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Agoraphobia

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Agoraphobia
Marissa Burton
SOC 313
Shamika Smith
February 18, 2013

Panic disorders are anxiety disorders, diagnosed in people who experience thoughts of intense fright or discomfort; they are described by panic attacks, episodes in which the individual has feelings of deep anxiety or terror, followed by a sense of imminent doom (Flavo, 2009).
Some people avoid going into situations or places in which they have formerly had a panic attack in anticipation of it reoccurring again. These people have agoraphobia, and they tend to stay away from public places where they feel that urgent escape might be difficult. About one in three people with panic disorder develops agoraphobia. Their world may become lesser, as they are always on guard, waiting for the next attack (Anxiety and Depression Association of America, 2010-2012). In this paper, I will discuss the lifestyle of people living with agoraphobia as well as the interventions, and factors that may act as retraining forces in agoraphobic individuals. Agoraphobia is a type of anxiety disorder in which individuals tend to avoid situations that they feel may cause them panic. People with agoraphobia may even avoid being alone, leaving their home or any predicament where they could feel humiliated, trapped, or helpless if they do panic. According to Mayo Clinic Staff (2011), people who are agoraphobic do not feel safe in any public place, especially where there is a crowd. They can feel trapped inside of their own home because their fears are so emotionally overpowering. Treatment for agoraphobia can be rough because this usually means coming face-to-face with their fears. Common places and situations that agoraphobic people fear are elevators, sporting events, bridges, public transportation, shopping malls, airplanes, and crowds or lines of people (Mayo Clinic Staff, 2011). A whole lifestyle develops where the person becomes ever more and more limited in his or her breadth and scope of living resulting in a greater dependency on others along with growing episodes of stress, depression, and frustration. A person who is agoraphobic will go out of their way to avoid those locations and scenarios where a panic attack may happen. They may even end up being secluded from crowded places making them housebound. In the article Agoraphobia, The Better Health Channel website states that this lifestyle is unhealthy in itself which can intensify agoraphobic attacks to happen in everyday normal conditions. The heart rate becoming elevated may lead to a panic attack episode because the person may wrongly assume having a stroke (Better Health Channel, 2013).
People who are agoraphobic may end up living a resisted lifestyle due to their growing fear of being vulnerable in the face of a panic attack. Activities that may require going outside of the home such as work, school, socializing, hobbies, and others forms of exercise may be out of reach. The person may come to realize that their fear is absurd but feel incapable to do something about it, feeling resentment and frustration within themselves. Feelings such as these have a tendency to damage self-esteem and contribute to depression and other anxieties and fears (Better Health Channel, 2013).
Ultimate outcome interventions are focused on improving the person’s quality of life, given the possible severity of impairment that can consequently appear from PD/PDA. Treatment is focused toward diminishing panic attacks and agoraphobia. The first goal-specific potential intervention that may facilitate independence is exposure. Beamish, Granello, Granello, McSteen, et al, (1996) state that exposure therapy is essential in treating avoidance in agoraphobia. Two-factor theories can account for the grounds for exposure of avoided situations which speculate that panic is corresponding with avoided situations by means of classical conditioning and then negatively reinforced through avoidance. Therefore, people are not taught to separate panic from these situations. In this intervention, it involves slowly exposing the individual to situations that they fear. Individuals are required to wait in the fear setting until their SUDS level decline at least 50% (Beamish, Granello, Granello, McSteen, et al, 1996).
Self-instructional training intervention teaches individuals to substitute poorly adaptive, self-defeating, anxiety frustrating cognition with more encouraging thoughts, which will then decrease dependence of safety behaviors as the end result. Individuals are instructed to visualize themselves in situations that are fearful and to speak adaptive thoughts. For example, the person may imagine themselves being surrounded by a crowd of people without being accompanied by a safety person. The therapist offers encouragement to the person as the person repeats statements such as “I can be surrounded by a crowd all by myself without the fear of a panic attack. I will be ok.” Individuals then apply these expressive positive thoughts when engaging in real-life feared circumstances. Self-instructive training intends to restrain unhelpful cognitions, quickly diminishing arousal and safety behaviors, as well as increased adaptive coping (Beamish, Granello, Granello, McSteen, et al, 1996).
Restraining forces in agoraphobics may come into play that may lead to the person not taking advantage of these interventions available such as allowing the subconscious mind to take over and believing that treatment is not an option. Agoraphobics know that there agoraphobia is irrational, but something goes wrong subconscious that connects a whole load of powerful negative feelings – mainly fear, restraining them and in doing so taking over their feelings. According to LindeMethod (2013), in the article Panic Away: Understanding Your panic Attacks, fear, anxiety, and worry are the internal conversations that over power the self talk – the inside conversations which runs in our minds continuously – this restraining conversation can be so controlling that it gets in the way of normal conscious thinking. It takes totally control of their lives (LindenMethod, 2013).
Trying to expose agoraphobics to places that may frighten them requires them to leave the house and step into a treatment setting. This predicament can make a few people with agoraphobia feel that their situation is impossible to eliminate. They have it in their minds that treatment is not an option for them due to their debilitating anxiety which acts as a restraining force in the intervention process (Behavioral Health, 2013).
In conclusion, I have discuss the lifestyle of people living with agoraphobia as well as the interventions, and factors that may act as retraining forces in agoraphobic individuals. People who have agoraphobia feel a sense of fear, fear of having a panic attack in places where they feel trapped with no means of escape. They feel as if that leaving there home will only cause there fear of the outside to worsen. Living life as an agoraphobic is not a healthy way to live, restricting the individual of ever having a quality chance at life. If they only believe that treatment for them is an option despite how ridiculous their actions may be. Knocking down that wall of restricted forces can help them seek out the interventions that are just a step away from treatment.

References
Anxiety And Depression Association Of America. Panic disorder and agoraphobia. Retrieved from http://www.adaa.org/understanding-anxiety/panic-disorder-agoraphobia
Beamish, P. M., Granello, P. F., Granello, D. H., & McSteen,P. B., et al. (1996). Journal of Counseling and Development. Outcome studies in the treatment of panic disorder: A review. (74) 5, 460. Retrieved from http://search.proquest.com.proxylibrary.ashford.edu/docview/219020697?
Behavioral Health. (2013). Understanding agoraphobia. Retrieved from http://www.elementsbehavioralhealth.com.mental-health/understanding-agoraphobia/
Better Health Channel. (2013). Agoraphobia. Retrieved from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Agoraphobia?open
Flavo, D., R. (2009). Medical and Psychosocial Aspects of Chronic Illness and Disability. (Ashford University ed.). Sudbury, MA: Kevin Sullivan
LindenMethod. (2013). Panic away: Understand your panic attacks. Retrieved from http://www.lindenmethodadvice.com/54-2/
Mayo Clinic Staff. (2011). Agoraphobia. Retrieved from http://www.mayoclinic.com/health/agoraphobia/DS00894

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