How to help an agoraphobic
How to Help Someone with Agoraphobia
Living with anxiety can be stressful; having a loved one who suffers from an anxiety disorder can be just as challenging.
You may not completely understand how they’re feeling or what situations can trigger a panic attack. Helping someone with agoraphobia, for instance, requires an understanding of the disorder itself and how it affects people. The professionals at our mental health care in Boca Raton are sharing some tips on how to help someone with agoraphobia.
What Is Agoraphobia?
Agoraphobia is an anxiety disorder in which an individual becomes extremely terrified or panicked when they’re in a place or situation that would be difficult to escape from or where they wouldn’t receive immediate help. Agoraphobia is often confused with just the fear of open spaces, but it’s much more complex than that. People with agoraphobia might be frightened of public transportation, shopping malls, or being outside of their home in general.
Other individuals with this disorder may be afraid of being in crowds, elevators, or on bridges, whether walking or driving. Agoraphobia is often a complication of a panic disorder, which is a type of anxiety disorder in which a person experiences intense fear and terror that can cause physical and psychological symptoms like panic attacks. This isn’t to say that all individuals who have agoraphobia have a history of panic disorders or attacks; every case is different.
Common agoraphobia symptoms and signs include:
- Avoiding certain places or situations
- Stress or fear upon leaving the house or in certain situations
- Panic attacks in certain places or situations
- Physical symptoms like excessive sweating, trouble breathing, shaking, and chest pains during a panic attack
Individuals with agoraphobia often benefit the most from professional treatment. Because this condition can cause panic attacks and other physical and mental symptoms, it can be a difficult disorder to live with.
At Banyan Mental Health, we offer a residential mental health program that allows patients to live onsite while they receive treatment and learn how to cope with both immediate and hidden symptoms of anxiety disorders.
Tips on How to Help Someone with Agoraphobia
No one wants to go through life fearful of certain situations or places. Anxiety disorders like agoraphobia can be extremely debilitating and can diminish a person’s quality of life. This disorder can make a person feel as if they’re unable to go out on their own or not at all. Agoraphobia can lead to relationship problems and financial problems as well. A person with agoraphobia who does not receive anxiety treatment may struggle with additional mental health issues like depression and may turn to dangerous coping methods like substance abuse.
Learning how you can help someone with agoraphobia is important if you have a loved one with this disorder. While you can’t formally treat that person, there are ways you can provide support.
Learn More About Agoraphobia
The first step in helping someone with agoraphobia is to learn more about it. This is a complex disorder that’s often misunderstood. Many movies and TV shows also obscure our views of mental illness by portraying them in a false or comedic light. Learn more about the triggers of agoraphobia as well as its physical and psychological symptoms. Gain a new perspective about this disorder by reading articles, reading blogs, and watching videos by people who have it.
Learn How to Be Patient
Patience is the key to helping an individual with any mental illness. It’s tempting and very easy to lose patience with someone with agoraphobia, but learning more about this condition can help you empathize with the individual when they feel anxious. Losing your patience will only make them feel self-conscious about their condition, which may prevent them from reaching out to help in the future.
Don’t Push Them to Do Things They Don’t Want to Do
Anxiety is a real disorder; it’s not a joke.
Agoraphobia is much more complicated than a simple fear; you cannot “fix” this disorder by forcing someone to face their fears. It’s an elevated sense of terror. If you wouldn’t force someone with a fear of heights to go rock climbing, then you shouldn’t pressure a person with agoraphobia to take the subway.
Don’t Belittle Them
Not only is it difficult for this person to live with agoraphobia, but it may also be difficult for them to be transparent about their disorder with others. Whether it’s a spouse, friend, or family member, this is a person who has trusted you with their struggles. It’s easy to belittle or dismiss the person’s feelings if you don’t struggle with this disorder. Don’t say “get over it” or “toughen up.” This can be frustrating for a person with agoraphobia and it can prevent them from reaching out for help in the future.
Check In Regularly
Call them or visit them regularly. People with agoraphobia may stay inside for days or weeks at a time, which can be damaging to their mental health, physical health, and their quality of life.
Even if they aren’t in a situation where they’re fearful or experiencing symptoms of anxiety, you should contact them to let them know you care.
Go Out With Them
People with agoraphobia often avoid leaving their homes alone, so a good way to help someone with this disorder is to accompany them to the grocery store, doctor’s appointment, and so on. This will at least help them fulfill certain responsibilities and ensure that they’re well taken care of.
Help Them Find Treatment
Help them find treatment. An individual with any anxiety disorder should receive professional treatment. If you have a loved one with agoraphobia, you should help them find professional mental health treatment that can address the short and long-term effects of anxiety on the body and teach them how to properly cope with these symptoms.
At Banyan Mental Health, we offer a variety of mental health programs in Boca that are led by licensed therapists and staff with extensive experience in treating mental disorders like anxiety.
If you or someone you know requires treatment for a mental illness, call us now at 888-280-4763 to learn how we can help.
