Agoraphobia is a mental disorder,At which there is a fear of crowded places, a fear of open spaces. Agoraphobia is a kind of protective mechanism, characterized by the unconsciousness of manifestation. Fear of crowded places appears due to fear of panic attacks in public. Such fear can appear due to fear of something that has a connection with people or with the emotional trauma they received from them. The individual, suffering from agoraphobia, can not practically feel safe in places where people gather, especially in places of mass congestion.
Often, agoraphobia can be caused by somePreviously occurred traumatic psyche situations associated with people. Subjects who are afraid of being in public transport or being in a crowded place often frighten directly out of the house, without being accompanied in a busy place, who can not be left without delay.
This is how a vicious circle appears - fearManifestations of panic in public places or "in public", causing agoraphobic subjects not to leave the house, which leads to an even more exacerbation of the disease. Along with this, many patients with agoraphobia are able to successfully communicate in a large team of people, provided that such communication will occur on its territory in the usual space. This kind of agoraphobia often occurs already in adulthood.
Today, many scientists believe that not allThe exact causes of agoraphobia are identified. Their absolute majority believes that it is a consequence of a number of psychological and physical factors.
The most common reason for the appearanceAgoraphobia is a panic attack. That is, agoraphobia occurs because of their complication. This disorder is characterized by regular periods of panic, severe fear, which lead to severe physical reactions. Panic attacks can be quite frightening, forcing people to think that they lose control or die.
Some people associate their panic attacksWith a certain one or more situations in which they happened. Therefore, they believe that avoiding such places or situations, they can avoid panic attacks and prevent possible relapses of seizures.
However, agoraphobia often occurs not as a result of panic disorders. In such cases, no one knows what causes the disease.
Agoraphobia can occur as a result of taking certain medicines. So, for example, long-term use of sleeping pills or tranquilizers can lead to the appearance of agoraphobia.
There are also a number of other factors that affect the onset of the disease, such as:
- Excessive consumption of alcoholic beverages;
- Drug abuse;
- Children's injuries;
- Severe stressful situations, for example, loss of loved ones, wars, devastating cataclysms, serious illness, etc .;
- Various diseases of the psyche, for example, eating disorders, depressive conditions, etc.
The clinical manifestations of agoraphobia are quite dynamic and polymorphic.
The main symptom of the disease is usually consideredThe emergence of panic attacks in the patient when visiting the places that used to cause him fear. During the onset of panic attacks in the human body there is a significant release of adrenaline into the blood, resulting in such a person begins to lose control of himself. Such attacks can occur completely unexpectedly and last from 15 minutes to 30.
In general, subjects diagnosed with agoraphobia,More often experience its symptoms, being in situations that cause them anxiety. Therefore, physical symptoms in such people are observed quite rarely, as they tend to avoid situations that cause them to panic. But nevertheless it is necessary to allocate a number of physical symptoms:
- Hyperventilation of the lungs, consisting in accelerated and shallow breathing;
- Redness and a feeling of heat;
- Dysfunction of the gastrointestinal tract, for example, diarrhea;
- Impaired swallowing;
- The appearance of trembling;
- Violation of sweating, the appearance of a feeling of dizziness;
There are also psychological symptoms that can sometimes be related to physical symptoms:
- Fear that surrounding people will notice panic attacks and, as a result, the appearance of a feeling of embarrassment and a sense of humiliation;
- Fear of the fact that when the attack comes, the heart can stop working, that it will be impossible to breathe or fear that they may die;
- Fear of losing the mind.
Other clinical manifestations are also possibleAgoraphobia from the psyche: insecurity, weak self-esteem, a sense of loss of control, depressive states, constantly present phobias, anxiety and anxiety, a sense of inability to cope with circumstances without the help of others, a fear of remaining alone.
There are four more behavioral symptoms.
The first is the avoidance of circumstances or the environment,Causing concern. In some cases, this avoidance is moderate. For example, in cases where the patient avoids being in a crowded train car. The second behavioral symptom is the certainty that appears in the presence of other people. That is, a person can go to the store, but with a friend or relative. In extreme manifestations, the patient will find loneliness intolerable.
The third is a warning behavior thatIs the need to possess or take something to be able to withstand circumstances or an environment of concern. So, for example, many drink alcoholic beverages before getting into places of mass gathering of people, and others leave on street only at confidence that the tablets necessary for them are near at hand.
The fourth symptom is to flee from the place or from a stressful situation and return home.
