Cognitive behavioral treatments
Exposure treatment
can provide lasting relief to the majority of patients with panic
disorder and agoraphobia. Disappearance of residual and subclinical
agoraphobic avoidance, and not simply of panic attacks, should be the
aim of exposure therapy. Similarly, Systematic desensitization
may also be used. Many patients can deal with exposure easier if they
are in the company of a friend they can rely on (Gelder, Mayou and
Geddes 2005). It is vital that patients remain in the situation until
anxiety has abated because if they leave the situation the phobic
response will not decrease and it may even rise (Gelder, Mayou and
Geddes 2005).
Cognitive restructuring has also proved useful in treating agoraphobia. This treatment involves coaching a participant through a dianoetic discussion, with the intent of substituting irrational, counterproductive beliefs with more factual and beneficial ones.
Relaxation techniques are often useful skills for the agoraphobic to develop, as they can be used to stop or prevent symptoms of anxiety and panic.
Cognitive restructuring has also proved useful in treating agoraphobia. This treatment involves coaching a participant through a dianoetic discussion, with the intent of substituting irrational, counterproductive beliefs with more factual and beneficial ones.
Relaxation techniques are often useful skills for the agoraphobic to develop, as they can be used to stop or prevent symptoms of anxiety and panic.
Anti-depressant medications most commonly used to treat anxiety disorders are mainly in the SSRI (selective serotonin reuptake inhibitor) class and include sertraline, paroxetine and fluoxetine. Benzodiazepine tranquilizers, MAO inhibitors and tricyclic antidepressants are also commonly prescribed for treatment of agoraphobia.
Antidespressants are important because some have antipanic effects
(Gelder, Mayou and Geddes 2005). Antidepressants should be used in
conjunction with exposure as a form of self-help or with cognitive
behaviour therapy (Gelder, Mayou and Geddes 2005). Some evidence shows
that a combination of medication and cognitive behaviour therapy is the
most effective treatment for agoraphobia (Gelder, Mayou and Geddes
2005).
Eye movement desensitization and reprogramming (EMDR) has been studied as a possible treatment for agoraphobia, with poor results. As such, EMDR is only recommended in cases where cognitive-behavioral approaches have proven ineffective or in cases where agoraphobia has developed following trauma.
Many people with anxiety disorders benefit from joining a self-help or support group (telephone conference call support groups or online support groups being of particular help for completely housebound individuals). Sharing problems and achievements with others as well as sharing various self-help tools are common activities in these groups. In particular stress management techniques and various kinds of meditation practices as well as visualization techniques can help people with anxiety disorders calm themselves and may enhance the effects of therapy. So can service to others which can distract from the self-absorption that tends to go with anxiety problems. There is also preliminary evidence that aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided.