Agoraphobia is a type of anxiety disorder that compels a person to avoid instances, places and often fills him or her with fear. This may also make you feel embarrassed, trapped or equally helpless that may lead to panic attacks.
The sufferer of agoraphobia can fear of an anticipatory or an actual situation like following a queue, using public transportation and being in a crowd of people. The anxiety is often caused due to the fear of the inability to escape from such stressful situations. Agoraphobic people often experience one or more panic attacks that lead them to a fear of being struck with another attack and they avoid being in such places.
Sufferers of agoraphobia may have a hard time staying in a public place, which are overcrowded at times. They may feel the need of being with a friend or a companion to visit a public surrounding. The fears can be so strong that one may be unable to leave home for saving themselves from witnessing such situations.
Agoraphobia treatment can be demanding as it may compel one to confront his or her fears. The agoraphobic trap can be escaped with psychotherapy sessions and medications.
Symptoms of Agoraphobia
Characteristic Symptoms of Agoraphobia Involve:
- Fear of being by yourself in any panicking situations.
- Fear of being in jam-packed places.
- Fear of losing self-control in overcrowded places.
- Fear of being in hard-to-leave places like a train or elevator.
- Inability to leave home or be able to leave only when accompanied by someone else.
- Over dependence on others.
Apart from all this, Patient may also Show Signs of Panic Attack like:
- Feeling shaky, numb or tingling
- Sweating excessively
- Feeling a loss of control
- Upset stomach or diarrhea
- Sudden flushing or chills
- Chest pain
- Breathing Trouble
- Rapid heart beat
- Dizziness or Lightheadedness
- Fear of dying.
Treatment Steps for Agoraphobia
The approach may be small and will target the panic disorders as well. The following steps may be approachable:
- Step #1: Learn about the condition and all the necessary changes that have to be made to relieve the symptoms.
- Step #2: A guided self-help program might be another alternative.
- Step #3: Undergo an array of intensive treatment like cognitive behavioral therapy (CBT) or see of the symptoms can be controlled with specific medications.
Step #1: Lifestyle Modifications and Self-Help Techniques to Treat Agoraphobia
Reading and understanding about agoraphobia, its relation with panic disorder and attacks may help in controlling the symptoms in a better way. Certain techniques can be used for controlling the panic attacks by controlling the emotions. Controlling the emotion in a confident manner is necessary for coping with the changing environment.
The Following Self-Help Techniques may come Handy:
- Stay put in the place consciously rather than running away from the situation. When you are driving, pull the car to a safer place and resist the urge of running away.
- Focus. It is essential for you to pay attention on certain things that are non-threatening. It is necessary to remind yourself about the signs and symptoms will eventually pass and there is no need to panic.
- Take slow and deep breaths. Feelings of anxiety and panic attacks can become severe if you are breathing heavily. Try to focus on deep breathing and count every breath that you take in.
- Try to know about your fears and find ways to tackle them. You can succeed in the end by understanding your fears and they will eventually pass with time.
- Create a mental picture. When you struck with panic attacks, resist the urge to be in flow with the negative thoughts. Instead, create an image in your head that will make you feel peaceful and relaxed even during disastrous times. Once this image is created in your head, you can easily focus on it.
- Never try to fight a panic attack. When you try to fight the symptoms, the panic attacks can worsen. Assure yourself that the symptom may seem difficult to tackle and the attack is not fatal.
Making Certain Lifestyle Modifications is Important and you can Follow the Following Steps to Adopt Newer Means:
- Indulge in a regular exercise. Exercise can lighten the mood and relieve the anxiety symptoms.
- Follow a hale and hearty diet. An insufficient diet can worsen the symptoms of anxiety and panic attacks.
- Keep away from alcohol and drugs. These means can offer some relief for a short time, but they may eventually worsen the symptoms.
- Avoid consuming caffeinated drinks like coffee, tea and cola as it can affect the brain for worsening the symptoms.
Step #2: Guided Self-Help for Agoraphobia
If your condition fails to cope with the above-mentioned lifestyle changes and self-help techniques, you may have to enroll in a guided self-help program. Through this program, you will work through various self-help manuals that elaborate various issues and teach you to deal with them successfully.
You will also find innumerable online programs like Moodjuice for tackling the emotional problems and solve them as well. The self-help programs for agoraphobia are often based on Cognitive Behavioral Therapy (CBT) that helps in changing the unrealistic patterns to bring a positive impact on the minds of people.
