Agoraphobia treatment usually includes both psychotherapy and medication. It may take some time, but treatment can help you get better.
Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is one of the most effective forms of psychotherapy for anxiety disorders, including agoraphobia.
Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build upon your initial success.
You can learn:
- That your fears are unlikely to come true
- That your anxiety gradually decreases if you remain in public and you can manage those symptoms until they do
- What factors may trigger a panic attack or panic-like symptoms and what makes them worse
- How to cope with these symptoms
- How to change unwanted or unhealthy behaviors through desensitization, also called exposure therapy, to safely face the places and situations that cause fear and anxiety
If you have trouble leaving your home, you may wonder how you could possibly go to a therapist's office. Therapists who treat agoraphobia will be well aware of this problem. They may offer to see you first in your home, or they may meet you in what you consider a safe place (safe zones). They may also offer some sessions over the phone, through email, or using computer programs or other media.
Look for a therapist who can help you find alternatives to in-office appointments, at least in the early part of your treatment. You may also want to take a trusted relative or friend to your appointment who can offer comfort and help, if needed.
Antidepressant and anti-anxiety medications are often used to treat agoraphobia and panic symptoms that frequently accompany agoraphobia. You may have to try several different medications before you find one that works best for you.
Your doctor is likely to prescribe one or both of the following:
- Antidepressants. Certain antidepressants called selective serotonin reuptake inhibitors (SSRIs), such as paroxetine (Paxil, Pexeva) and fluoxetine (Prozac), are used for the treatment of panic disorder with agoraphobia. Other types of antidepressants, such as tricyclic antidepressants or monoamine oxidase inhibitors, may effectively treat agoraphobia, although they're associated with more side effects than SSRIs.
- Anti-anxiety medication. Also called benzodiazepines, anti-anxiety medications are sedatives that, in limited circumstances, your doctor may prescribe to relieve anxiety symptoms. Drugs in this category that are used for the treatment of panic disorder with agoraphobia include alprazolam (Niravam, Xanax) and clonazepam (Klonopin). Benzodiazepines are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you've had problems with alcohol or drug abuse.
Both starting and ending a course of antidepressants can cause side effects that seem like a panic attack. For this reason, your health care provider likely will gradually increase your dose during treatment, and slowly decrease your dose when he or she feels you're ready to stop taking medication.
May 02, 2014
- Anxiety disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Dec 10, 2013.
- Highlights of changes from DSM-IV-TR to DSM-5. American Psychiatric Association. http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf. Accessed Oct. 8, 2013.
- Ravindran AV, et al. Complementary and alternative therapies as add-on to pharmacotherapy for mood and anxiety disorders: A systematic review. Journal of Affective Disorders. 2013;15:707.
- Natural medicines in the clinical management of anxiety. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 11, 2013.
- McCabe RE. Agoraphobia in adults: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis. http://www.uptodate.com/home. Accessed Dec. 10, 2013.
- Numbers count: Mental disorders in America. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml#Agoraphobia. Accessed Dec. 10, 2013.
- Kava. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 17, 2013.
- Anxiety disorders. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Accessed Oct. 11, 2013.
- Mayo-Wilson E, et al. Media-delivered cognitive behavioural therapy and behavioural therapy (self-help) for anxiety disorders in adults (Protocol). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005330.pub3/abstract. Accessed Oct. 11, 2013.
- Whiteside SP (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 2, 2014.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 17, 2014.
- Pexeva (prescribing information). Miami, Fla.: Noven Therapeutics; 2012. http://www.pexeva.com/index.php. Accessed Jan. 21, 2014.
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