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Stress and anxiety
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Help for agoraphobia
Originally Published: April 13, 2001
~ Last Updated / Reviewed on: March 03, 2006
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Dear Alice, I have suffered from agoraphobia since the age of thirteen. I am now twenty. I have tried hypnotherapy counseling and psychologists and herbal tablets, but nothing seems to help me. Please, can you help a young, outgoing twenty-year-old who wants to start living!
Dear Reader, Agoraphobia is a disorder characterized by intense anxiety about having a panic episode in places or situations from which escape could be challenging or uncomfortable. Some people experience agoraphobia as a fear that stems from not being able to receive assistance during an anxiety attack. For instance, many people with agoraphobia fear leaving their homes alone, being in a large gathering of people, being on a bridge, or riding in various vehicles.Agoraphobia frequently goes with other anxiety disorders, including panic disorder and specific phobias. Panic attacks are intense feelings of fear and often doom, which usually build and peak within about ten minutes of onset. Some of the most typical symptoms of a panic attack include:
These attacks can be terrifying and physically overwhelming. (People experiencing panic attacks often rush to the emergency room convinced that they are having a heart attack.) Sometimes the attacks are prompted by a particular experience, and sometimes they seem to come out of the blue. Once a person has had some panic attacks, they may begin to fear having one in public and thus develop an additional panic reaction to these situations, and therefore, agoraphobia. It's important to be as specific as possible when describing your experiences to your health care provider(s). This will help them to determine, with your help, what kinds of treatment approaches might be right for you. They're likely to ask you questions such as:
Also, keep in mind that although you may not have had much success with certain therapists or therapies, that doesn't mean that you couldn't find the right treatment with another therapist. Some possibilities that you may want to consider with your health care provider include cognitive behavioral therapy and/or medication. Research has shown these treatments to be very effective in treating panic attacks and agoraphobia. Cognitive behavioral therapy is essentially just what it sounds like: an approach that aims to change behavior by helping a person adjust his or her way of thinking. It often includes real or imagined exposure (in a protected environment) to the situations or triggers that cause the fear. Over time, a person can learn to understand and therefore manage the fear that comes with being confronted with the traumatic object or situation and identify what maladaptive coping mechanisms have arisen. In doing so, that person can develop new, more reasonable ways of managing stress. The National Institute of Mental Health (NIMH) reports that treatment can reduce or completely eliminate panic attacks in 70 to 90 percent of cases. (Early treatment can also help avoid the progression of panic disorder to agoraphobia.) The NIMH web site contains more information about treatment options and referrals to help find a therapist who specializes in treating agoraphobia. You can also contact the Anxiety Disorders Association of America for more information.Your persistence in seeking help is commendable. With your determination to get your life back, and a good therapist who's knowledgeable about your particular concerns, there is a lot of hope. If you're a student at Columbia, you can contact Counseling and Psychological Services (CPS) for a full assessment and referral for follow-up at x4-2878.
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