At Banyan Mental Health, we offer a variety of mental health programs in Boca that are led by licensed therapists and staff with extensive experience in treating mental disorders like anxiety. If you or someone you know requires treatment for a mental illness, call us now at 888-280-4763 to learn how we can help.
Agoraphobia - Diagnosis and treatment
Diagnosis
Agoraphobia is diagnosed based on:
- Signs and symptoms
- In-depth interview with your doctor or a mental health professional
- Physical exam to rule out other conditions that could be causing your symptoms
- Criteria for agoraphobia listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association
Treatment
Agoraphobia treatment usually includes both psychotherapy and medication.
It may take some time, but treatment can help you get better.
Psychotherapy
Psychotherapy involves working with a therapist to set goals and learn practical skills to reduce your anxiety symptoms. Cognitive behavioral therapy is one of the most effective forms of psychotherapy for anxiety disorders, including agoraphobia.
Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to better tolerate anxiety, directly challenge your worries and gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.
You can learn:
- What factors may trigger a panic attack or panic-like symptoms and what makes them worse
- How to cope with and tolerate symptoms of anxiety
- Ways to directly challenge your worries, such as the likelihood of bad things happening in social situations
- That your anxiety gradually decreases if you remain in situations and that you can manage these symptoms until they do
- How to change unwanted or unhealthy behaviors through desensitization, also called exposure therapy, to safely face the places and situations that cause fear and anxiety
If you have trouble leaving your home, you may wonder how you could possibly go to a therapist's office.
Therapists who treat agoraphobia are well aware of this problem.
If you feel homebound due to agoraphobia, look for a therapist who can help you find alternatives to office appointments, at least in the early part of treatment. He or she may offer to see you first in your home or meet you in what you consider a safe place (safe zone). Some therapists may also offer some sessions over the phone, through email, or using computer programs or other media.
If the agoraphobia is so severe that you cannot access care, you might benefit from a more intensive hospital program that specializes in the treatment of anxiety.
You may want to take a trusted relative or friend to your appointment who can offer comfort, help and coaching, if needed.
Medications
Certain types of antidepressants are often used to treat agoraphobia, and sometimes anti-anxiety drugs are used on a limited basis. Antidepressants are more effective than anti-anxiety medications in the treatment of agoraphobia.
- Antidepressants. Certain antidepressants called selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), are used for the treatment of panic disorder with agoraphobia. Other types of antidepressants may also effectively treat agoraphobia.
- Anti-anxiety medication. Anti-anxiety drugs called benzodiazepines are sedatives that, in limited circumstances, your doctor may prescribe to temporarily relieve anxiety symptoms. Benzodiazepines are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these drugs aren't a good choice if you've had long-term problems with anxiety or problems with alcohol or drug abuse.
It may take weeks for medication to relieve symptoms. And you may have to try several different medications before you find one that works best for you.
Both starting and ending a course of antidepressants can cause side effects that create uncomfortable physical sensations or even panic attack symptoms.
For this reason, your doctor likely will gradually increase your dose during treatment, and slowly decrease your dose when he or she feels you're ready to stop taking medication.
Alternative medicine
Certain dietary and herbal supplements claim to have calming and anti-anxiety benefits. Before you take any of these for agoraphobia, talk with your doctor. Although these supplements are available without a prescription, they still pose possible health risks.
For example, the herbal supplement kava, also called kava kava, appeared to be a promising treatment for anxiety, but there have been reports of serious liver damage, even with short-term use. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using any product that contains kava until more-rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.
More Information
- Cognitive behavioral therapy
- Psychotherapy
Request an Appointment at Mayo Clinic
Coping and support
Living with agoraphobia can make life difficult.
Professional treatment can help you overcome this disorder or manage it effectively so that you don't become a prisoner to your fears.
You can also take these steps to cope and care for yourself when you have agoraphobia:
- Stick to your treatment plan. Take medications as directed. Keep therapy appointments. Communicate regularly with your therapist. Consistency can make a big difference, especially when it comes to practicing skills and taking your medication.
- Try not to avoid feared situations. It's hard to go to places or be in situations that make you uncomfortable or that bring on symptoms of anxiety. But practicing going to more and more places can make them less frightening and anxiety provoking. Family, friends and your therapist can help you work on this.
- Learn calming skills. Working with your therapist, you can learn how to calm and soothe yourself. Meditation, yoga, massage and visualization are simple relaxation techniques that also may help.
Practice these techniques when you aren't anxious or worried, and then put them into action during stressful situations. - Avoid alcohol and recreational drugs. Also limit or avoid caffeine. These substances can worsen your panic or anxiety symptoms.
- Take care of yourself. Get enough sleep, be physically active every day, and eat a healthy diet, including lots of vegetables and fruits.
- Join a support group. Support groups for people with anxiety disorders can help you connect to others facing similar challenges and share experiences.
