According to the Mayo Clinic, a phobia is defined as an “overwhelming and unreasonable fear” of something that doesn’t actually pose a legitimate danger. A person can be fearful of spiders for instance and suffer from a condition known as arachnophobia. The fear of clowns, common among both adults and children, is known as coulrophobia. Generally speaking, a phobia may be harmless; however, in some cases, the fear can be so severe that it can affect every aspect of one’s life. In the case of a fear of spiders, for instance, we might scream when we see one, or we may avoid places where spiders are likely to live, like our basement or a cave in the wilderness. People who are fearful of clowns may avoid the circus. Agoraphobia, however, is an anxiety disorder that is characterized as the fear of being in any situation that may cause you to panic, and this can be a phobia that affects all aspects of a person’s life.
What Is a Panic Attack?
If you’ve ever been in a highly stressful situation, such as a car accident, you may have experienced panic. The heart races, fear surrounds you, and you may have difficulty breathing. When someone suffers from a panic disorder, they experience panic attacks that they can’t necessarily explain. They feel as though they are losing control regardless of the situation at hand – many times in situations that shouldn’t cause someone to normally feel fear. They may experience the physical symptoms of panic as well.
Signs and Symptoms of Agoraphobia
A person who suffers from agoraphobia may experience panic attacks based on certain situation that have to with how they relate to the people in the world around them. Some of the symptoms of this condition include fear of being alone in public, fear of crowds, feeling helpless in situations where they may not be able to leave of their own accord (like an airplane or train), and, of course, panic attacks as a result of these types of situations. Some individuals who suffer from agoraphobia avoid these types of situations by refusing to leave their homes for long periods of time, even years.
Causes of Agoraphobia
Like many panic disorders and phobias, the exact cause of this condition is not known. Some experts, as related by PubMed Health, theorize that panic is a learned behavior. An individual may have had a traumatic experience in a certain location, like a shopping mall, and they develop a fear of that place which can lead to a panic attack. As the panic attacks worsen, he or she may become embarrassed or fearful that they may have an incident in public, which may cause them to develop agoraphobia.
Treatments for Agoraphobia
According to Psychology Today, there are two main treatments for the condition of agoraphobia. The first is to use certain types of medications to control the symptoms. These medications can include antidepressants or anti-anxiety medications known as selective serotonin reuptake inhibitors, or SSRIs. Other choices are tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs). Each of these types of medications has their own benefits and risks, so it is important for a medical professional to thoroughly examine the individual prior to writing a prescription. Other types of medications that are effective for anxiety are called benzodiazepines. These types of drugs, including clonazepam, lorazepam, and alprazolam, have fewer side effects than some of the other drugs, but they can be addictive when abused.
The purpose of treating agoraphobia with anti-anxiety medication is to reduce the frequency and severity of the panic attacks. In theory, this reduction in anxiety and panic will then give the individual the freedom to participate in normal life activities such as leaving one’s home or attending social events with friends and family members.
Unfortunately, if someone suffers from a Dual Diagnosis of anxiety and addiction, treatment with medications such as benzodiazepines may be more risky than is acceptable. When this happens, there are other non-medication-oriented forms of treatment. For instance, Cognitive Behavioral Therapy (CBT) has been used to treat this condition.
How Does Cognitive Behavior Therapy Work?
In order to understand how Cognitive Behavior Therapy can help someone suffering from agoraphobia, it is important to understand the two basic elements of the treatment process. The first concerns the cognitive functions of the human psyche. Cognitive refers to thought patterns. Specifically, it refers to how we, as human beings and as individuals, think. Behavior refers to how we react to those thoughts and our behaviors based on those reactions.
An example pertaining to agoraphobia might involve an individual who leaves their home to check the mailbox on the street. In order to get to the mailbox, they have to cross an expanse of lawn that is wide open to the view of all of his or her neighbors. The agoraphobic may have the fear of people watching and judging them, so this trek across the lawn can instill panic. The panic, in its most severe form, may result in panic attacks that ultimately make the chore of checking the mail no longer worth the effort.
Cognitive Behavioral Therapy may help this individual in the following ways:
- It can help them examine the thought process of neighbors watching them.
- It can help them to understand that the resulting panic attack is not life-threatening on a physical level (it’s not a heart attack, for instance).
- It can give them the tools to leave their house through physical techniques to get them used to going outside again.
- It can be tailored to the individual’s specific situation and life events.
The benefits of this type of therapy over traditional talk therapy are many. According to the National Association of Cognitive Behavioral Therapists, CBT is designed to take place over a shorter and more direct timeframe. In fact, the average number of sessions is only 16, versus years of traditional therapy. During this type of therapy, the therapist and the patient work together in a partnership while the patient is encouraged to ask questions and provide honest answers. For instance, if the individual has experienced panic because of the fear of a neighbor spying on them as they walked to their mailbox, they might ask whether the neighbor in the window could have possibly been watching for the mail delivery person instead.
Agoraphobia and the Treatment of Addiction
Any time an individual suffers from addiction and another condition at the same time, they are said to have a Dual Diagnosis. It is incredibly important that both conditions be treated simultaneously in order for either treatment to be effective, according to the National Institute on Drug Abuse. It doesn’t necessarily matter which condition occurred first in this process. What is important is that both are addressed. For instance, if a person has been using drugs or alcohol to “self-medicate” their agoraphobia, they may find that they can abstain from substance abuse while in treatment; however, when their symptoms occur in an uncontrolled environment, they may find themselves abusing drugs again to mask the symptoms. On the other hand, simply treating the agoraphobia, particularly with addictive medications, will not address the physical disease of addiction.
When you’re ready to address a Dual Diagnosis condition involving agoraphobia, ask yourself the following questions to help you find the right facility for your needs:
- Does the facility have the experience necessary to treat Dual Diagnosis?
- Does the facility tailor their treatment programs to the needs of each individual with the flexibility to change as the patient’s needs change?
- Does the treatment program include evidence-based therapies, such as Cognitive Behavioral Therapy?
- Does the treatment program last long enough to address my individual needs and treatment objectives?
- Does the program incorporate the 12-step model of recovery into their overall program?
If you have any questions or concerns about Dual Diagnosis treatment to help you overcome not only an issue with substance abuse but also difficulties with panic disorder or agoraphobia, please contact us today. You do not have to live in fear, and you do not have to suffer alone. We have the experience and the information you need to break free and begin living your life without fear or the ravages of substance abuse and addiction. Call now.
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.