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  • Q&A with Australian Health Practitioners

    What is the relationship between agoraphobia and panic attacks?

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    Panic Attacks
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    Dr Toni Metelerkamp

    Clinical Psychologist, Psychologist

    As a humanist, I believe everyone wants and deserves happiness, but life sometimes takes us on unexpected paths, making it challenging to be in the … View Profile

    Agoraphobia is an anxiety disorder. People with Agoraphobia are anxious about being in places or situations where they think they may not be able escape from, or where help may not be available, if they have a panic attack.  The anxiety usually means avoiding more and more places or situations and becoming increasingly anxious in situations, even those that were once enjoyable. 
    Agoraphobia can develop with or without a history of panic attacks. 

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  • Joe Gubbay

    Clinical Psychologist, Counsellor, Psychologist, Psychotherapist

    I have worked in public hospitals as well as private practice over the past 25 years. As a clinical psychologist I treat depression, social anxiety, … View Profile

    I agree with Toni, agoraphobia can develop with or without panic attacks, though it's much more common for agoraphobia to be associated with a fear of having panic attacks.  It can be effectively treated using a cognitive behavioural therapy approach; ask your doctor for a referral to a suitable health professional, such as a psychologist.  

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    Damien Haines

    Clinical Psychologist, Psychologist

    Damien Haines is a registered Clinical Psychologist who brings a warm and empathetic approach to therapy. He emphasises engagement in the world and encourages clients … View Profile

    Agoraphobia tends to develop over a period of time. Places that were once thought of a “safe” have now become “dangerous”. A typical development of Agoraphobia may begin with a panic attack at a major supermarket. Depending on how you think about that attack, you may associate it with the supermarket. Therefore, it has now become an unsafe place to be, because you may have another panic attack there, or you can re-imagine yourself having that attack when you go near it. So to cope you go to another supermarket. This may work well for a period of time until you say have another panic attack at it. Now it too is tainted and supermarkets are bad.

    So you then go to corner stores etc etc. Basically your “safe” areas become less and less and less. Your belief in yourself becomes less and you focus more and more on your panic symptoms and how to avoid them.

    Typical things people with agoraphobia avoid include public transport, shops, churches, parks, tunnels, planes, only being able to travel within a certain radius from home, only being able to make L hand turns while driving.

    Agoraphobia and Panic Disorder are very treatable conditions using exposure techniques (in CBT). The key part of treatment is not the talking about it, but the relearning that these places are safe by being in previously believed unsafe places. The taking of Benzodiazapines, Anti-Psychotics and sedating Anti-hystamines is contra-indicated for all anxiety disorders, in particular for Panic and Agoraphobia. Taking these medications can make your anxiety even worse, and hinders your brain from the learning one normally has while undergoing exposure therapy. Thus you may become treatment resistant due to the medications.

    I hope you do find the treatment and therefore, relief you want.

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