How does agoraphobia develop?
The initial panic attack may lead to hypervigilance–that is, cautious worry that other panic attacks will occur. As a consequence, panickers learn to avoid situations that arouse anxiety. In fact, avoidance and escape become the major coping mechanisms used to handle anxiety. Many agoraphobics enlist a “safe person”–someone who accompanies them in case the panicker becomes anxious and needs to escape. The panicker suffers from anticipatory anxiety—“Will I have an anxiety attack on the subway?” or “Will I have an anxiety attack at the party?” Panickers fear driving because they fear that they might have a panic attack and lose control of the wheel. Even though their avoidance may have led to few or no anxiety attacks in months, panickers often worry about the next attack. The world becomes smaller and smaller as a result of this avoidance. Because of this constriction in their lives, many panickers are also depressed. Some panickers become so anxious that they self-medicate with alc