Preparing for your appointment
If you have agoraphobia, you may be too afraid or embarrassed to go to your doctor's office. Consider starting with a phone call to your doctor or a mental health professional, or ask a trusted family member or friend to go with you to your appointment.
What you can do
To prepare for your appointment, make a list of:
- Any symptoms you've been experiencing, and for how long
- Things you have stopped doing or are avoiding because of your stress
- Key personal information, especially any significant stress or life changes that you experienced around the time your symptoms first developed
- Medical information, including other physical or mental health conditions that you have
- All medications, vitamins, herbs or other supplements you're taking, and the dosages
- Questions to ask your doctor so that you can make the most of your appointment
Some basic questions to ask your doctor may include:
- What do you believe is causing my symptoms?
- Are there any other possible causes?
- How will you determine my diagnosis?
- Is my condition likely temporary or long term (chronic)?
- What type of treatment do you recommend?
- I have other health problems.
How best can I manage these together? - What is the risk of side effects from the medication you're recommending?
- Are there options other than taking medications?
- How soon do you expect my symptoms to improve?
- Should I see a mental health professional?
- Are there any printed materials that I can have? What websites do you recommend?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:
- What symptoms do you have that concern you?
- When did you first notice these symptoms?
- When are your symptoms most likely to occur?
- Does anything seem to make your symptoms better or worse?
- Do you avoid any situations or places because you fear they'll trigger your symptoms?
- How are your symptoms affecting your life and the people closest to you?
- Have you been diagnosed with any medical conditions?
- Have you been treated for other mental health disorders in the past? If yes, what treatment was most helpful?
- Have you ever thought about harming yourself?
- Do you drink alcohol or use recreational drugs? How often?
By Mayo Clinic Staff
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What is agoraphobia and how people live with it
Alena Agadzhikova has agoraphobia: she is afraid to leave her apartment and find herself in an unfamiliar place.
Alena decided to conduct an experiment by placing herself in uncomfortable conditions. PR manager Dasha Tikhomirova agreed to do the same. Both girls kept diaries in the "here and now" format. Afisha publishes them along with a psychotherapist's commentary.
What is agoraphobia and where does it come from?
Agoraphobia is supposed to be the fear of open spaces. In fact, it is both the fear of not being able to immediately leave a place or situation, and the fear of being away from home. The discrepancies are due to the fact that at the time of the introduction of this term into psychiatry, there were no typical agoraphobia triggers for the modern world: public transport, passenger planes and shopping centers. Maybe in the time of Karl Westphal (a German psychiatrist and neurologist who lived in the 19th century, the author of many psychiatric terms. - Note ed. ), who first described agoraphobia, the open spaces of the piazzas were as unpleasant as our subways are now at rush hour.
Agoraphobia is now commonly referred to as the fear and avoidance of independent movement outside the home (or other safe place).
The disorder arises from a predisposition to anxiety and psychological factors. The latter, according to the British Ministry of Health, include: sexual abuse (especially in childhood), bereavement, divorce, job loss, anorexia or bulimia, alcohol abuse, being in an unhappy relationship or in a relationship with an over-controlling partner. In national studies of various Western countries, figures from 1.3 to 3.5% of the prevalence of agoraphobia in the population appear. Anxiety disorders are diseases in the development of which a genetic predisposition factor plays a relatively large role, so their incidence is approximately the same in different countries of the world. Based on this, it can be assumed that in Russia, about one in 50 people is also subject to agoraphobia.
Most people with agoraphobia begin with panic attacks in public places.
For many, a panic attack is one of the worst emotional experiences of a lifetime.
The strongest fear is instantly associated in the brain with the place where this event occurred. When you visit it again, the deep parts of the brain responsible for the fear reaction (in particular, the amygdala) are activated again and further strengthen this conditioned reflex connection. In the future, fear can spread to other places similar to the first in some characteristics: for example, it becomes scary to be not only in the supermarket on the minus the first floor where the first panic attack occurred, but also in all public places where you need to go down to escalator. If a person knows what kind of sensations await him in such places, he begins to avoid them. It turns out that he actually avoids not public places, but his own emotional reactions and difficult to bear bodily sensations that arise there . Sometimes a person can have both claustrophobia (fear of enclosed spaces.
- ed. note ) and agoraphobia. There are no contradictions here: a common place in these states is the fear that it is impossible to instantly get out of the situation and find yourself in a “safe” place. And both the crowd on the street and the closed elevator doors can prevent this.” nine0003
What happens if a person with agoraphobia confronts their fear?
Situation
Plan: take the subway two stops. I definitely won't do it anymore. One is not interesting, because I want to live the moment when the train stops, the doors open, and I don’t run out and go on. The last time I was on the subway was about a year and a half ago when I was trying to get out of my comfort zone and train myself. Before that, I had not been to the subway for about two more years. Agoraphobia began in me during an exacerbation of an anxiety-depressive disorder, which I have been suffering from for several years. In general, panic attacks have been with me all my life: they appeared and left, I felt bad on the subway or on the street, but I coped without medication, because there was no choice - I hid these conditions from relatives and friends, I was ashamed.
