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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: Pregnancy Blues – What Every Woman Needs to Know About Depression During Pregnancy

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Pregnancy_Blues - Dealing with Prenatal Depression

Pregnancy Blues: What Every Woman Needs to Know About Depression During Pregnancy by Shaila Kulkarni Misri is a ground-breaking book that has seminal work exclusively focusing on prenatal depression. Pregnancy blues unravels this agonizing yet treatable illness by providing insight into the key social and biological factors that combine to create a hostile environment for depression and anxiety to thrive, as well as proposing the numerous effective treatments that exist.

Each year in the United States, well over 400,000 babies are born to depressed mothers, making prenatal depression the most under-diagnosed pregnancy complication in the country. The numbers are astonishing as the author also highlights that up to 70 percent of pregnant women go through a certain level of depressive symptoms, out of which 12 percent meet the symptoms of major depression.

Given the current global situation, this book may prove to be helpful to many to-be mothers as the novel coronavirus (COVID-19) may have added to the existing feelings of stress, anxiety, and depression. In addition to focusing on elements that pregnant women can control, they also have access to this useful resource to aid in alleviating uncertainly and stress.

Though pregnancy is considered blissful, there are numerous women out there whose excitement is often overwhelmed by feelings of fear, confusion, and sadness. Prenatal depression is seldom discussed and most often misunderstood as opposed to postpartum depression, which is well portrayed and accepted by the medical community.

This book aims to change that perception by focusing entirely on depression during pregnancy and making it a credible reference for women by including invaluable case studies and medical information.

The author, Dr. Shaila Kulkarni Misri, a prominent reproductive psychiatrist with 25 years of medical practice and research has been successful in offering hope, assistance, reformative actions, and laying the myths to rest on the subject through this book.

The fact that will particularly resonate with many is that all pregnant women are vulnerable during the course of their pregnancy. To which the author explicitly states: “If a woman (…) feels burdened rather than uplifted by her pregnancy, she should be particularly aware that while her physical health may be fine, there is something very wrong emotionally and she needs to seek help.”

Di. Misri also focuses on the cultural nuances of birth and pregnancy, she challenges the basic traditions and beliefs relating to pregnancy and motherhood by exploring the misinterpretations that have led to under-diagnosis and insufficient treatment of prenatal depression.

In the opening chapter, it is validating how the author talks about the numerous ways in which societal expectations and pressures, inner stress, and women’s distinct biology all work together to affect mental health during pregnancy.

“I believe it’s time to take off those rose-colored glasses and look at a picture of pregnancy that may not be as pretty as the one that’s been painted by the media but which is, for too many women, sadly more realistic.

Until we are willing to do that, we are unwittingly sentencing these women to continue hiding in plain sight, unable or unwilling to admit, perhaps even to themselves, that their experience of pregnancy is not what they’ve been taught to expect, and that what appears to be so joyful for others is for them a time of sadness, fear, and confusion.

These women need to know that it doesn’t have to be that way, that there is help, and that they cannot and should not be embarrassed or afraid to get the help they need.”

Noteworthy Learnings from the Book

  • Exactly how you can identify the signs and symptoms of depression-and recognise when to seek help
  • Information on the role of female hormones, explaining why women are more vulnerable to depression as opposed to men
  • How depression disguises itself in your physical complaints, such as back, stomach, or chest pain
  • The implicit connection between infertility and depression
  • The antidepressant debate, outlining the facts of specific drugs, their safety and when medication is the correct choice
  • The risks and benefits of breastfeeding and medication

In addition to above, the author also offers beneficial self-tests and resources, particulars on the alternative treatment options ranging from therapy to acupuncture and far more.

Why you should read this book?

Pregnancy Blues has a remarkable balance of clinical information in simple language, together with a multicultural perspective on birth and pregnancy. Dr Misri’s extensive experience in clinical practice and examining over 3,000 women a year in her pregnancy depression clinic adds credibility to this book.

During pregnancy, just like your body, your mind should be in a healthy state as well and this book helps to achieve just that. What can be appreciated most is how strikingly the author has given a voice to all women out there suffering from prenatal depression and assuring them comfort in their difficult time.

Prenatal depression is often masked in silence, shame, and denial, by having access to factual resources, such as this book, we can help ourselves as well as several women around us who may be silently suffering too. This book is filled with stories of women who took a step forward and transformed a potentially damaging experience into a manageable one that eventually brought them the joy of bonding with a healthy and happy baby.