If an individual suffers chronic agoraphobia, when he can not leave the house at all, then in such cases the psychiatrist's help is required.
At the first signs of agoraphobia, when,To force yourself to go out into the street, you need to exert a certain effort, and with every new exit you try to persuade yourself more and more difficult, you can apply the techniques of auto-training.
In general, the treatment of agoraphobia includesCombination of methods of psychotherapy and drug therapy. In most cases, the prognosis is favorable - either complete cure comes, or the patient learns to restrain the manifestation of agoraphobia and keeps it under control.
Medical treatment of agoraphobia isTaking antidepressants and tranquilizers in cases of panic attacks. More often used antidepressants, which are selective inhibitors of serotonin reuptake (SSRIs). However, these drugs have a number of side effects, such as pain in the head area, sleep disorders, nausea, sexual dysfunction.
Even more side effects have monoamine oxidase inhibitors also used to treat agoraphobia.
To reduce anxiety,Anti-anxiety drugs, for example, benzodiazepines (Alprazolam). However, too long use or use in large doses than prescribed, leads to the appearance of dependence. Adverse reactions: confusion, increased drowsiness, loss of balance, loss of memory. The course begins usually with small dosages, gradually increasing them. At the end of the course, the dosages are again reduced.
Psychotherapeutic methods in the treatment of agoraphobiaAre the impact on the psycho-emotional area. Among the most sought-after psychotherapeutic methods, one discovers belief, understanding, suggestion. They also include certain instructions that are implemented in such a way that the individual can see himself and personal problems more realistically, develop the desire to overcome or cope effectively with them, master the special exercises and behavior that is necessary for a speedy recovery. The most effective, structured techniques that are limited in time, such as cognitive therapy, behavioral psychotherapy, rational-emotional therapy and hypnotherapy, are often used to treat agoraphobia.
Cognitive-behavioral psychotherapy includesYourself two parts. It allows you to get more information about what agoraphobia and panic attacks are, about how to manage them, the cognitive part of the technique. The patient is helped to know what are the triggers of panic attacks, and what, on the contrary, improves the condition. The psychotherapist helps transform the threatening interpretation into a safe one, transforms the catastrophic thinking into a more positive one, which relieves the patient from strong negative emotions and negative manifestations. The behavioral part of the technique involves the transformation of unwanted or unhealthy behavioral responses. Such changes are achieved by implosion or by desensitization. In this case, the patient quite successfully counteracts the circumstances or the environment causing panic attacks.
In connection with the fact that often the causes of agoraphobiaHidden in the subconscious, they are difficult to identify and eradicate. Therefore, hypnosis is used successfully in the treatment of agoraphobia. Therapy with hypnotic suggestion has proven itself in the treatment of anxiety conditions. It allows free access to the subconscious of the patient so that the doctor can make the required transformations at a deeper level. In a state of hypnotic sleep, the patient can be inspired with thoughts that will be opposite to thoughts provoking panic states, completely or partially neutralize threatening situations or conditions.
Agoraphobia treatment alone
As has been proved by many years of medical practiceTherapy and psychotherapy do not always bring the expected effect. Along with this, many people suffering from panic attacks with agoraphobia are well helped by the means of "folk" medicine. Treatment of agoraphobia alone can not only reduce the manifestation of symptoms, but in some cases completely reduce them to naught.
The first thing you need to do with an independentGetting rid of symptoms, this is to stop discussing the clinical manifestations of agoraphobia with close people. We must stop asking for help from relatives and friends. You should take responsibility and understand that you are an independent, conscious, adult person who can independently cope with unpleasant symptoms. It is important to believe in yourself and your own body.
Also, it is necessary to stop attending variousForums and sympathize with them, discussing the disease and the causes of panic conditions. Since the bright and colorful descriptions of someone else's clinic can only exacerbate the psychological state of the patient.
It should be taken for granted that the individual's physical health is within normal limits.
Agoraphobia is not a consequence of fear, but merely an unconscious attempt to avoid a situation that causes fear.
Coping with the clinical manifestations of agoraphobia is well helped by self-distraction and relaxation, such as meditation or breathing techniques.
In cases of panic attacksAgoraphobia is most effectively assisted by respiratory gymnastics, which promotes relaxation and leads the individual to a state of peace of mind. Respiratory gymnastics consists of a rare, but rather deep breathing, in which the expiration is twice as long as compared with the inspiration. In order to facilitate this method, you can use the package, preferably if it is made of paper. The recommended duration of this method is five to seven minutes.