phobia Tag

Agoraphobia

Agoraphobia

Agoraphobia is a type of anxiety disorder that can sometimes co-occur with panic disorder. Its prevalence rate in the population is low, occurring in only about 1.1% of the population. Agoraphobia is hallmarked by a fear of leaving the house or other safe place. This often cooccurs with panic attack or panic disorder because a person has experienced a panic attack and then fears that they may have one again or that they will experience some other feared situation such as traveling on a bridge, going through a tunnel, or being stuck in a crowd of people. In some situations, the person may be able to encounter the feared situation, but they do so with such dread that the activity and many other parts of life lose their joy and peacefulness, which can even lead to depression and other psychiatric disorders. In some instances agoraphobia can be diagnosed without a history of panic disorder.

The criteria for Agoraphobia are as follows:

1. A fear or anxiety about being in places or situations where escape may be challenging. This fear is often surrounding being unable to quickly escape if the sufferer has a panic attack and could become trapped or unable to leave.
2. The fear of being unable to leave leads to an avoidance of said situations which can result in restriction of travel or in some instances the situations are endured but only with a certain safe person or friend.
3. This specific phobic avoidance is not accounted for by another disorder such as social anxiety or post traumatic stress disorder.

A person who has experienced a panic disorder may state “ Before I sought treatment and recovered from agoraphobia, I rarely left my apartment for 2 years. It all started when I was walking down a crowded street in downtown Pittsburgh and suddenly I had hot flashes, I was sweating and couldn’t breathe, the pain in my chest became so bad that I ran for help and reached for the lady next to me and told her to ‘Help, call 911!’ When I was diagnosed as having a panic attack the hospital I couldn’t believe it, everything changed for me then. I wanted to avoid having another episode and the only place I felt better was at home. I avoided everyone and even did my grocery shopping online. It became so bad that I started to feel anxious when I thought about leaving home for anything.”

A person with agoraphobia suffers greatly, their ability to function in life is limited including socially, emotionally, and psychologically. Treating panic disorders can be extremely difficult because the person may not want to leave their home even to seek help, fortunately treatment using distance or online counseling is now an option. The best treatment for Agoraphobia is psychotherapy, a counseling or therapy approach which uses exposure therapy and cognitive behavioral therapy. Medication or Pharmacological therapy including anxiolytic medications and SSRI’s are often used effectively to treat Agoraphobia too, medication is often used in conjunction with counseling or psychotherapy.

Phobia Therapy & Treatment

Phobia

A phobia is a fear or anxiety response of heighted arousal, ie rapid heart rate, rapid breathing, and thoughts of intense worry and this most likely leads to avoidance of the situation or object. Some examples of typical phobias are fear of public speaking, fear of choking or vomiting, fear of spiders (arachnophobia), fear of enclosed spaces (claustrophobia), fear of bridges, fear of tunnels, fear of large crowds, fear of blushing, fear of water or other natural environments, fear of contamination or germs. Phobia is distinct and much more severe than a natural aversion, for instance in the example of arachnophobia, many people do not like spiders and insects but wouldn’t qualify for a disorder because this doesn’t interfere with their functioning and enjoyment of life. A person who simply doesn’t like spiders may sheik if they encounter one and quickly try to remove it from their environment. A person who has a phobia of spiders may feel anxiety if they think about a spider, they may never go into a forest or stay away from other natural environments, they may start to take precautions like spraying repellant everywhere and have continual intrusive thoughts about the possibility of encountering spiders and even stop leaving home or developing agoraphobia because their wish to avoid the spider is so powerful.

The Diagnostic Criteria for A Specific Phobia are;

1. A continual, persistent, and excessive fear caused by the presence or anticipation of the situation and or object, examples may be choking, bridges, tunnel, flying, insects, fainting, speaking, blushing.
2. When exposed to the object or situation an anxiety or hyperarousal response is invoked. This is also a different response in children.
3. In panic disorder the persona experiencing the disorder does recognize that the fear is unreasonable and the response is excessive.
4. The situation or object may be faced or endured but only with very visible and tangible fear, anxiety and distress.
5. This fear and anxiety interferes with the enjoyment and participation of life, limiting professional, occupational, social, relational, and academic performance and functioning.
6. This can be diagnosed only in individuals who are over the age of 18 and it must be experienced for longer than 6 months.

The best way to treat a phobia disorder is with psychotherapy, your licensed counselor can help you by using a very specific kind of therapy called Exposure Therapy. This is a behavioral therapy which a licensed therapist who specializes in treating anxiety disorders will be able to guide you through. In other instances, medication including anxiolytic medication, anti-anxiety and SSRI’s are best used medication therapy to treat and manage panic disorder. Other forms of therapy which may help to manage specific phobias including meditation, mindfulness, exercise and other integrative options like nutrition counseling and acupuncture.