Now I have been seeing a psychiatrist for three years now, I visit a cognitive-behavioral psychotherapist once a week, I drink a “cocktail” of antidepressants and tranquilizers. nine0003
Beginning
I usually become anxious about going out as soon as I know it is necessary. This may be the decision to go to a cafe with a friend, the need to go to the doctor without her husband, and anything else. Anxiety increases on the eve of the event. This manifests itself in hyperventilation (frequent shallow breathing. - Note ed. ), stomach cramps, dizziness, pain in general in all muscles of the body, tachycardia. That's what happened this time as well. nine0003
When Alena invited me to participate in the experiment, I was horrified. I immediately began to choke, the muscles of my forearms cramped.
Further, as a rule, the same thought loops in the head, which is almost impossible to get rid of. Now this is a picture of how I cannot get out of a subway car during a panic attack.
Such situations happened to me more than once, and they merge into one terrible scene at once. A panic attack sets in, I restrain it with all the methods known to me: I touch objects, listen to smells, count colors, stretch my feet. Fear drives me crazy and makes me depressed. It is at such moments that the desire to commit suicide escalates to a maximum. nine0003
Preparation
In order to fool my brain, I have developed a system of rituals that helps reduce anxiety to a level that allows you to even step over the threshold of the house. Here they are: wash your hair, style your hair beautifully, carefully choose clothes. Then I start putting on makeup. These are my ways of putting extra armor on my body to protect myself from the outside world. In addition, this is a rather meditative process that requires concentration. Anxiety has less space in the mind. In parallel, I think about all the options for the development of events and convince myself that none of them will lead to my death.
nine0003
So, I carefully put on makeup, dressed up, admired the new coat and pink shoes, checked if clonazepam (an antiepileptic drug, used by a doctor. - Note ed. ) was in place and whether it was enough (I usually wear a minimum three tablets, although a quarter or half is enough to relieve a panic attack). She said all the options: I have an attack, I'm shaking, I can't breathe, I grab onto all the surrounding objects, everyone is staring at me, it gets dark in my eyes, my legs buckle, I dream of losing consciousness, nothing helps, the train gets stuck in the tunnel, I feel even worse, clonazepam does not help. I run up to the car doors to run out, as soon as they start to open, my legs give way, I lie down and sob. I countered: “You know that you don’t die from a panic attack!” People around are not evil: they will either sympathize or not pay attention. Someone can offer help. It gets a little better. nine0003
Climax
I alone could not decide to accomplish this little feat, I asked my husband to take part in the experiment.
My husband is getting dressed, I am furious because it seems to me that he does it too slowly. When the inevitable is near, you want it to happen as soon as possible. We go out into the street, my husband tries to distract me with conversations on external topics. When he sees that it does not work, he starts asking questions so that I can express my feelings. He pronounces all the ways of salvation: we can go home at any moment, we will be very close to home, so it will not take much time. If it gets bad, bury yourself in me. We continue to walk: I am surprised how the road to the metro has changed (new paths, fences), the area in front of the metro (a mini-square with benches has been broken!), the entrance group (like fashionable). nine0003
Coming down. I feel my leg muscles contract, it hurts to walk. I turn off consciousness, something like depersonalization sets in. It’s as if I’m watching from the side as the girl Dasha applies the ticket, stands on the platform.
The train is coming. Once I enter it, it will be impossible to escape. I start crying (this is another tension-release mechanism recently discovered by accident). In front of the car doors, I say: "NO!" I take my husband by the arm, I feel that now I will collapse.
All muscles are so cramped that it is almost impossible to walk. Breathing is impossible. Hands and feet are icy, palms are shaking, sticky with sweat. nine0003
People squint, we quickly leave. I feel like I'm sweating through, right down to my beautiful blue coat. The scarf is pulled off, it is unbearable to feel something on the throat. I'm very hot, we're walking back down the street. It's cold outside, but I can't button up.
Walking is still very painful, you have to walk slowly. Gradually, the panic passes, and a feeling of devastation remains. I start to get cold, I wrap myself in a scarf, I overcome the rest of the way in silence, my sadness becomes somehow flat, I hate and despise myself. I try to feel sorry for myself, but it doesn't work. I feel ashamed in front of my husband. nine0003
When I get home, I immediately take off all my clothes, wash off my make-up, and get under the covers. It’s not easy to relax, I put clonazepam under my tongue. I feel nauseous, the muscles gradually relax, but continue to whine. My head hurts. Even drawn curtains let in too much light. I wrap myself up in a blanket very tightly, put on a mask over my eyes and fall into a viscous disturbing dream. When I wake up, I continue to feel nausea, headache, dizziness, anxiety returns, but drinking clonazepam again means falling asleep again. I'm trying to disperse, eat something, breathe. I turn on the Colombo series: I know all the episodes by heart, but nothing new comes out of watching in this state. "Colombo", "Poirot" and "Harry Potter" are stored on the computer in the "Eternal" folder - I turn them on randomly in any incomprehensible situation. nine0003
For the next two days I continue to experience headaches and muscle pain, it is difficult for me to concentrate, I feel moral devastation, frenzy.
