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.

Social Anxiety Therapy

Social Anxiety or Social Phobia

Social and anxiety or social phobia is a kind of anxiety disorder in which the person experiencing the anxiety is fearful of experiencing embarrassment in social situations. According to epidemiological statistics this disorder has a lifetime prevalence rate of as much as 3-13%. Researchers have also noticed a strong family component to this disorder meaning that social anxiety or social phobia occurs with more frequency in first degree relatives. The onset of this particular kind of anxiety disorder is often in the teen years and can sometimes result after having experienced humiliation an embarrassing social situation.

According to the Diagnostic and Statistical Manual IV, this fear is very marked and when a person thinks about performing, speaking, or interacting in a social situation they may notice the fear response and or anxiety onset immediately in the form of sweating, heightened heart rate, increased respiration as well as cognitive responses such as worry and fearful thoughts. The symptoms of social phobia are marked and the person experiencing them recognize that they are excessive fears. An example of social phobia or anxiety is that person is terrified that if they speak up in class that they may blush and others will then see it and laugh at them. As you can imagine this can cause impairment in academic functioning and in many instances the person will avoid the possibility of enduring such a response and could skip class or even drop out of school. Some individuals with a social anxiety may be able to face the feared situation with distress.

Treatment for Social Phobia often involves therapy with a licensed professional counselor or licensed therapist. Counseling has many clinically verified treatment methods which are scientifically validated to reduce the anxiety related to this disorder and help individuals experiencing social anxiety to live normal healthy lives. Mindfulness based stress and anxiety reduction techniques including integrative medicine, medication therapy, meditation, acupuncture, diet, and exercise may also be helpful in treating this anxiety disorder. Please talk to your medical or licensed mental health professional to see which of these would be the best option for you.

Panic Attacks and Panic Disorder

Panic Attacks and Panic Disorder

As many as 4.7% of people will experience a panic attack at some point in their lives, panic disorder is a form of anxiety disorder which can be extremely intense, many times individuals who have a panic attack end up going to the emergency room imagining that the rapid heart beat and dizziness are a heart attack. Symptoms and features of anxiety disorder according to the Diagnostic and Statistical Manual IV, laid forth by the American Psychiatric Association are as follows: To have experienced at least 4 of the following 13 symptoms;

Heart Palpitations

Trembling

Shaking

A feeling of smothering

Feeling of Choking

Discomfort or Pain in the chest

Nausea

Abdominal distress including a heightened need to urinate or defecate

Dizziness or Lightheadedness

Derealization or Depersonalization

Fear of losing control or a feeling that you are “going crazy”

Sweating, Chills or Hot Flashes

The symptoms of a panic attack are hallmarked by their sudden onset and intensity, unusually a panic attack has an onset in as little as 10 minutes. In example a person who has experienced a panic attack may say “I was sitting on the bus when all of the sudden I felt like I couldn’t breathe, it was like my throat closed up and I was choking but there was nothing in my mouth. I became dizzy and my heart felt like it was beating out of my chest, I started looking around and was going to cry for help. My fingers and toes felt numb and tingling, in a few minutes my heart slowed down a little bit but my stomach was really tight for hours after.”

As you can imagine someone who is experiencing a panic attack is suffering greatly. There are several different types of Panic disorder according to whether they are caused by a specific cue, such as public speaking or encountering an enclosed space such as the panic that can happen with claustrophobia. In other instances, panic attacks can be un-cued or non-specifically cued, this means that sometimes a person who has a panic attack may not understand what the trigger for their panic is until they seek treatment for the panic and uncover the deeper fears and how to manage the panic with their therapist.  A panic attack is differentiated from having a panic disorder which is to have had recurrent and unexpected panic attacks for a period of one month or more. Treatment for panic disorder are therapy, often most effectively Cognitive Behavioral Therapy, with a licensed professional counselor and also medication is sometimes the best treatment. Usually it is a combination of these two treatments which best helps to manage panic disorder. Untreated panic disorder can greatly reduce quality of life, leading to long standing feelings of guilt and shame and even agoraphobia.

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.

Therapy and Counseling, Treatment For Anxiety

Treatment for Anxiety

Treatment for anxiety takes many forms, there are generally three main agreed upon and clinically verified methods to manage and reduce symptoms of anxiety. Counseling or Therapy with a licensed counselor or therapist is the first treatment route. The treatment route for this form of help can vary from short term, brief solution-focused counseling interventions as well as long term treatment including cognitive behavioral therapy and even existential therapy. Only you and your counselor or therapist can determine which method will be best for you.

Other ways to manage symptoms related to anxiety are to enhance total wellness, this includes  integrative medicine, nutrition counseling, acupuncture, fitness, meditation, and mindfulness. Some people experiencing anxiety find that a holistic approach suites their lifestyle best, in turn they explore clinical herbalism and integrative interventions to learn how this can support positive emotional health and wellness. Holistic therapy is best utilized along with counseling or psychotherapy from a licensed counselor  which is therapy which will focus on finding triggers and changing the cognitive response to anxiety. The final way to treat anxiety is to use medication therapy. Medication has many different options including SSRI’s which must be taken for several weeks before taking effect and then other anxiolytic medication which is more short acting, talk with your psychiatrist or prescribing PCP to explore which form of medication therapy is the best for you to treat your anxiety. Medication often works best to diminish anxiety when it is paired with counseling and therapy which can change the thought patterns, discover underlying causes of anxiety and mange the full way in which it effects quality of life.

