Tips for Treating Agoraphobia
Agoraphobia has been linked to social anxiety disorder, to depression and to generalized anxiety disorder. In certain cases, the disorder can be misdiagnosed, as it occasionally mimics the actions of a person with obsessive-compulsive disorder, such as following a ritual before driving or always ensuring the presence of an item during movement. Symptoms include a feeling of helplessness, panic or fear when confronted with an unfamiliar location or situation, as well as more general signs of anxiety, such as sweaty palms, nervousness, increased heart rate and respiration and occasionally cramps. Agoraphobes tend to actively avoid switching jobs, routines or situations and have been known to turn down promotions and even raises to avoid change in their safe zones. They will also follow very set paths to and from work or stores and will generally not want to try “new” things.
The disorder is, fortunately, relatively rare. Current medical case studies indicate that agoraphobia is one of the less common phobias, with about .25% or 1 in 400 people suffering from the phobia. In most cases, the phobia is relatively light, manifesting only as an uncomfortable feeling of unease or “butterflies” when the sufferer is forced into unfamiliar surroundings.
The cause of agoraphobia, like most phobias, remains unknown. Scientists have theorized that the phobia is the result of an imbalance of certain neurotransmitters; the fact that some agoraphobes respond well to anti-anxiety medications lends credence to this theory. Others, however, suspect that the agoraphobe is trained into the behavior, that the early family life in which most decisions are made by others has somehow been perpetuated beyond the normal span. Whatever the cause, however, the disorder can often be treated effectively.
Know the “Safe Zone”
To treat agoraphobia, the sufferer must first understand what precisely he or she considers “safe.” For most, the safe zone is defined by narrow parameters, such as workplace, home, local grocery store, and the like. For others, it is defined by routes taken to move from one location to the other (i.e. always using Main Street). For still others, it is defined by people, items, or methods. It is this last which is most likely to allow effective treatment by interventionary therapy, since the presence of individuals or items is not dependent upon location.
Agoraphobes that fixate upon people tend to have a core group of individuals, generally family or close friends, which they consider “safe.” Whether the individual in question is actually capable of ensuring the safety of the agoraphobe is not generally a criterion; agoraphobic mothers have actually included infant children as “safe” people and react accordingly. The presence of one or more of these “safe” people allows the agoraphobe to react to situations in a normal manner instead of evincing the signs of fear or panic that would otherwise occur. It is also common for items to render an agoraphobe “safe;” examples of items include maps or directions, religious icons, and music.
Treatment options
Therapy as an intervention and desensitization tool is most effective when used with those agoraphobes that fixate to people or items. It does, however, require the involvement of members of the “safe” group, and a level of dedication on the part of the agoraphobe. Over time, agoraphobes can expand their list of “safe zones,” that is, the number of places which have been visited repeatedly by the agoraphobe to the point where he or she feels comfortable in the surroundings. The goal of the therapy, then, is to establish as large an area as possible as a safe zone. This may require a certain amount of fortitude on the part of the “safe” group, since it involves sending the agoraphobe into otherwise unknown situations without the support personnel or items. Introductory-level therapy might be as simple as sending the agoraphobe alone into a convenience store, while later methods of treatment might involve the agoraphobe going to a location that he or she has never been before without the “safe” group or items (an extreme that, if successful, would virtually assure treatment success).
Some agoraphobes respond positively to certain psychotropic medications, most notably anti-anxiety prescriptions. Some psychiatrists have also noted positive results with anti-depressive medications. However, the experts seem to agree that the best, and possibly the only, long-term solution involves the intensive confrontation therapy, which requires a willingness on the part of the agoraphobe and a strong support network. Group therapy and “talking out the problem” has not proven to be very effective, however.
Of course, that failure has led to more than one joke at medicine’s expense. The best explanation for the apparent failure of this approach came from a witty agoraphobe, who stated that “it doesn’t work, because everyone’s afraid of going to another person’s house for the session!”
Above all, be confident in yourself. Confidence, and trust in yourself and your support network, is the first and most vital step to overcoming agoraphobia.
