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Agoraphobia Definition and Symptoms
Agoraphobia is the fear of being in certain places. Where you have anxiety and you're unable to escape or get help. The official definition of agoraphobia is a fear that has a big impact on your ability to maintain a high quality of life.
It makes it really difficult for you to leave the house and to be around other people, especially new people. Makes it hard for you to enjoy new activities and even more difficult to maintain your physical and your mental health.
In general, agoraphobia is an anxiety disorder that causes you to avoid public places for situations that might cause you to fall into panic. Things that might make you feel trapped helpless or embarrassed.
The diagnostic manual for mental disorders lists five kinds of places that you fear going to. Because of this issue, of not being able to escape when you have anxiety. The five scenarios are using public transportation like trains, planes, and buses.
Being in open spaces like parking lots of shopping malls, bridges, being in an enclosed space like a shop or a theatre standing in line, or being in a crowd. And the last one would be being outside of your home alone.
With the agoraphobia, you fear or avoid these situations. Because you fear that you may not be able to escape in the event. That you become panicked or in the event that you have some other incapacitating or embarrassing symptoms.
See, the anxiety here is caused by the fear that you won't be able to escape, or to get any help if your anxiety intensifies while you're out. An example of this could be a person who manifests anxiety with nausea.
Another aspect of this is that you actively avoid the situation or require someone to accompany you in a situation. Unfortunately, agoraphobia tends to be pretty chronic, and more than a third of the people who get agoraphobia become completely homebound and unable to work.
It's often associated with a panic disorder where people have an attack of anxiety, and because of the anxiety, the person fears to be out in these situations. Having an anxiety attack and they can't escape or they can't get hoped for it. If this is the case you would be considered to have panic disorder with agoraphobia.
But agoraphobia can be its own entity and that can occur all by itself. That would be like in the case of the elderly person who fears to fall, they don't necessarily have big eruptions of panic attacks, their fear is about being somewhere and falling.
Therefore the agoraphobia works into where they avoid a bunch of stuff because of that fear. Because you might say; well that's a reasonable concern and of course, it is but if you get to the point where you're homebound because of the concern. That you just may fall and there'll be no one there or you can't do anything about it that would be considered agoraphobia.
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Some people with agoraphobia struggle to even go out, to like a public park, that they could go home at work, they could drive from home to work. But they won't go to the park, they won't go to this store, it won't do anything. Some people can't leave their house at all.
Most people understand agoraphobia to mean you can't leave your house at all. But what you have to understand is that it might also mean that you just can't go anywhere unfamiliar to yourself. However, a social anxiety disorder which is also called social phobia also involves high levels of anxiety. Also involves a lot of fear. Also involves being an inability or lack of desire to leave the house like a willingness to leave the house.
It also involves avoiding social situations and also due to the feeling of fear of embarrassment. Self-consciousness and concern about being judged or viewed negatively by other people.
With exposure therapy, the goal is to desensitize you to the thing that you fear. And's a standard treatment used for other phobias as well, because the more you avoid the thing that you fear the bigger the monster becomes.
Now with exposure therapy, you wouldn't just be thrown back into the situation that you don't want to be in. You and your therapist would come up with a hierarchy of fears. So you would come up with a list of situations, from least anxiety provoking to the worst possible scenario that you can imagine. Then you would little bit by a little bit expose yourself to these situations.
Now depending on what kind of situation it is that you need to be exposed to. The exposure can be a real one where you actually go to the place, or it can be an imagined exposure. Where the therapist helps you create the scenario in your mind because it's not one that's practical for you to actually be in.
An example of this would be someone who has post-traumatic stress disorder from combat, it's not practical to put themselves back in actual combat, so they create a scenario in their minds that's similar to the situation. There's also a technology now that stimulates virtual reality. It stimulates or simulates the scenarios to help people reexpose themselves to these anxiety-provoking situations, and it's called virtual reality graded exposure therapy.
It's more commonly used with military personnel, but nevertheless, it's an emerging field that will probably become more popular in time. Another common therapy approach for agoraphobia would be cognitive restructuring. Cognitive restructuring helps identify unrealistic or irrational beliefs that you have about your situation.
These cognitive distortions an example of a cognitive distortion is catastrophizing. Catastrophizing involves assuming the worst case scenario every single time, even if you've never gotten close to experiencing. The worst case scenario each and every time you think this is the time that it's really gonna happen.
For some people, cognitive behaviour therapy is sufficient to treat their agoraphobia, but in more severe cases like someone who's completely homebound or someone who just needs a faster recovery than they can get with therapy medications may be the way to go.
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Anxiety Panic Attack and Agoraphobia
Therapy helps in a variety of different ways one it helps to identify real versus imagined causes of your anxiety. A lot of times it helps you to focus on what kinds of thoughts are going through your head when you have an anxiety or a panic attack.
A lot of times we have these feelings start to come up, and then we start to think very negatively about what's going on.
What's going on with my body? I'm going to die., I'm going to have a heart attack., I'm going to faint., people are going to laugh at me., they're going to make fun of me., this is very uncomfortable. I can't stand being uncomfortable all those kind of things.
It also helps to educate people on what anxiety is, and what it isn't a lot of time anxiety, it starts as it's a brain issue. It also helps to educate people on what anxiety is and what it isn't a lot of time anxiety it starts as it's a brain issue.
It starts out as a brain issue. You have various parts of your brain, once called your amygdala, and it's a small almond-shaped sized portion of your brain. That is your early warning detection device.
What it does is it basically picks up things from the environment, and it starts to fight, or flight symptoms, it starts to fight, or flight process going. Whereas if like let's say you see a bear in the woods, your amygdala is going to fire off, that's dangerous, it's going to give you a shot of adrenaline so that you get prepared to either fight or flight.
You're probably not going to fight the bear, you're going to run from the bear.
Sometimes your amygdala will fire off in situations that there's no bear, and it misinterprets cues within your environment. well, your amygdala kind of sits next to your what's called your limbic system, which is where your emotions are processed, and your hippocampus which is where your memories process.
Your amygdala looks at when having we ever been in a situation like this before, what are the feelings that we're supposed to go along with this, and it doesn't all that's called pre-consciously or does it before your conscious brain can kick in and say oh no we don't really have to worry about the situation.
It's already started this whole process going. You've already got this adrenaline rush going. You've already starting to have the symptoms, maybe your palms are sweating, maybe you feel keyed up, maybe you're starting to breathe funny, and there's a variety of different physical issues that are going on.
That therapy helps you to identify what those are, and kind of take the mystery out of them.
Like your heart beating fast. Well, your hearts designed to beat fast. I mean if you go jogging or do strenuous exercise, your heart's going to beat fast and people worried that I'm going to have a heart attack.
Actually, when you have a panic attack, or anxiety too, it's the opposite of a heart attack.
A heart attack is when your heart stops beating or just Quivers a panic attack, is your heart beating more quickly? and so people worry about am I going to faint because they feel dizzy.
One of the things is that you probably won't faint, because you're actually raising your blood pressure, and you're increasing your blood flow to your brain, which is the exact opposite of what happens when you faint. When you think you're decreasing your blood pressure, and you're decreasing that blood flow to your brain.
Therapy can help with that, therapy also helps with managing stress, teaching you how to manage stress, teaching you how to use appropriate relaxation techniques, also helps you to monitor what you eat what you intake, your sleep habits, those kinds of things. Because those are all really important in dealing with anxiety.
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