Things that can make a difference include:
- learning about agoraphobia and the self-care techniques you can use to manage it
- psychological therapy
- medication.
For most people, a combination of these will work best.
What self-care is there for agoraphobia?
There is a lot that you can do to care for yourself and reduce your symptoms.
- Tell the people you trust about your agoraphobia and stay in touch with them.
- If your agoraphobia is mild, it’s important that you face your fear by going out often, so that the fear doesn’t grow. The more often we let a fear stop us from doing something, the harder it is to do it the next time. The key is to feel the fear and do it anyway.
- If your agoraphobia is stronger, you can ask family/whānau and friends to come with you when you go out. Let them know in advance that you might have to wait for a panic attack to pass, or even go home so that you feel less pressured or embarrassed if that happens.
- Learn how to reduce panic and anxiety through relaxation techniques and mindfulness.
- Learn more about managing and improving your condition with the self-help books and online tools listed below.
- Exercise can help. If you can go outside, walk each day, especially in a natural environment. If you are housebound, it’s still important to move as much as possible.
- A healthy diet supports you to manage your stress well.
Psychological therapy
There are trained professionals who know about agoraphobia and how to help someone who is affected by it. They can provide you with support and help for working through any distressing thoughts and feelings you have and support you to make positive changes in your life. For some people, it might be helpful to understand why your agoraphobia developed, and this may involve processing earlier trauma. For others, this is not important or useful, and instead, the key is to focus on changing your thinking and behaviour.
Cognitive-behavioural therapy (CBT), a psychological therapy that largely focuses on overcoming unhelpful beliefs, has been shown to work well with agoraphobia. Sometimes, therapy will also involve desensitisation which is a gradual exposure to your fear of situations or places that would be difficult to get away from or get help in. This can be a very effective step in getting over your phobia. Don’t worry though – this only happens when you are ready and at a pace that is right for you.
Ask your doctor for a referral or find a counsellor or therapist(external link)(external link) or find a psychologist(external link)(external link) yourself. If you can’t get out to see a counsellor or therapist, some people offer phone counselling. Phone Anxiety NZ 0800 ANXIETY (0800 269 4389) for a recommendation.
Medication
Medications such as selective serotonin reuptake inhibitors (SSRIs), or benzodiazepines may be used together with relaxation techniques and psychological therapy. The choice of medication will depend on your preference, response to previous medication and consideration of possible side effects.
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that has been found to be effective in treating mood disorders such as anxiety, panic attacks and obsessional thoughts. An SSRI called sertraline is usually recommended for people with agoraphobia. Side effects associated with sertraline include feeling sick, problems with eyesight and vision, diarrhoea(external link)(external link) or constipation(external link)(external link), feeling agitated or shaky and excessive sweating(external link)(external link). These side effects usually go away with time. Read more about sertraline.
Benzodiazepines have a calming, relaxing effect and a short course may be prescribed for severe flare-ups of panic-related symptoms. Benzodiazepines must be used for a short time only. Ongoing use for longer than two to four weeks is not recommended. Read more about benzodiazepines.
