence of a companion' (APA 1994).
Agoraphobia in Social Phobia is avoidance behaviour 'limited to' social situations. In obsessive compulsive disorder it is avoidance behaviour relating to the particular obsessive thoughts and in post traumatic stress disorder it is avoidance of 'stimuli' related to the trauma (APA 1994). Although the avoidance behaviour is limited to the particular disorder, it can be all encompassing and people may become housebound.
Some people will become housebound, totally avoiding situations and/or places, from the first spontaneous attack. In other cases, avoidance behaviour may be gradual and increasingly restricting, or it may be permanently limited to one or two situations and/or places. People may have occasional panic attacks for years before avoidance behaviour sets in. In this case, the onset of avoidance behaviour is not a result of the panic attack itself, but is usually a fear of a new symptom of anxiety.
Agoraphobia can affect people in different degrees. It can also affect the same person in different degrees at different times. It is a multi-faceted and multi-contradictory condition.
Avoidance behaviour doesn't mean we are not trying to 'pull ourselves together', nor does it mean we are giving in to the disorder. Avoidance behaviour is a defence against it, and it has been one of the few controls we've had.
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