depression

Agoraphobia – Causes, Symptoms & Treatment

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Agoraphobia

Agoraphobia is an anxiety disorder that reveals itself as a fear of situations that can cause feelings of helplessness, embarrassment, panic, and being trapped. This disorder causes symptoms of a panic attack, even in people with no history of such attacks. It can cause nausea and rapid heartbeat. For some people, these symptoms can arise simply by anticipating an unsavoury situation.

Agoraphobia can get so severe that it can cause people to avoid doing regular activities like going to the bank, being in a crowd, on a bridge, or even staying outside alone. In this post, we will consider the causes, symptoms, and treatment of agoraphobia.

Quick Facts on Agoraphobia

  • It might occur after suffering a panic attack.
  • Agoraphobia manifests in different forms, including fear of open spaces, elevators, and leaving home.
  • It can come with physical symptoms like nausea, dizziness, and shortness of breath.
  • Agoraphobia can be treated.

What is Agoraphobia?

The word Agoraphobia is derived from the Greek word ‘Agora,’ which connotes a market or place where people are gathered. Agoraphobia is usually confused with a dread of open spaces, but it is more complicated than that.

As the name implies, anxiety disorders are a constant feeling of stress and anxiety and they can worsen over time. A panic disorder that usually triggers agoraphobia occurs when a person feels sudden dread without any apparent cause of said terror.

Symptoms of Agoraphobia

There are several symptoms of this disorder.

The common ones are:

  • Fear of leaving the house for long periods
  • Fear of being alone in a crowd
  • Fear of losing control in outside spaces
  • Fear of enclosed spaces like an elevator or car
  • Tremendous anxiety or agitation
  • Detachment from others

Agoraphobia often goes hand in hand with panic attacks. Thus, a person who has agoraphobia might suffer physical problems like:

  • Chest constrictions
  • Shortness of breath
  • Shaking
  • Rapid heartbeats
  • Chills
  • Diarrhea

And agoraphobia is a vicious cycle: stressful situations cause a panic attack, and the memory of the panic attack increases the fear of being in such circumstances.

How Agoraphobia can affect the sufferer’s life?

As you can see, it is a debilitating condition that can affect the sufferer’s quality of life. Although sufferers often know that their fear is irrational, they cannot do anything about it no matter how hard they try.

This phobia can change sufferers’ behaviour and affect their performance in school, work, or other aspects of their life. It can make them depressed and sad and can even make them contemplate suicide. Some sufferers turn to substance abuse. And a recent study shows that agoraphobia can lead to inflammation which can increases the chances of heart disease and atherosclerosis.

Causes of Agoraphobia

As with several other phobias, the exact cause of agoraphobia is unknown. Nevertheless, research shows that some factors increase the chances of suffering agoraphobia.

Some of these factors are:

Agoraphobia occurs in more women than men and often starts at age 20. However, these are the average statistics: It can happen at any age before or after age 20.

Agoraphobia Diagnosis

How is this phobia diagnosed?

Usually, a person who feels he has agoraphobia has an interview with a healthcare professional – often a psychiatrist or someone in the profession.

The professional will assess the symptoms based on different parameters. Family members or friends may describe the sufferer’s behaviour to help with diagnosis. Sometimes, a physical exam might be done to eliminate the chances of other conditions with similar symptoms.

Within the Diagnostic and Statistical Manual of Mental Disorder 5, the criteria for diagnosing agoraphobia include stress or extreme terror at being in two or more of the following circumstances:

  • On public transportation
  • In an open place
  • In enclosed spaces
  • In social gatherings
  • Away from the house alone

It might also include:

  • Overblown fear of actual danger
  • Avoiding situations or needing the help of someone to face the situation
  • Long-term phobia

Agoraphobia Treatment

While agoraphobia can be debilitating, the good news is that it can be treated successfully. There are different ways to treat it, and most professionals combine one or two treatments to achieve a positive result.

  • Therapy

There are three therapies mainly used to treat this phobia – psychotherapy, cognitive-behavioural therapy (CBT), and exposure therapy.

  • Psychotherapy

Talk therapy has proved to be an effective treatment for different types of phobias, including agoraphobia.

