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As a woman overcame her agoraphobia, she taught others to follow in her footsteps.
By CHRISTINA K. COSDON
© St. Petersburg Times, published January 28, 2001
LARGO -- An exuberant Martha Cadden swept into her bookstore in Largo. Smiling, she made small talk with a clerk. She was happy to be back to work after returning last month from South Carolina for a visit with her son and his family.
Such normal activities as working and traveling once were inconceivable to the tall, vivacious 66-year-old Seminole resident.
For more than 20 years, Mrs. Cadden battled panic attacks so severe that she often couldn't leave her house, even to take out the garbage. In 1979, homebound in a haze of medication prescribed by doctors who considered her depressed, she found help through a People magazine story on a doctor doing pioneer work in the field of phobias. And she found a name for her illness: agoraphobia.
"Life is very precious to me because of the suffering I endured all those years," said Mrs. Cadden. "I can get on a plane -- what joy."
She still battles occasional attacks, but she has learned how to overcome them, she said. However, there is one paper tiger she has yet to conquer.
"I can drive and fly, visit people and places, go to the movies and play cards. But I don't go over the Sunshine Skyway Bridge," she said.
"You're never cured," Mrs. Cadden said. "There's no logic to panic, but you learn to confront the source of the panic attack and work through it by talking and using relaxation techniques."
Although agoraphobia is commonly thought of as a fear of being in public places, it is more complex than that. The malady is a severe anxiety condition as well as a pattern of avoidant behavior, said Dr. M.J. Gimeno of Clearwater, who specializes in phobias and has worked with Mrs. Cadden.
"If the panic attack occurred while driving, then that person may start avoiding the particular street or bridge or highway, thinking that this was what brought on the panic attack," he said. "In due time, the avoidant behavior spreads to other areas. Eventually, the victim can become housebound."
What the agoraphobic fears are the intensely unpleasant and profound feelings associated with the panic attacks, which can include such symptoms as an urgent need to escape, chest pains, difficulty breathing, disorientation, visual distortion, smothering sensations, rapidly pounding heartbeats and feelings of doom.
Mrs. Cadden knows too well the personal hell of the agoraphobic. For years, her only view of the outside world was through her living room window.
She was 20 and newly married when she had her first panic attack.
"Two months after I was married, we were in church and it hit me," Mrs. Cadden recalled.
Her heart began pounding and her legs got weak. She felt a surge of intense fear and thought she was going to have a stroke. She got up and walked as fast as she could out of the church.
The same thing happened the next Sunday. The third week she spent a sleepless Saturday night worrying that she would have another attack on Sunday. She went to a different church.
Panic.
She tried going to church on a Saturday night.
Panic.
Then she began having attacks while driving, at restaurants and movies and even at a football game.
The medical establishment of the 1950s didn't know what to make of her problem. But that didn't stop her doctors from prescribing a cure.
"They told me that what I needed was to have a child," she said.
In 1960, she and her husband Bernie adopted a baby girl. Two years later, they adopted a 9-month-old boy.
"I had several very good years, until the children were 3 and 4," she said.
Then the panic attacks set in again, more frequently and worse than before.
"For the next 23 years, I only existed. I was up and down like a yo-yo," she said. "I lived in a bottomless pit."
During those years, her husband, Bernie, did the grocery shopping and attended the children's school functions. She couldn't go to her daughter's church confirmation or see her son as an altar boy. She shopped from a Sears catalog. If friends invited them out, they always had an excuse. Throughout the years, her family supported her.
"Bernie (who died in 1981) was the most loving, happy, even-keeled human being," she said. "He was always optimistic that I would get better. Humor -- his, mine and my children's -- bailed me out many times.
"I never lied to my children. They knew I was frightened and that I didn't know why."
Her son Glenn Cadden, now 39 and living in South Carolina, said he didn't realize that anything was wrong with his mother until about the eighth grade.
"She had good and bad days, but we didn't really understand what was going on," he said. "She's 100 percent different now, in her attitude and in the way she approaches things. She is outgoing and independent."
