Agoraphobia and Treatment

Leaving my house gives me the tingles. Agoraphobia is defined by an extreme or irrational fear of entering open or crowded places, leaving one's home, or being in places from which it's difficult to escape. 

By the end of this video you'll know what agoraphobia is and what I tell my patients on how to treat it. 

It's theorized that agoraphobia starts when an individual has one or more panic attacks, causing them to worry about having another attacks and avoiding the places that it happened. The thing about panic however is that it can happen anywhere and the brain is soooooooo good at remembering the places. It sends out the signal that those places are dangerous. People start realizing that their world starts shrinking and shrinking and shrinking. I can't go to grocery stores any more, gas stations are out of the question, driving is a no-no, the last social event caused me to panic, those are out. Forget flying or any type transportation because I cannot get out if I start to panic. 

You know the safe place to be. Home. I don't panic at home. What ends up happening is that this magical illusion that home is safe becomes a reality. If the person attempts to leave, even to get the mail, they panic because....they've told themselves that home is safe and WHY ARE YOU NOT IN YOUR HOUSE! How about I give you a panic attack to set you strait. 

You can see how difficult this can be for someone. Why panic if we don't have to. Even at the expense of others and missing out on life. 

It's not only panic that sets in, but various physical symptoms. Chest pains, chills, diarrhea, feelings of choking, feelings of unreality, nausea, numbness, rapid heartbeat, shortness of breath, sweating, and shaking. Yikes, with all of these physical symptoms after leaving the house, why would you. 

Typically agoraphobia doesn't just start overnight. It's a longer process of eliminating the places, people, things around you. 

So how do we get out of this sticky mess! The most effective treatment that works for agoraphobia is called exposure and response prevention.

Essentially, you are facing your fears, sensations, panic, and anxiety. Most start slow. They write down all the places they would like to revisit and go and rank them from easiest to go to, to hardest. The ideas is to start getting yourself to that place, but in the right way.

Here is what I mean. If my goal is to get to the mailbox. I may be focusing on sitting on my front porch and noticing how much distress or panic this brings. I need to sit on my front porch, feeling all the feelings, and respond differently to them. If panic attacks happen. Great! We don't run. We don't fix. We sit with the feelings. Some may even say, "yep" there is the panic attack. Sweet, it may last forever. Focusing on taking all this value away from it. Panic isn't the enemy. Your body thinks it's keeping you safe. The panic and distress have to go down. When the distress levels go down, you haven't done any compulsions and you've responded completely differently, some may walk inside for a few minutes and then do it again. 

Repeat until the distress levels just simply don't rise as much as they used to. Then, the person chooses to move closer to their goal. Maybe it's sitting in their yard. Read a book. Be there. Again, not fixing, not running, embracing the feelings. You then move closer and closer. Each time this process is done, the brain learns who's the boss. You are the boss. We repeat this for everything on the list. 

Ultimately, it's accepting that there will be panic. But it can't hurt you. You can teach it that you're cool with it. Physical symptoms can happen, but you're staying put. It can feel like a tough process, but I find that the anticipation of doing these exposures tends to be worse than the actual thing. 

You need to learn to respond the correct way with these panic attacks, click right here to watch my other video on how to do this. 

Have you struggled with agoraphobia before? What places do you avoid?

Thanks for watching and I will see you next time. ​

How to do treatment for agoraphobia

Exposures for agoraphobia