It involves talking regularly to a mental health professional. Talking can help the sufferer disclose the fears and issues that contribute to the phobia.

In some cases, it is coupled with medication. Psychotherapy is a temporary treatment and it can be stopped once you can deal with the cause of your fears.

  • CBT

CBT is the most common treatment for agoraphobia. It helps the sufferer to understand how they feel and view agoraphobia. It also allows sufferers to replace thoughts of dread with peaceful, helpful ideas that can drive the fear away.

  • Exposure therapy

In this treatment, you are exposed to the situations that trigger agoraphobia in a controlled environment. This gentle and slow exposure can help you to lose the fear gradually. They serve as hormone medication.

Some drugs can help with agoraphobia. Some of these include Paxil, Prozac, Elavil, Pamelor, Xanax, Klonopin, and Effexor. Inhibitors, anti-depressants, and anti-anxiety medication. You’ll probably use these medications for six months or one year. If you get better, the doctor might start limiting the dosage.

  • Self-help

You can help yourself, to an extent, by changing your lifestyle. Some of the things you can try are:

  • Exercising regularly
  • Having a healthy, balanced diet
  • Practicing meditation or deep breathing exercises to reduce stress and fight panic attacks.

Concluding Thoughts

It might not be possible to prevent agoraphobia. But with early detection and treatment, you can fight it and get better. While there is no definitive cure, early implementation of the procedures discussed above can help minimize the symptoms and help you gain control of your life.

Melancholic Depression

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Melancholic Depression

Melancholic depression is a sub-type of major depressive disorder (MDD) with melancholic features. Major depressive disorder is a serious mental health condition that features persistent and strong feelings of sadness and hopelessness with melancholia being one of the indicators.

From the perspective of emotion, melancholy is dissimilar to grief and depression. It has distinguishing features of vague sadness and an unexplainable feeling of sorrow for which you are not able to determine the cause. Changing state of affairs in life allows melancholy to tiptoe in perniciously and catch you by surprise whereby you experience instants of extreme cheerlessness or strong yearning for no one or nothing in particular. You may struggle to feel any happiness, even though there are good things happening in your life.

From another standpoint, going through a melancholic phase can benefit you in some ways as it heightens mindfulness enabling your awareness of the present. It may also allow you to become more insightful and empathetic towards others. However, prolonged melancholy can have a considerable negative impact on your mental as well as physical health. Extreme sorrow can cloud your judgement and suppress logical reasoning.

What Causes Melancholia?

Melancholia is often referred to as “endogenous depression,” which means “depression that comes from within”. The condition is hereditary as in most instances, people with melancholia have a family record of mood disorders or suicides. And unlike other depression subtypes, melancholic depression is rarely associated with social and psychological factors.

Is Melancholy the same as Depression?

Melancholia is quite distinct from non-melancholic depression. When comparing to an individual with a different type of depression, the person with melancholia in general:

  • Builds up symptoms at a later age
  • Experiences more intense symptoms, like instead of a dull mood they are unable to sense any happiness
  • Is more likely to have suicidal thoughts and anxiety

Melancholic depression can also occur in conjunction with other specifiers. For instance, melancholia is more dominant when weather temperature is low and there is no sunlight or exist with depression with psychotic features.

Features of Melancholic Depression

With melancholic features, a patient must display four of the eight symptoms mentioned below.

The two symptoms stated below are linked to each other. The patient may experience a loss of pleasure in the common activities that they once were fond of. Similarly, the patient may not have any reaction to a normally enjoyable event, it may elevate their mood a little but will quickly return to their previous negative perspective. Also to new events, the patient with melancholic depression holds the same perspective on life and has minimal or no reaction.

  • Loss of pleasure in all or almost all activities
  • No reaction to a normally enjoyable event

Three or more of the following is experienced during the most severe period of the present episode:

  • Severely depressed mood – patients experience a severely depressed mood over time. The distinguishing features of this include unexplained sadness, despair, and a sense of loneliness. And every day, this perspective towards life remains the same which is quite distinctive to their previous attitude.
  • Waking up early and unable to return to sleep, which is more than 2 hours before usual waking time.
  • Sense of depression is regularly worse in the morning – bodily, the patient will show signs of weight Loss. Their overwhelming feelings of melancholy make them uninterested in life as well as in eating. 
  • Change in energy level – patients will normally experience one of the two changes in energy levels, either they will have a significant decrease in the level of activity, slower response time, slower movements or have faster movements, high agitation, and increased activity levels.
  • Excessive or inappropriate guilt – patients with melancholic depression may also experience feelings of guilt. The distinguishing feature is the intensity of the guilt as the guilt expressed will not match the event that occurred.