Remember that the worst way to manage your anxiety is by doing nothing at all in the hope that your symptoms will disappear. Managing anxiety is done best when we treat it early and completely with solid medical and therapeutic interventions.

Jackie Mandock, LPC, NCC

Jackie Mandock, LPC, NCC, LBSC, MH is a counselor at Counseling and Wellness Centers of Pittsburgh- Monroeville. She provides therapy to children, adolescents, families, couples, and adults. Jackie approaches therapy from a holistic perspective, always staying mindful of how the body, mind, and spirit are interconnected. Jackie is certified in trauma focused cognitive behavioral therapy and is trained in parent-child interaction therapy.  She has worked with many different concerns in these specialized populations ranging from attention-deficit hyperactivity disorder to trauma, as well as anxiety and depression. Jackie is also a licensed behavioral specialist with a strong background in autism.  Jackie was a school-based therapist and is familiar with school concerns and supporting educational issues. She is a graduate of University of Pittsburgh with a Bachelors in Psychology and Neuroscience and  from Chatham University with a Masters in Counseling Psychology. Jackie also has a Master Herbalist diploma from American College of Health Sciences.

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Counseling Pittsburgh

Our licensed professional counselors are here for the community offering evidence-based therapy, marriage counseling, family counseling,  child therapy, art therapy, premarital counseling, all by top rated clinicians. Our team of therapists has over 150 years of experience between us, we offer therapy to heal from Depression, Anxiety, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder, and our Couples Therapists can treat a full range of relationship issues from conflict communication, to intimacy enhancement, and parenting concerns. In all of our centers, we also provide a menu of comprehensive wellness services. We offer wellness support including health treatment options from our certified nutritionist, kinesiologist, clinical herbalist who specialize in offering the people of The Greater Pittsburgh and Western Pennsylvania communities providing wellness solutions for mind, body, and spirit. Be well with us!

Contact us at our Pittsburgh location 830 Western Avenue Pittsburgh Pa, 15233 Our Pittsburgh center is located in the northshore of the downtown Pittsburgh. Therapy near Northside, Southside, Brighton heights, Lawrenceville, Shadyside, Bloomfield, Strip District, and Mt. Washington. Our hours are from 7-am-8 pm  Monday through Sunday. We accept UPMC, Highmark, Blue Cross Blue Shield, United, Magellan, Aetna, and Comp Psych as well as Out of Network, Self Pay, and Sliding Scale options.

For a therapist near you – Call us at 412-322-2129

Counseling Monroeville, PA

Counseling in Monroeville at Counseling and Wellness Center of Pittsburgh our therapists are trained in a variety of specialties including Marriage and Family Therapists, Child Therapy, and Certified Nutritionist, Kinesiologist, Clinical Herbalist, and Meditation Instructor are proud to be Monroeville’s only Integrative Counseling Center. Our Counseling team include top-rated therapists with decades of experience in Mental Health and Marriage or Couples Counseling in Monroeville.

Our therapists serve Western Pennsylvania and our Counseling Center East is near you in Monroeville, Murrysville, Penn Hills, Plum, New Kensington, and Westmoreland County. We provide compassionate and scientifically validated therapy solutions specifically available for your emotional health and wellness. Our counselors treat individuals who are suffering from a broad range of mental health concerns such as anxiety, anger management, depression, chronic mental health diagnoses, trauma, bipolar disorder, late stage alcohol and substance abuse recovery, intimacy, life transitions, managing the emotional effects of a medical diagnosis, grief counseling, stress disorders, stress management, obsessive compulsive disorder, mood disorders, personality disorders, compassion fatigue, parenting, life balancing, postpartum depression and many more. Our child therapists help children who are dealing with bullying, trauma, grief, behavioral, and attentional disorders. The Counseling and Wellness Center of Pittsburgh has therapists with specialties in all ages and stages of development.

Some of the commonly treated disorders which can be helped by our Couples Therapy specialists are intimacy, communication, conflict, infidelity, parenting and co-parenting, as well as premarital counseling. Family counseling is also an option and our therapists have worked with families of all types and sizes including parent child, adult children and parents, step families, siblings, and grandparents.

As an integrative counseling center we utilize many approaches and offer solutions for emotional, relational, and physical health in our centers. Our counselors use cognitive behavioral therapy, mindfulness, humanistic, psycho-dynamic, and emotionally focused techniques as well art therapy for kids. We also have a wellness team to provide natural solutions to enhance well-being including herbalism, meditation, and nutrition counseling. In other instances we are glad to collaborate with psychiatrists and psychologists to provide continuity of care for those clients who hold psychiatric diagnoses. Please refer to our providers individual bio’s for a more comprehensive explanation of their professional styles, training, and educational backgrounds.

We accept many insurance companies including UPMC, Highmark Blue Cross Blue Shield, United, Aetna, and Cigna. Additionally and for your convenience we also accept HSA, credit and debit card for self paying clients. We staff therapists who care and who do offer the sliding scale so that all clients can access the mental health coverage that they need.

We do offer distance solutions at all of our centers and can provide counseling using Skype.

If you have a question about whether we have a counselor to treat your specific concerns and emotional needs, please send an email and we will be glad to let you know or answer any other specific questions or inquiries.

Counseling and Wellness Center of Pittsburgh is conveniently located at 2539 Monroeville Blvd, Monroeville, PA, 15146. We are in a freestanding building with a large parking lot attached to our center.

Call us at 412-856-WELL or 412-856-9355

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Monday 7am-9pm

Tuesday 7am-9pm

Wednesday 7am-9pm

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