I cancel all the few things I do, eat, take care of myself, lie under the covers, correspond with the psychiatrist, note that this time I have gone much further than before (for example, often I just cancel the meeting after not coping with anxiety), praise myself for the fact that I learned to stop in time and decided to try it in general. I believe that everything will be fine. nine0003
Afterword
Actually, my life is not so terrible. I learned to build it by avoiding trigger situations. I almost never go to public places, but I can go to a concert or a restaurant if my husband is with me or not far away. I communicate with friends by inviting them to visit or coming to them. I go to the doctors by taxi. Previously, this was also difficult for me, but now I almost do not experience unbearable anxiety. I see progress in treatment and thank myself for every small step in overcoming myself and the disease. nine0003
13:00. Flight from Moscow to Prague
It's so gray outside that you don't want to live.
I'm going in a taxi to Sheremetyevo. I'm horrified: I'm late for the flight, and my anxiety is going through the roof. I thought that after two flights in my life, in which I was naturally delighted with air pockets and felt as safe as possible, there would be no more fear. But he is.
“What if the plane leaves and I stay at the airport? I will have a panic attack, I will lie on the ground, everything will go dark in my eyes, as it was once in the subway. Will have to call an ambulance. Don't care what people think! I don’t give a damn about the fact that at such moments my body becomes icy from the inside, and I almost can’t speak.” Great thoughts! The most it is before the flight. nine0003
I see terminals somewhere in the distance. So maybe I won't be late. When I have such anxiety, my intestines weaken. This is probably the most socially disturbing thing for me. Lying in the middle of the crowd is still all right, but crap yourself... We are approaching. I am not late. Glory to Gagarin.
I am sitting in the airport lounge. I was not late, although I could. It seems that I need to listen to my mother more, even if she gets on my nerves with her catastrophizing. Behind the glass are airplanes. The condition, despite yesterday's gin, is quite tolerable. Probably worth saying thanks to phenazepam (drug, taken only as directed by a doctor. - Note ed. ) and herself. Two years ago, the mere thought that I would be flying in an airplane plunged me into a state of acute panic. Imagine that I am sitting here, drinking water without gas, and even one ... Show me such a photo of me before, I would definitely say that this is photoshop. And angry: "I feel so bad that I can't fly anywhere, and you're kidding!"
Beginning
It all started at 10 years old. Then I started having panic attacks. Nobody knew what was happening to me: they took me to church, to a fortune-teller, once they took me to a district psychiatrist - he refused to accept "without taking into account", requested a bribe and prescribed Novo-Passit (a sedative of plant origin.
- Note ed. ) . As a child, I didn’t know what was happening to me: just one night I suddenly started shaking, and it also seemed that my head was going numb. Further - as if in a fog: unbearable horror and fear. Fear of death? No, I was not afraid to die, I knew that I was not dying. Fear of losing control? More like the truth. nine0003
Fear of fear, fear of this uncontrollable shaking, numb hands, growing terror? Yes.
I recently had five CBT sessions. The psychiatrist said that panic disorder develops into agoraphobia most often in those alarmists who do not have a specific phobia. In other words, the fear of death, the fear of social condemnation, the fear of a stroke are things that are less likely to lead to the fact that you will be afraid to be far from home. But the feeling of the impossibility of experiencing this difficult state, concentration on it - this is exactly that. nine0003
Panic disorder was followed by OCD (an obsessive-compulsive disorder in which a person has obsessive thoughts, memories, movements and actions, as well as various fears.
- Note ed. ). For OCD - an anxiety-depressive disorder (a disease in which a person experiences both anxiety and depression without a clear dominance of one of the conditions. - Note ed. ). It's me now, examined by psychiatrists and undergoing psychotherapy, I know what's wrong with me. And then, ten years ago, information came in pieces and through the Internet. nine0003
My life underwent a major change when I suddenly became terribly afraid of being away from home. I remember at the age of 14 I stayed with my boyfriend on the other side of Moscow. It was night, neither he nor I had any money. He fell asleep, I didn't. And suddenly a familiar horror began to seize me, the back of my head began to go numb. It was cold outside, the lanterns were burning with a nasty yellow light. I became incredibly sad and scared. I thought: “What should I do if I want to go home right now? How can I get home RIGHT NOW, because the subway does not work, there are no buses, my parents will not understand me if I call and ask in a panic to pick me up.
WHAT SHOULD I DO?" Panic thoughts began to come one after another. I was shaking. I was afraid to wake up the guy, because he, like me, did not know what was happening to me, so he would twist his finger at his temple. nine0003
I lay there unable to move, thinking of all sorts of crazy ways to get out of the house.