Treatment of Melancholic Depression

Normally, a physician will recommend antidepressants and depending on the assessment, the physician may suggest a long-term or shot-term treatment.

Together with medication, it may be suggested to see a psychologist who can treat with cognitive behaviour therapy.  This will allow the patient to discuss their difficulties and progress with new behaviour and goals. Talking can help adjust to a stressful event, replace the negative thoughts with positive ones, raise self-esteem and regain control in life.

However, if melancholic depression is severe and a challenging case, the patient may require electroconvulsive therapy (ECT). This form of therapy includes sending electrical impulses to the brain by connecting electrodes to the head.

With proper treatment and support from family and friends throughout the entire treatment, a patient with melancholic depression can make full recovery. However, after being treated it is essential to maintain a healthy lifestyle and social interaction to prevent relapses.

Non-Medical Treatments for Melancholic Depression

Below are few tips to divert you from extreme sadness and uplift your mood so that your mind and body can gradually go back to your usual self.

Colour Therapy

Different colours draw a physiological response from us. Choose colours that you are delighted with as colours can be deeply intimate and induce fond memories. You can revamp your wardrobe with happy and fun coloured clothes, paint your living space with brighter hues or get throws pillows and rugs in cheerful colours. Colours like orange, yellow and red can lift your mood and boost self-esteem, whereas blues and greens can be tranquilizing.

Journaling your Thoughts

Benefits of journaling are when you review it, that’s where you see your response in those instants and you can reflect and analyze your feelings. It can also be seen as a really good way to blow off some stream without actually getting involved in a distasteful encounter. Also important to know that journaling is very different from diary entries and to-do lists as journaling are noting down your thoughts, feelings, and reflection of a meeting or an event.

Take Vitamins and Minerals

Vitamins can assist your body to tackle the symptoms of melancholy, stress, and depression namely B-complex vitamins like B1, B2, B3, B5, B6 B12 and Vitamins C and D. These supply the body with the energy to fight stress, fatigue and assist in the creation of the happy hormones (serotonin and dopamine). Vitamin C is also essential for individuals with lower serotonin as insufficient serotonin is related to depressive mood disorders. Deficiency of minerals like calcium, magnesium, iron, zinc, potassium, and manganese can also induce depression

Avoid Negative Thought Process

Having specific thoughts that are self-focused and narrow can result in melancholy. These unsound thinking patterns can become habitual and grasp your mind and result in despair and sadness. These thoughts might include comparing yourself to others, not counting your blessings, and catastrophizing where you always think and expect the worst to happen.

How can you help a loved one with melancholia?

It can be tough to see your loved one go through melancholic depression. Below are some ways you can help support them:

  • Help them get started in the morning as melancholia symptoms are the worst when a person wakes up. Assisting them with their early morning tasks will give them the strength to get through the day
  • Try to ensure they eat regularly. Even though they do not feel hungry, their body still requires food.
  • Avoid judgmental expressions like “snap out of it”. You have to be understanding of the fact that people with melancholia need time and professional treatment to get better.
  • Do not take their mood personally as people with melancholia struggle to feel happy and it doesn’t reflect how they feel about you.
  • Know when to get help. In a situation where you are certain that your loved one is about to cause self-harm you can call 911 or the suicide prevention lifeline.

Overall, melancholic depression can greatly impact a person’s relationships, occupation and health. In most severe cases, it may provoke an individual to attempt suicide. Unlike other types of depression, melancholia causes long periods of suicidal thoughts. If you or a loved one is suffering from melancholic depression, know that there is hope. Assistance from a licensed therapist with medical and non-medical treatments together with love and support from family and friends can help you recover from melancholic depression.

Book Summary: A Guide to Rational Living

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A Guide to Rational Living - Dealing with Anxiety!

