Help For Agoraphobia - Treatment for Agoraphobia

Written by HealthyPlace.com Staff Writer

MaryJ: Dr. Foxman, I am most interested in your CHAANGE program. I have been housebound three years and have no help. I don't know where or how to begin. I can't take much more of this and I am depressed all the time.

Dr. Foxman: Mary, you raise a few important points. One is the relationship between anxiety and depression. It is natural to become depressed when your life is so restricted, and when you are not in control of the anxiety. However, there is hope. The CHAANGE program is a 16-week course in learning how to overcome anxiety. The success rate is quite high, about 80 % based on patient self-ratings at the beginning, middle, and end of the program. You can learn more about the program from my book, Dancing with Fear, or by calling the national office at (800) 276-7800 and requesting a free information kit.

David: And that brings up another important point, and I know you are not a psychiatrist or medical doctor, but generally speaking, are anti-anxiety medications effective here in relieving the high level of anxiety and depression that many agoraphobics experience?

Dr. Foxman: My position on medications is that they can be helpful in the short run for controlling symptoms and enabling some anxiety sufferers to focus more effectively on learning the necessary new skills. However, medications have many pitfalls, such as adjusting the dosage to get a therapeutic effect, side effects, etc. I do not think medication is a good long term solution to anxiety. Even when they work, some people are fearful that their anxiety will return when they stop medications. I have had some patients come in with the presenting problem being fear of stopping medication.

David: We have some audience questions on whether a medical problem could have resulted in developing panic disorder. Here's an example, Dr. Foxman:

violetfairy: I have a personal question I hope you'll answer. I was a housebound agoraphobic for 3 1/2 years, then recovered (yay!). HOWEVER, I still experienced major disorientation often. (That was always what set off my panic attacks.) I found out I have a giant cyst in my sinuses and I'm going for surgery next week. It seems to me that this could cause a lot of disorientation (I am particularly disoriented whenever there are barometric pressure changes-- right before it rains). Can you tell me if it's possible that the cyst is what caused the panic disorder?

Dr. Foxman: Yes, a medical condition can trigger panic disorder. However, it is usually the anxiety associated with the medical condition that the person fears. In your case, it is the disorientation that was so distressing, and it sounds like you have developed a fear of disorientation which is a precursor to the panic feelings.

Tess777: I was in my 40's when I had my first anxiety attack, which was after I witnessed my husband having a gran mal seizure. Is it possible that could have caused it?

Dr. Foxman: Yes, you witnessed a "traumatic" event and that may have "scared" you. Once you had the "scary" feelings, you developed a fear of that happening again. Everyone should keep in mind that it is the anxiety that is feared in agoraphobia and panic disorder.

Dlmfan821: I have a terrible problem with feeling guilty. It used to be I was the one everyone could turn to. I have four children, all grown now, thank God, and now I have to depend on them and my husband. My husband was in the military for many years and we moved from one end of the country to another and since my husband was gone a lot, I took care of everything without a problem. Now, when it is supposed to be time for my husband and I to vacation, maybe go on a cruise, etc., I've ruined everything.

Dr. Foxman: I can understand your feelings of guilt and letting your family down. What may have happened is that you worked so hard taking care of your family that your stress level went into overload and you became symptomatic. It is not a permanent condition.

David: I'm sure that many agoraphobics and those with panic disorder, because of their self-imposed restrictions, are unable to go places and family members get very upset. 1) How would you suggest handling the guilt the agoraphobic feels and 2) then how do you deal with friends and family members?

Dr. Foxman: It is always important to maintain balance. When we go out of balance, we become symptomatic. Take it as a learning experience and focus on resuming balance by taking care of yourself. This means addressing your health needs: diet, proper rest, exercise. These are the basics of health and energy. If you are in a deficit due to being out of balance, it may take some time to restore your balance. Just work at it everyday and it will come in due time.

zeena: Can fear of driving be a type of agoraphobia?

Dr. Foxman: Yes, absolutely. Fear of driving is a common form of agoraphobia. However, it is not the car or driving that one fears. It is the anxiety that might occur in the car or while driving that one fears. It usually develops from having an anxiety experience while driving. Many of my anxiety patients say, "I don't get it it. I used to love driving, now I am afraid to drive or I avoid it." The issue, again, is fear of anticipated anxiety, not of cars or driving. The same can be said of other feared situations, such as travel, airplanes, malls, or even being alone. It is all about the fear of anxiety. ga

David: This is from Jean, who has severe agoraphobia. She says she has no family or friends. She is housebound, feeling desparate and developing physical problems. Is it possible to recover from agoraphobia on your own, through self-help?

Dr. Foxman: Yes, it is possible. But as I have been stressing tonight, it is important to have some guidance in learning the approrpriate new ways of thinking and behaving. Some people can learn on their own, using a guidebook or program such as CHAANGE. But most people benefit most from contact with a trained professional who knows what skills are important. Some anxiety therapists are willing to provide telephone counseling to the homebound agoraphobic. That could be a viable option.

David: I'm getting some questions about what if you can't afford therapy?

Dr. Foxman: Naturally, cost can be a factor. Consider using a structured guidebook, such as the Anxiety and Phobia Workbook, or my book, Dancing with Fear. Also, group therapy is an effective form of treatment for anxiety, and usually it costs less than half the fee for individual counseling. I run two anxiety therapy groups per week and find it powerful and gratifying.

The self-help strategies I mentioned earlier are low-cost steps that can make a significant difference. Also, consider a relaxation tape, daily yoga or other form of relaxation, and then use imagery desensitization to prepare for facing phobic situations.