Anxiety; Pills and Possibilities, A Psychotherapists Musings

Who among us has not suffered from feelings of anxiety at some point in his or her life, it is common enough to be among the more often seen symptoms which bring an individual into a therapist’s office. Even for the most staunchly healthy psyches anxiety is a typical benchmark which exists in a range of degrees within the human emotive process. Depending upon you as the individual and the technical approach of your clinician you may be offered a multitude of conflicting remedies to intervene upon that which is ailing you.

There are the wildly popular pharmacological interventions such as Xanax or Valium, while widely popular these interventions do nothing to examine the “how’s” or “why’s” of an anxious feeling. These interventions assume that an increased cardiovascular response, heightened worry, tense muscles, sleepless nights, feelings of agitation are all in the physical realm yet quite mysterious. Indeed anxiety in its more insidious form is a grave health concern so it is with accolades that I note the vast number of humans seeking treatment to escape its grips. There is something inexplicably disconcerting about the hyper arousal of anxiety which compels one towards a greater risk for many other issues health issues such as addictions, depression, coronary heart disease, even eroding the erectile function of both the male and female, to name but a few.

 Most of us recognize that there are yet other forms of anxiety which are our “bon amie,” the kind which compels our actions for good causes such as self and social betterment. Without a touch of anxiety one may hit the snooze button each and every morning and drop out of society all together. Yet for our purposes we will consider the more sinister form with its wanton undesirability which causes many to seek its avoidance at all costs. There are vastly varied approaches within the medical community in terms of treatment of anxiety, there are folk remedies, homeopathic remedies, new age methods, each with their unique utility. Yet most all of these interventions lavish attention upon the amelioration of physical symptoms but may from sheer neglect, fail to examine the psychological underpinnings of anxiety itself. For those who do experience the necessity of utilizing anti-anxiety medication it is an empirically validated fact that the best therapeutic outcomes exists for individuals who make use of psychotherapeutic settings simultaneously. It is within the psychotherapeutic setting that the focus is cast specifically upon the unique psychology which may be breeding and offering sustenance to an overabundance of anxiety.  Allow the remainder of this small essay to offer a rudimentary overview of some of the more typical sources of psychological anxiety.

Significant Life Changes

This form of anxiety is a reaction to some looming occurrence which has skated its way across your horizon, it may be adaptive and is completely natural. Many of us thrive upon constancy, as much as this tendency is at odds with the nature of the universe, inevitably we experience some anxiety while changing jobs, graduating, marrying, divorcing etc. While it is normal to exhibit some emotional reaction to such transitions be mindful to give extra care to yourself even during those joyous transitions. For any anxious feeling that continues to gnaw at your innards, give yourself some time to thoroughly examine  all of your thoughts surrounding the (fill in blank) transition. This reflection affords the opportunity to hone in on any ways your emotional self may be beckoning you towards a closer look at something that your conscious awareness is not seeing completely.  

Emotional Expression

 The more that we attempt to repress our emotional experience the more that they tend to rupture forth in greatly unmanageable ways. Perhaps you are a product of early learning which valued emotional repression and lack of expressiveness. In some way you may have learned early or later in life that it is dangerous or taboo to talk about feelings or even notice that they exist for you, yet the vast and unstoppable torrent of the feeling state will not be escaped. This form of anxiety or panic urges the person towards understanding and experiencing of inner awareness and emotional expression.

Time

The exactitude and finite nature of time is stated by some to be the source of all anxiety. What is it that you will you do with your precious earthly allowance? By becoming more aware of lapsing time, acknowledging that life proffers beauteous opportunity, love, and abundance still too, how will you cope with mounting defeats, losses, and unrealized potentials? Ones highest hope is to make father time ones friend, utilizing our human energies to compel feats which contribute to human progress. For you that may mean many things, to raise a family, build computer software, tend the forest, love deeply, the myriad meanings for the human riddle.

Control

For some of us it is alarming to consider doing something that risks ones perceived control over ones surroundings. That could mean riding in an airplane, making interpersonal changes like developing new relationships, people are the ultimate unknown variables full of competing needs and possibilities.  Will you be able to extend the risk of letting go of the known order to enjoy the potentials?

While this is in no way an exhaustive exploration of that powerful human indicator named anxiety it is something that may compel one to begin to relate to it in a slightly different manner. Perhaps it is time to consider its possibilities, its latent messages, it may one with greater respect for behoove one to not simply extinguish an anxious feeling with a pill or an exercise but to sit with it, even for just a moment, entering its heart palpating, dizzying sensation, in reverential respect for its utility and possibility as an psychic indicator. There is an understanding that in most cases, under the layers of any symptom are a fortunate beckoning towards the best version of yourself, the unrelinquishable layers of consciousness which insist that ideals will be felt and known.

In good health and energy,

Stephanie McCracken MSPC

412-215-1986

Reviving Minds Therapy

1010 Western Ave

Pittsburgh Pa 15233

*This article does not intend to diagnose, treat, or in any way address an anxiety disorder or supplant psychological or medical advice. This is intended for your consideration only.