Cognitive Behavioral Therapy (CBT) also uses exposure therapy where an individual is exposed to certain fearful situations or objects and anxiety is reduced using various relaxation techniques. The CBT therapist may also arrange a brief conversation face-to-face or over the telephone. You may be asked to participate in group sessions and work with people who are agoraphobic and struggling with panic disorders.
Such self-help programs are inclusive of various goals that have to be achieved during the time limit of five to six weeks.
Step #3: Therapies and Medication for Controlling the Symptoms of Agoraphobia
You may be asked to be a part of intensive therapy, if the above-mentioned programs fail to work or show any signs of relief in your symptoms.
These are primary options that may be adopted:
- CBT (Cognitive Behavioral Therapy) with a therapist
- Applied relaxation
- Pharmaceutical Treatment (Medication)
Cognitive Behavioral Therapy Sessions for Handling the Symptoms of Agoraphobia
Cognitive behavioral therapy (CBT) is often based on the fact that an unrealistic thinking often leads to negative behavior. CBT works in breaking this cycle and develop new ways of behaving in a positive manner. The therapist who is conducting the Cognitive behavioral therapy (CBT) session may encourage you to think positively and keep you in an assurance that these situations will pass with time.
This paradigm shift in the thought process can help in following a positive behavior where a person will learn to tackle the situation and get through them successfully.
CBT is often combined with exposure therapy and modest goals will be set by the therapist in the initial stages. As you are able to confidently tackle the daily goals, the level may be eventually increased. The CBT course may last for 12 to 15 weeks and each session may last for a period of one hour. During the entire session, an individual will be asked to adopt new goals and learn to tackle them successfully.
Applied Relaxation Sessions for Treating Agoraphobia
Applied relaxation works on the principle that agoraphobic people lack an ability to relax and tackle various panicking situations. The applied relaxation techniques that are included in this technique will help you in relaxing along with a series of techniques that may help with:
- Spotting the symptoms and signs of stress
- Relieving the tension by relaxing the muscles
- The use of methods that will prevent you from panicking situations and worries when such events occur.
The applied relaxation therapy sessions may last for 12 to 15 weeks with duration of an hour per session. This pattern is similar to the course of treatment in CBT (Cognitive Behavioral Therapy).
Pharmaceutical Treatment for Helping Patients with Agoraphobia
In many cases, medication may be used as the only treatment for relieving agoraphobia. In severe cases, a combination of medication along with Applied Relaxation Therapy or Cognitive Behavioral Therapy may be used.
Selective Serotonin Reuptake Inhibitors (SSRI's) for Treating Agoraphobia:
The physician may prescribe a selective serotonin reuptake inhibitors (SSRIs) course, if you are listed for a medication. SSRIs were primarily developed for treating depression and they have proven to be effective in treating other mood disorders as well. These may include obsessional thoughts, panicky feelings and anxiety. "Sertraline" an SSRI (serotonin reuptake inhibitors) is recommended for agoraphobic people. The side effects that may be seen by consuming this drug are:
- Sick feeling
- Loss of sex drive (libido)
- Blurred vision
- Diarrhea or constipation
- Feeling agitated or shaky at times
- Extreme sweating
These side effects should alleviate with the passage of time, still some persist occasionally.
You may be asked to follow or set up on an optional SSRI or any other medication like serotonin-norepinephrine reuptake inhibitors (SNRIs), if sertraline fails to alleviate the symptoms. The course of medication may vary depending on a person's response to a particular medication. Some people may have to follow the prescription for 6 to 12 months.
When your doctor decides according to your will to stop SSRI medication, you will be asked to discontinue completely by reducing your dosage gradually. It is advisable to avoid stoppage of these medications without your physicians' consultation.
Pregabalin for Treating Agoraphobia
If your medical history does not allow you to take SNRIs or SSRIs or you may have some side effects, then pregabalin may be prescribed by the physician. Use of pregabalin may be associated with common side effects like drowsiness and dizziness.
Benzodiazepines for Treating Anxiety in Agoraphobia Patients
If you experience an elevation in the symptoms, a short-term prescription of benzodiazepines may be suggested. The tranquilizers may help in reducing anxiety and promote relaxation as well as calmness.
Consuming benzodiazepines for more than two weeks is not recommended as it may cause addiction.