Here I imitate pain in my stomach and call an ambulance, but no, the ambulance will not take me home, but to the hospital... Here I am borrowing money from friends, but from whom? Everyone is asleep. Yes, and how to explain what urgency is? Morning has come. I didn't get any sleep. All day long she walked in a fog, periodically plunging into panic attacks and gritting her teeth.
Worsening
Over time, these attacks became more frequent. It became difficult for me to travel out of town. Already on the bus, I began to think: “What if I want to get off the bus right now? I can't do that. And if I do, where should I go?" The image of me in an unfamiliar area, unable to move, firmly settled in my head.
I began to avoid traveling anywhere. The next nightmare was the subway. A train stopping in a tunnel is the worst picture that has remained with me so far. nine0003
The quintessence of a situation that cannot be influenced. I was lucky to get both claustrophobia (fear of closed spaces) and agoraphobia. Every time a train gets stuck in a tunnel, I sit for three or four minutes, and then I start thrashing about. I imagine how I break the windows, how I get out. It becomes hard to breathe, there is a feeling that my own horror will eventually drive me crazy. My dream when the train stops in the tunnel is to faint and wake up when it is already at the station. nine0014 But, unfortunately, I fainted only a few times and in other circumstances.
At the age of 20, I started treatment - antidepressants, therapy. If I had started it earlier, at least four years, much could have been avoided. It would be easier to overcome the same agoraphobia. My social capital would be even greater, the number of accumulated impressions too.
But right now it's a sin to complain.
Boarding begins.
I try to take a deep breath and realize what work has been done over all these years. nine0003
15:25. I'm on the plane
We took off. I smile and fall asleep. This is my third flight in my life and the first in the evening. It's so great that there is no light in the cabin and you can see the glow of the blue horizon of clouds - like Kuindzhi in the picture. It feels like all the problems have remained below, under the clouds, and I am cradled in a warm cradle. Something that, as it seemed to me for many years, can drive me crazy, gives a feeling of happiness and peace. I feel light and relaxed. I can not continue to write, a strong drowsiness attacked. I'll sleep. nine0003
Did not sleep. We are flying over Vilnius. I would like to visit Vilnius. And everywhere, since now I can fly.
How did it happen that I started flying? My beloved person moved to Prague. My best friend has been living there for the eighth year now.
And so I won a grant covering flights, accommodation and study for a month in Prague. I, in fact, had no internal choice: either now or never.
First flight
On the eve of the first flight, I was shaken from the very morning. Parents followed. Most of all, I was afraid of waiting. The flight itself is not very good, I am not afraid of heights and death. I will die and die. Now it seems to me that death from a fall is far from the worst option. It's beautiful, and in the chest everything will go to the end. But then I was shaking because I was afraid of panic at the moment of waiting, fear of fear. A tranquilizer and awareness of what was happening helped me. Here I am registering. Here is passport control. Here I am laying things out at customs. And here - wow - I'm in the green corridor. It made me laugh that this is technically a "nowhere" zone. I prepared myself for the worst: "Land the plane, call the paramedics" . But - as is almost always the case - my catastrophe was overdone.
Yes, I was shocked, yes, I felt anxious. But all this is at the level of tolerable. I think it was largely because the people I loved met me in another country.
My worst recurring dream looks like this. I find myself in a foreign country where everyone speaks an incomprehensible language. I don’t know where to go, and when I try to ask passers-by, only a wheeze comes out of my mouth. Those around me shun me, and I sit down on the ground and cry as the waves of horror roll over me again and again. nine0003
In my dream I want to go home. The house is my apartment. My bed.
I remember a real incident from my childhood that reminds me of this dream. One day my mother took me to the market and quickly went ahead. I looked at the bright counters and lost sight of her. I started looking around, I felt dizzy, I wanted to call my mother, but for some reason I became afraid and ashamed to open my mouth. An unforgettable feeling in the worst sense of the word: a five-year-old child lost in the whirlwind of the market.
When my mother saw me in the crowd, she pulled off her jacket by the sleeve and loudly, harshly scolded me. So she expressed fear. nine0003
18:15. Prague
We sat down. I like it when people clap for the pilot, even if many people think it's ridiculous, they say, thank you for being alive. And I rejoice in this fact. Even in the cockpit it is very beautiful and the control of the aircraft seems to me some kind of impossible action. Pilots are cooler than gods - so why don't they clap?
End of the journey. Return flight
Three weeks have passed since I last opened this text. During this time, a lot has happened. Outside the window - minus 54 degrees. I'm flying to Moscow. During takeoff, it seemed to me that something bad was going to happen. This is my fourth flight. In the past, I was very proud of the fact that I like air pockets and pitching. This time I was almost thrown into a panic because we failed in the second minute of takeoff.
