Panic with Agoraphobia: The Spatial Orientation Factor

Panic with Agoraphobia

“This panic with agoraphobia business is a nightmare, Bill. Sure would help if I at least knew why it was happening. Any clues?”

Okay, chipur readers, raise your hand if you’ve ever endured agoraphobia. I assure you my arm is extended upward. In the early ’80s I was just about 100% housebound because of it. And I’ll tell ya’, if I did give the outside world a go, it was with a few drinks under my belt and a cigarette hanging out of my mouth.

Thankfully, it’s been decades since agoraphobia cut a wide swath through my life. Good riddance! But the upside of what I endured is it allows me to pass along meaningful and effective assistance to those presently enduring the same misery.

That said, I’d like to share some relevant and interesting information regarding the relationship between agoraphobia and something known as spatial orientation.

Okay, before “onward and upward,” let’s lay a solid foundation by handling some definitions…

As you likely know, agoraphobia is a compound word. “Agora” comes from the Greek for “place of assembly;” and, of course, “phobia” comes from the Greek, “phobos,” meaning “fear.” So, literally we have “fear of the place of assembly.” No great secret: agoraphobia and panic attacks are attached at the hip. In fact, a formal diagnosis of panic disorder is made “with or without agoraphobia.”

Simply, agoraphobia is anxiety about being in places or situations where a quick exit may be tough to pull off. And let’s toss-in feeling uneasy about who’s going to come to the rescue should panic-like symptoms – or an attack – occur. Ultimately, things escalate to the point where places and situations of perceived threat are most often avoided. If not avoided, they’re endured with buckets of angst.

Okay, so just what is spatial orientation? It’s pretty cool, actually. How ‘bout we say it’s our ability to maintain a sense of body orientation and/or posture within the context of our surrounding environment in the immediate. And this applies to when we’re moving and static.

Though it’s so wonderfully natural it seems as though it “just happens,” that isn’t the case. No, to maintain sufficient spatial orientation our brains blend proprioceptive (from the skin, muscles, tendons, and joints – tactile) and vestibular (from the inner ear) cues with visual messages. And adjustments are made as changes in environment and/or positioning occur.

Fairly recent research has discovered a relationship between agoraphobia and problems with spatial orientation that makes a whole lot of sense – and explains much. It seems as though many agoraphobics have sub-par vestibular functioning. As a result their brains are forced to rely solely upon visual and tactile cues for spatial orientation.

Well, this becomes a major problem if visual cues are tough to come by – say, if one is standing in the middle of a desert. And problems also occur if the visual input is overwhelming, like what may be experienced if one is on the dance floor of a popular night club. Finally, those with spatial orientation challenges have difficulty with irregular surfaces or landscapes – say, one of those goofy rooms in an amusement park funhouse where the floor is severely tilted.

Hmmm. Standing in the middle of a desert, being on the dance floor of a popular night club, a severely tilted floor in a funhouse. Aren’t these places and situations that are generally very disturbing to agoraphobics and panic sufferers? You bet. And it’s all about having difficulty with processing out-of-the-norm audiovisual input.

So there you have it, perhaps something about agoraphobia you didn’t know.

When confronted with troubling symptoms, my bet is anyone enduring a mood or anxiety disorder frequently asks themselves, “What’s behind these demons?” And though answers don’t necessarily bring immediate relief, they can sure pave the highway. Knowledge is always power.

Agoraphobia and spatial orientation: yet another logical explanation. And it can only further the cause of removing mysteries – and eliminating fear.