A Cup of Coffee – Agoraphobia: I can’t leave home.

Welcome back! Last week we asked, “Is Santa real?”. If you missed that blog and would like to catch up, click HERE.

This week, we are going to discuss a condition known as Agoraphobia. I had a special request for this particular blog, so here we go…

You may know a few people who have said that the pandemic has created a desire within to “just stay home and never go out again”. For some, this may be due to fear of getting sick, but for others, the pandemic may have triggered something a little more serious. Some will read this blog and recognize a condition that they are all too familiar with and have lived with for a very long time. Agoraphobia.

What is it?

The Mayo Clinic tells us that, “agoraphobia is a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd. People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fear can be so overwhelming that you may feel unable to leave your home”.

How does one develop agoraphobia?

Medical News Today states that “Agoraphobia can develop after a person has had a panic attack. A fear of further attacks, for example, may cause the person to avoid the kinds of situation in which the first attack took place. Though agoraphobia may follow panic disorder, the DSM-5 considers them separate diagnoses”.

What are the symptoms?

The Mayo Clinic can help us out here:

Symptoms

Typical agoraphobia symptoms include fear of:

  • Leaving home alone
  • Crowds or waiting in line
  • Enclosed spaces, such as movie theaters, elevators or small stores
  • Open spaces, such as parking lots, bridges or malls
  • Using public transportation, such as a bus, plane or train

These situations cause anxiety because you fear you won’t be able to escape or find help if you start to feel panicked or have other disabling or embarrassing symptoms.

In addition:

  • Fear or anxiety almost always results from exposure to the situation
  • Your fear or anxiety is out of proportion to the actual danger of the situation
  • You avoid the situation, you need a companion to go with you, or you endure the situation but are extremely distressed
  • You experience significant distress or problems with social situations, work or other areas in your life because of the fear, anxiety or avoidance
  • Your phobia and avoidance usually lasts six months or longer

How can I get over being agoraphobic?

Yes, you can! It may take some work, but all things worth having are worth working for, right?

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 the 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.

What if I don’t have health insurance and can’t access medication or therapy?

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.

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. It is best to join a group that is outside of your home, not online so that you have a good reason to leave your home.

Consult a doctor

This blog is not a replacement for sound medical advice, and many diseases, disorders, and syndromes have symptoms that overlap. Only a qualified medical professional can diagnose you. That said, if you think this blog may be helpful to others, please hit the Facebook Icon and share it on your personal pages. Thank you for reading us, we really do appreciate you!

See you next time!

That’s all I have for you this week, Dear Reader. Have a fantastic week, an amazing holiday for those who celebrate, and we will meet here again next Wednesday to share another Cup of Coffee.

Executive Director’s Note: Linda Tate will be on medical leave for the next two weeks. The Foundation will be running old blogs that haven’t been read in a while but were well received the first time around. We wish her a speedy recovery!

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