help for anxiety

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.

Post Traumatic Stress Disorder Therapy and Counseling

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder is a form of anxiety disorder which stems from exposure to a traumatic event or situation which caused real or threatened injury to and this can also be caused by the witnessing of an event or situation which injured or threatened injury to another person. According to the DSM IV, there is a lifetime prevalence rate of about 8% for the development of PTSD. Muggings, rape, terror, hostage attacks, natural disasters, car accidents, are situations that can increase the likelihood that a person may develop PTSD.

As a therapy practice which also specializes in marriage and family counseling, we support the research which suggests that individuals who have experienced an infidelity in their relationship may also go on to develop symptoms of PTSD or Acute Stress Disorder.

There are certain occupations which put people at risk for developing Post Traumatic Stress Disorder by exposing them to frightening and dangerous situations. Those who work as military/armed forces, policeman, fireman, and detectives may be particularly vulnerable for developing PTSD. Finally, there is a second form of PTSD, Vicarious or Secondary trauma, this form of trauma is caused by exposure to information related to traumatic events and is commonly seen in therapists, social workers, attorneys, judges and persons who offer support and services to those who have had trauma.

The Diagnostic Criteria for PTSD are;

• The person has witnessed, was confronted with or in some way threatened with death or serious injury to the self or others.
• The response to this event or threat was intense fear, horror, anxiety, and or helplessness.

1. The events is then continually and persistently re-experienced in the form of imagery, thoughts, perceptions, the person may also experience frightening and recurrent dreams related to the traumatic event. The person will then attempt to avoid any associated triggers of the event and have an over all numbing and or a hyper-vigilance meaning they become hyper-aroused when exposed to triggers for the trauma. They also may have difficulty falling asleep, concentrating, regulating mood, and have an increased startle response. Individuals exposed to trauma may too are also at increased risk to develop mood disorders such as depression and are also at increased risk for developing substance abuse.

Treatment for Post-Traumatic Stress Disorder often involves Trauma Focused therapy with a licensed professional counselor or therapist as well as medication therapy in certain instances. Another form of therapy which has proven effective in clinical models is EMDR.