I felt dizzy, sweat appeared on my forehead, then the plane somehow spun and spun, and the magnificent clouds outside the window did not calm me down a bit. In one second, I imagined that I was losing control of myself: that I was starting to cry, I was hysterical, or I was silent like a fish. I'm not afraid that others will see it. This state itself is terrible: cold, I am locked in my own body and I can hardly speak. And people with their anxious faces scare even more. nine0003
Do you know how I spent the last ten days? "I" is ironic. Lying at a friend's house because I broke my leg. What I feared most of all, not traveling until 25 years old, happened - I seriously injured myself in a foreign country. If my loved one and best friend were not in Prague, I don’t know what state my psyche would be in, even though I drink an antidepressant. On the seventh day I had a panic attack. Nightmares began to occur: now I can’t fly away from the country, here I am lying and silent, before my eyes there are terrible pictures, some figures with gouged out eyes.
I plunge into my own panic, nothing distracts me, I feel insane and losing control. nine0013 And again this feeling of being locked in the body. Perhaps this is where agoraphobia and claustrophobia are similar: a deep-seated feeling of being unable to do anything. Moreover, the impossibility is not real, but internal, phobic.
Adrian (Alyona's favorite person, to whom she flew to Prague. - Note ed. ) is sitting next to him in the plane and drawing. Outside the window is a bright sun and curly clouds. In the morning, my mother sent photos of the frozen trees of South Butovo and signed: "Beauty!" nine0003
All I dream about is to enter my clean house in the middle of an icy country, throw away my crutches, crawl under the covers and watch Homeland until I feel comfortable and at home again.
Is this progress? Definitely. Can you travel if you have agoraphobia? Of course. Whether you are 20, 30, 40 or 50 years old. It won't be easy, but the very fact that "it will be" will help to move away from the feeling of uncontrollable inevitability.
Can agoraphobia be overcome?
Agoraphobia can take on a progressive character, over time taking away more and more freedom from a person, compressing his comfort zone to the limits of an apartment. This can happen when a person unquestioningly obeys orders dictated by fear. Unfortunately, doctors' appointments in state medical institutions often have a disabling effect. The average psychoneurologist in a polyclinic or PND is most likely to prescribe phenazepam for anxiety disorder, which relieves panic attacks situationally, but in the long term causes addiction and becomes another form of avoidance. nine0003
Since agoraphobia is almost always a consequence of panic attacks and serves as a means of avoiding them, treatment should be aimed at coping with panic disorder. The first line of therapy, according to international recommendations (American Psychiatric Association and British National Health Service), should be one of the following methods: cognitive behavioral therapy or a course of taking an antidepressant of the SSRI group (selective serotonin reuptake inhibitors.
- Note ed. ). Considering that cognitive behavioral therapy provides a more stable effect and requires only short-term work (8-12 sessions), we at the clinic recommend this option to most clients.
Let me tell you a little about the content of psychotherapy. Cognitive theory considers a panic attack primarily as a consequence of an incorrect assessment of bodily symptoms: "If my pulse is more than 130, then something is wrong with the heart"; “I feel dizzy, so I can lose consciousness”, “The world around me looks strange - I must be going crazy”, etc. At the first stage of work, we identify these erroneous interpretations and replace them with more rational ones, teaching the client basics of normal physiology. This allows you to neutralize a significant part of the experiences. nine0003
After some time, we encourage client to deliberately evoke fear and experience it in the safe environment of a therapy session. This is the key moment of treatment.
A person who decides on exposure (intentional immersion in fear) forever changes his attitude towards panic attacks. He learns new knowledge: that unpleasant bodily symptoms are not a threat, that a panic attack should not be fought in any way, it does not need to be saved from it, because it passes by itself. And after that, we actually work with agoraphobia. After going through the first exposures, the client already understands that the panic attack is actually not as bad as it seemed before; at this stage, he is already ready to conduct sessions outside the office, in public places that frighten him - first accompanied by a therapist, then on his own. nine0003
I metaphorically imagine agoraphobia as some kind of evil entity that tries to stay in the host organism as long as possible with the help of threats and cunning like a parasite.
Since lies and manipulation are her main weapons, it is unlikely that she will be able to outmaneuver her with the help of any tricks: she reads your intentions three steps ahead.
Only one remedy is effective: stubborn, systematic disobedience to her demands. You can make this task easier for yourself: find, for example, through some forum on anxiety disorders, a person in your city with a similar problem and train in independent exposure together. You can challenge each other with visiting various public places. Mutual face-to-face support from someone who knows firsthand about your difficulties is powerful medicine. nine0003
A loved one with agoraphobia needs to find a certain balance: on the one hand, give him enough emotional care, on the other hand, try to less indulge his avoidance. The gradual, jointly planned rejection of ubiquitous accompaniment and the transition to independent travel outside the home is an essential component of psychotherapy.
Agoraphobia - symptoms and treatment of agoraphobia in Kyiv
Agoraphobia: what does it mean, what are the main signs? nine0218
Agoraphobia is an anxiety-phobic disorder characterized by fear, panic attacks, anxiety due to being in such circumstances or places where it is not possible to leave them now and unhindered.