A Guide to Rational Living, by Albert Ellis & Robert A. Harper, is a praiseworthy self-development guide with practical and proven techniques to change your self-destructive emotions and behaviors. The book vividly demonstrates what you do to unnecessarily distress yourself and how you can overcome this to become an emotionally stronger person. 

With the on-going global coronavirus pandemic, this book proves to be particularly valuable as most individuals face unprecedented challenges in their lives; having to deal with emotional disturbance, extreme feelings of uncertainty, anxiousness, and recurring depressive thoughts.

The author, Albert Ellis (1913 – 2007) was one of the most prominent psychotherapists as he pioneered Rational Emotive Behaviour Therapy (REBT) which gained an extensive standing in the 1960s and is the basis of this book.

REBT is based on the concept that our thoughts generate our emotions and influence our behaviors. The author, Albert Ellis was certain that people can change their emotions together with their behaviors by debating their irrational thoughts with facts and reasoning. In this book, he highlights the top 10 irrational ideas that cause the greatest number of people to experience unpleasant emotions.

The author clarifies that the objective of implementing rationality is not to be more happy, but rather to make straight one’s thinking so that one is constantly less unhappy.

How to deal with anxiety

Observing your Internal Dialogue

Ellis explains that we humans as language-creating animals tend to articulate our emotions and ideas in words and sentences which effectually become our thoughts and emotions. So fundamentally, we are what we tell ourselves, and for any personal change, it requires us to initially look at our internal conversations. Do our internal dialogues SERVE US or UNDERMINE US?

On the topic of anxiety, Ellis emphasizes being able to challenge our irrational philosophies:

“…track your worries and anxieties back to the specific sentences of which they consist. Invariably, you will find that you are telling yourself:

“Isn’t it terrible that…” “Wouldn’t it be awful if…”

Ellis guides his patients to oppose these irrational philosophies with questions like:

“Why would it be so terrible that…?”

“Would it really be so awful if…?”

He goes on: “Certainly if this or that happened it might well be inconvenient, annoying, or unfortunate. But would it really be catastrophic?”

Consequently, in order to address any form of anxiety, Ellis marks:

“…verbal and active de-propagandization are usually essential. You must first realize that you created the anxiety by your internalized sentences, and you must vigorously and persistently ferret out these sentences and challenge and contradict them. Then you must also push yourself to do the thing you are senselessly afraid of and act against your fear.”

Never being ‘desperately unhappy’ again

Ellis goes on to highlight the fact that the greatest challenge for individuals today is having control over their emotional lives.

A Guide to Rational Living contains various records of therapy sessions between Ellis and his patients. Following is a considerable example of his advice to one of his clients suffering from depression.  

 “The best you can do, at first, is to observe your depressed state after they have already arisen. And then to see, by theoretical analysis and inference, that you must have brought them on by telling yourself some nonsense.”

“…this will often be difficult. For once your depression sets in, as you noted a while ago, you don’t feel like un-depressing yourself again; you almost want to stay depressed. And unless you combat this feeling, and actively go after your underlying sentences with which you created your depression, you will, of course, stay quite miserable.”

Now, the individual will face a dilemma: remain depressed for the foreseeable future or make an effort to fight the negative feeling by noticing what they did to initiate it.

 “A tough choice,” Ellis states “But if you keep taking the lesser of these two evils. That is –combating your negative feelings, then eventually the time comes when your basic philosophy of life matures. As a result, you will depress yourself much more rarely, to begin with, and have an easier time getting yourself out of your vile mood when you do unconsciously put yourself in one.”

The Ultimate Point

Are human beings RATIONAL or IRRATIONAL beings?

According to the book, we are both. We are intelligent but we still pursue immature, nonsensical, bigoted behavior anyway. The basic to a good life is applying rationality to the utmost irrational aspect of life, the emotions.

There is a mirror of Buddhism in the rational-emotive approach as it recognizes that no matter what happened in your past, it is the present that matters and what you can do NOW to improve it. The author, Ellis learned this himself as a child: that you don’t have to become upset by circumstances unless you allow yourself to be, it is always possible to control your reactions. Even though this form of therapy is tough-minded, it in fact signifies an optimistic view of people.