When the attacks abated, Mrs. Cadden took care of the house, read a lot and worked on crafts -- and dreamed of owning a bookstore.
"The highlight of my day was looking out the front window and watching the children get off the school bus," she said. "I'd look out that window and tell myself, "I know there's a world out there, and someday I'm going to own a bookstore."
When the attacks were at their worst in the late 1970s, "I felt like death was around the corner 24 hours a day," she said. The fears were so physically overwhelming that she dreaded each day. Some days, paralyzed with panic, she didn't get out of bed.
"I was never suicidal," she said, "but I didn't want to live."
Holidays such as Christmas were even more painful.
"The depression was so horrendous," she said. "I couldn't go out to shop for my children. All our friends were partying and we couldn't go. And I had these feelings of "Oh, dear God, another year is ending and I'm no better.' You put all that together and it's pretty brutal."
In 1979, Mrs. Cadden saw an article in People magazine about Dr. Arthur Hardy in California, who was doing pioneer work in the field of phobias. He wanted to see her but, of course, she couldn't leave her house. They talked on the telephone.
"His opinion was that I had an extreme case," she said.
He sent her tapes and a correspondence course, detailing his program of diet changes, behavior modification and desensitization to the phobias. After two years of "the hardest work I've even done and the best $225 I ever spent," she said, she was ready to start living again.
Hardy, who died in 1991, encouraged Mrs. Cadden to start a support group for other phobics in the Tampa Bay area while she was still recovering.
Sandra Winn of Seminole, another agoraphobic, saw the ad in the St. Petersburg Times for the support group meeting in Clearwater in the spring of 1980.
"I thought, what an oxymoron -- who's going to go to a support group meeting for a bunch of agoraphobics afraid to leave their homes?" she said.
She had three young children and was homebound most of the time. But she went to the meeting -- her husband drove her.
Mrs. Winn's panic attacks started when she was in kindergarten and got trapped in a bathroom stall. They continued until she met Mrs. Cadden and went through Dr. Hardy's recovery treatment program.
To Mrs. Winn and others who attended the support group, Martha Cadden was a hero.
"As we saw her recover, it gave us hope to follow," Mrs. Winn said. "The support group kept us motivated. Ten of us went into the Hardy program and we all made it."
Many agoraphobics appear to function quite well, yet they may be experiencing extreme distress, Dr. Gimeno said. Many manage to hide their discomfort so effectively that others don't believe there is a problem.
Mrs. Winn said she would stay home and take care of other people's children so they could drive her children to school activities and parties.
"My secret was safe," she said.
But like Mrs. Cadden, Mrs. Winn was frequently paralyzed with fear and the feelings that she was going to die, that she couldn't function and would never be well.
Today, Mrs. Winn works in anger management and as a prevention specialist in the areas of violence, drugs and alcohol with middle school children in public schools.
"School was my most hated thing, the thing I feared the most, and here I am working in schools," she said. "It's joyous, it's awesome. I just enjoy every second."
Mrs. Cadden and Mrs. Winn and their families became close friends after that first support group meeting in Clearwater.
In April 1981, Dr. Hardy put together a course and flew here to train Mrs. Cadden and her husband in starting a franchise in his Territorial Apprehension program, now a respected anxiety treatment program around the world.
"Before we knew it, we were traveling around Florida teaching his methods," Mrs. Cadden said.
When her husband died that year, Mrs. Cadden took Mrs. Winn on as a partner in the business. They ran it for another year until Mrs. Cadden decided to turn the business into a non-profit foundation, the Bernie Cadden Foundation, to teach others the Hardy methods.
"People came to our classes and gave us donations that kept us going for 15 years," Mrs. Cadden said. "We were all volunteers. We didn't make any money, but it was something we wanted to do because we had walked in their shoes." The foundation closed in 1997.
In the meantime, Mrs. Cadden realized that long-ago dream of owning a bookstore. In December 1990, she bought a bookstore of new and used books for $25,000 at 12005 Indian Rocks Road in Largo and named it Martha's Book Vineyard.
"I've had the most wonderful 10 years anyone could ask for in life," she said. "My message is that there is life after panic disorder."