Agoraphobia in translation means “fear of the market, shopping area”, that is, a large, crowded open space and similar situations, crowds, being away from home, etc. Anxiety-phobic disorder prevents a person from adhering to a normal lifestyle, restricts him in work, personal life, leisure, since it is difficult for a person suffering from agoraphobia to leave the house. nine0003
A trip to the subway, a trip to the supermarket, to study is accompanied by increasing panic and an inability to soberly assess the environment. In people prone to panic attacks, agoraphobia is more likely to manifest as an accompanying symptom.
Fear of open spaces can also be manifested by other phobias, for example, fear of open doors, crowds of people. In combination with agoraphobia, an anxiety disorder can develop, manifested by a constant fear of being shamed, ridiculed in society, and a persistent anxiety disorder that is not associated with specific objects or situations. nine0003
Symptoms of agoraphobia
Phobia manifests itself unconsciously as a defense mechanism of the organism.
This disorder can be obtained in real life due to fear for something, fear of something related to people and emotional and psychological trauma, strong emotional upheavals.
Phobia is often accompanied by other obsessive states: fear of enclosed spaces, fear of getting sick, obsessive fear of loss of loved ones, self-control, anxieties caused by thoughts of death, etc.
An obsessive state is often accompanied by depression and panic attacks, as well as autonomic regulation disorders: a feeling of rapid heartbeat, lack of air, attacks of heat or a feeling of trembling, cold throughout the body, a feeling of a foreign object in the throat and heaviness in the chest.
Many people who suffer from such an obsessive state understand its strangeness and think that there will be nothing terrible when they leave the apartment. But a person cannot do anything with himself, since phobic states cover him every time, one has only to think about the need to go outside. nine0003
Causes of agoraphobia
Phobias most often develop during adolescence, but also occur in adults.
The etiology of phobias can be a psycho-emotional trauma that is associated with people or situations that occurred outside the apartment (attack, accident, terrorist act, etc.).
The disease can also be due to panic disorder, manifested as:
- fear of fear. When a similar situation repeats, a person experiences a panic attack. As a result, there is a fear of a situation that he will avoid in every possible way, fearing repetition of panic attacks; nine0245
- conditioned reflex. A person automatically begins to experience anxiety, phobias, panic, only approaching the place where this fear has already been experienced.
The patient, going out into the street, is faced with a strong attack of inexplicable anxiety, an incomprehensible feeling of an impending catastrophe. This condition is accompanied by a release of adrenaline, an increase in blood pressure, a person is able in such a situation to lose self-control, faint, start screaming, run away in an unknown direction.
Over time, the number of factors provoking fear only increases, panic attacks become more frequent, the patient avoids leaving his apartment in every possible way. nine0003
A person with agoraphobia is often withdrawn, which hinders timely therapy, turns the treatment of anxiety disorder into a long and complicated process.
How to treat agoraphobia?
The treatment of agoraphobia includes several effective methods: psychotherapy, drugs for drug correction, a modern rehabilitation method of therapy through biofeedback.
Methods of individual psychotherapy are an important step in the fight against anxiety disorder. Cognitive-behavioral treatment allows you to realize that everything that happens to a person, his feelings and phobias at the moment of panic are the result of perception, and not the situation itself. The treatment also uses auto-training, suggestive psychotherapy (for example, non-directive hypnosis based on the technique of hypnotic suggestion and induction into a trance).
Medications alleviate the clinical picture of the disease, but it is necessary to fight the causes of agoraphobia, with which psychotherapeutic techniques and biofeedback therapy will help get rid of. nine0003
Treatment by a psychotherapist is aimed at solving the following problems:
- awareness of the root cause that causes an anxiety state, a panic attack;
- teaching a person skills to prevent or stop anxiety, panic;
- mastering the skills to control breathing, heartbeat and other physiological indicators;
- elimination of distortions in thoughts, development of positive thinking, the ability to adequately perceive the situation. nine0248
Medications can help alleviate the symptoms of pathology. Therapy for agoraphobia, depending on the patient's condition, may include psychotropic drugs to correct anxiety, muscle relaxants, analgesics and anti-anxiety pills to relieve phobias, panic attacks, as well as sedative pharmaceuticals.
How to deal with agoraphobia?
Agoraphobia is the result of psychological problems, the ignorance of which leads to social isolation, behavioral disorders, alcohol anosognosia and depression. Highly qualified specialists of the Verum expert clinic know how to defeat panic attacks, achieve stable remission, and overcome such an anxiety-phobic condition as agoraphobia. nine0003
Biofeedback treatment is an innovative non-drug treatment for mental disorders. By means of a computer program, the patient can be taught to control physiological parameters: heart rate, respiration, blood pressure, muscle relaxation. Such skills allow you to cope with panic, stress and anxiety in difficult situations, stop a panic attack in time.
The doctor chooses the therapy for each patient individually, taking into account the symptoms, time of onset, severity of the disease, age, sex of the patient, concomitant diseases. Detailed recommendations on how to cope with a mental disorder will be provided by the attending physician.