Why you should read this book

It is an excellent self-help book on psychotherapy without the use of psychology jargon making it fit for laypeople. It essentially delivers emotionally troubled individuals with all the answers they seek especially those suffering from depression.

A Guide to Rational Living can benefit anyone to understand how their emotions are initiated, and most importantly how reasonably happy and fruitful life can be yours just through discipline and more caution in your thinking.

You may be doubtful of the fact that reasoning is the way out of your emotional clutter, but Ellis’s revolutionary ideas that are supported by his forty years of cognitive psychology is the rationale that it works. 

Neurofolin – L-Methylfolate for Dietary Management of Depression

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Neurofolin

Neurofolin is an item of nourishment for the special medicinal purposes that provides nutritional support in the management of depression. The main content of Neurofolin is L-Methylfolate which is an active form of folate found to be deficient in individuals experiencing depressive disorders. It nutritionally supports by creating mood-regulating neurotransmitters such as serotonin and dopamine. Neurofolin has shown to be a promising adjunct therapy as it has successfully been used together with depression’s primary treatment, anti-depression medicine

Individuals with depressive disorders can experience a treatment that is partially effective at relieving their depression and some that cause unbearable side effects. It is likely it may be treatment-resistant depression where symptoms have not improved after being treated for depression.  In situations like this, it is best to work closely with your psychiatrist to explore options like supplementing with L-Methylfolate.

How does Neurofolin work?

Neurofolin has been precisely formulated for the nutritional support of depression management and contains 15mg of L-Methylfolate – an active form of folate.

Folate is a B-group vitamin and like all B vitamins, folate plays a vital role in maintaining the well-being of the nervous system and aids in processing fats and carbohydrates.  In addition to other health complications, folate deficiency can be associated with the development of the major depressive disorder (MDD). In fact, studies have successfully linked folate deficiency to depression.

Regular folic acid cannot cross the blood-brain barrier and need to be transformed to L-Methylfolate in the body before entering the brain, Neurofolin, on the other hand, contains the L-Methylfolate which avoids this step and directly crosses the blood-brain carrier. Once in the brain, L-Methylfolate helps to produce a vital cofactor called BH4 which is involved in the creation of key neurotransmitters dopamine, serotonin, and epinephrine that is found to be deficient in individuals with major depressive disorder.

What are the Benefits of Neurofolin?

  • Provides access to faster and an active form of folate
  • Proficient strength as it is available in 15mg doses
  • Provides brain and mood support as L-Methyfolate is significant for the production of neurotransmitters related to sleep, concentration, energy, and mood stability.
  • Well tolerated when added to anti-depressant therapy
  • Adjunctive treatment for depression, making it a positive addition to depression management 

Highlighted below are two examples of how people have benefited from the dietary supplement:

  • By taking L-Methylfolate, Colbey’s mental health showed significant improvement and after five months the symptoms had reduced significantly.
  • Neurofolin is seen as a major development for depression sufferers in Australia.

What are the side effects of taking L-Methylfolate?

L-Methylfolate is generally well tolerated when taken in normal doses, however, it can cause a reaction in some people, particularly when taken in high doses. Some of the common side effects include bloating, sleeping difficulties, and nausea. Other possible reactions to L-Methylfolate, especially when taken in a higher quantity include irritability, abdominal pain, decreased appetite, problem staying focused, and feelings of discomfort. Some of the serious side effects which need to be immediately reported to your health care provider include seizures, confusion, or numbness. Mentioned above are most of the side effects, but not all, your health care provider will be able to confer a comprehensive list with you.

Guidelines for Use

Neurofolin being a water-soluble diet supplement comes as an effervescent powder in 15g sachets. Each sachet can be consumed once daily by completely dissolving in 200ml of normal temperature or chilled water, taking note that it needs to be stirred briskly and consumed straightaway.

Where to Buy:

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Conclusion

To sum up, it is important for individuals with depressive symptoms to be examined by a mental health professional and also advisable to seek professional medical advice before self-administering Neurofolin. There is certainly an affirmative global trend in depression treatment towards augmenting medications with particular nutritional support to increase the number of individuals who benefit.