The feeling of panic/anxiety arising in situations where one cannot escape easily and/or with feelings of being trapped is a general symptom of agoraphobia
. It's completely expected and relatively normal. However...
I feel as though I'm going to pass out, which I never have during these episodes. Although I have these feelings I force myself to go into these situations because I've read that avoiding them will only make things worse. It's just such a struggle to force myself to do this.
You are definitely on the right path here, rationally, in realizing that you should *not* avoid these situations. Avoidance is the worse thing to do as far as fixing the underlying problem which causes the anxiety in the first place. See, the problem here is that your brain believes those environments are threatening - even though rationally we know they're not supposed to be threatening. Rationality does not matter here - the brain thinks it's dangerous and triggers the sympathetic nervous system to prepare for fight/flight mode. The latter is what gives you feelings of extreme anxiety, heart racing, sweatiness/clamminess, shortness of breath, pre syncope, and overall creeping dread feeling. The majority of these are legitimate physical symptoms as a result of the body preparing itself for a threat. But here's the gotcha: the sufferer does not perceive an active threat at the time - and as a result they cannot make a rational connection between the reaction of the mind/body and the actual reality they're part of at that moment. A panic "attack" usually occurs as a result. Compare this to a legitimately fearful situation (e.g. car accident, dog attack, fight, etc.) where the body has similar physical symptoms but which are quickly masked by the crisis at hand and also dissipate fairly quickly (physically and mentally) because there is a logical connection that the brain recognizes. On top of that, the vast majority of panic sufferers also help facilitate the situation by providing anticipatory anxiety - where they become anxious about potential anxiousness that has yet to happen and in a way help drive self-fulfilling anxiety.
How to stop the madness:
1. Accept that this is 100% anxiety and not some kind of hidden physical illness, brain tumor, MS, ALS, lyme, lupus, cancer, heart problem, adrenal dysfunction, etc. (you seem on the right track here).
2. Do NOT avoid potentially anxious/panic-like situations as a way of coping or trying to make the problem go away. It will not go away like this. Avoidance is a form of negative reinforcement.
3. Realize you can be actively rational/safe and the mind/body irrational/threatened. There may be no logically explainable reason behind the mind's rationale for feeling threatened at the time (although usually there is some kind of potentially "trapped" feeling buried somewhere). Recognize and catalog triggers but don't get excessively wrapped up in trying to determine logical explanations.
4. Reduce anticipatory anxiety and other precursor fears about potentially anxious places/situations you'll be placed in. Instead, be prepared for them to happen (or not happen) and have the attitude of "if it happens, it happens - if not, great." When the seemingly random panic attack does set in you'll easily recognize it for what it is and can react with confidence rather than fear.
5. Breathing exercises as a means of managing and reigning in the sympathetic nervous system when it's triggered by the irrational mind over a non-threat. This is important - and helps keep the physical symptoms controllable and manageable. It really is as simple as inhaling deeply and exhaling slowly. Don't worry if other people notice this, what matters is that the physical symptoms are regulated.
6. Actively challenge your anxiety and panic to cause you problems in situations/places where you expect it to occur based on past history. Think of it as the reverse of anticipatory anxiety. Rather than becoming fearful of the same-ole attack happening in it's expected places - instead actively laugh at the ridiculousness of our own brain's irrational reaction to non-threats.
7. By this point you're gaining control. Do not envision anxiety as some kind of life-long sentence or place it on a totem pole. Be aware of how it fits into your life now, but absolutely know it will be gone by the time you're done with it.
8. Repeat over and over until the brain (hippocampus in this case) sees and learns (and trust me, it will) that these environments are *not* actually threatening. The brain will recognize your own abilities in confidently mitigating the physical effects (via breathing/active awareness) and respond, through learning, by diminishing the severity of false threats until they're effectively nil again.
This is why exposure therapy and CBT
work. Exposure therapy causes the brain to reteach itself to stop the madness by breaking the dysfunctional feedback loop through repetition and relearning.
Avoidance keeps anxiety sufferers trapped for as long as they choose to avoid whereas awareness and confronting it make the disease go away. You'll know you're on the right track when you have that "a-ha" moment about how it all fits together after successfully managing a few panic attacks and eventually realize just how ridiculous anxiety actually is once you gain real control over it.