Agoraphobia

[Spiffor]

You really need to see a doctor or shrink ASAP.

A comrade (aged something like 70) has a gravely anxious/agoraphobic wife. It wrecks both their lives. She can barely leave home at all. And he can't leave her for more than an hour before she has an anxiety crisis.

Look for a cure as soon as you can, before it's too late.

[Spec]

Originally posted by Jon Miller
Chemistry is in my opinion, the last thing to use.

JM

Me too.

Spec.

[Wernazuma III]

Is it a fact that agoraphobia (or whatever causes this anxiety) is extremely more frequently found among women?

In this thread, only women who show this disorder have been mentioned, I myself know one tragic case that led up to suicide and 2-3 less severe cases of this kind of disorder - all women.

[Cort Haus]

Has she ever had a bad trip?

[Spec]

Yes she has, but more than a year ago.

Spec.

[lord of the mark]

IIUC behavioral therapy, involving gradual desensitatization, tends to work pretty well for this and other specific phobias. Though for underlying anxiety disorders Cognitive therapy and meds are preferred.

I still dont see why meds are "last resort". Is coffee your last resort to wake up in the morning? Is a decongestant your last resort for dealing with hay fever? If meds ARE recommended, theres no good reason to let things get worse while you wrestle with whether youre at the last resort yet. No wonder there are so many anecdotes of meds not working, when people wait till the situation is totally f**ked up before they will use them.

[Cort Haus]

Originally posted by Spec
Yes she has, but more than a year ago.
Spec.

Could be a factor, unfortunately. Such anxieties can be persistent.

[snoopy369]

Originally posted by lord of the mark
IIUC behavioral therapy, involving gradual desensitatization, tends to work pretty well for this and other specific phobias. Though for underlying anxiety disorders Cognitive therapy and meds are preferred.

I still dont see why meds are "last resort". Is coffee your last resort to wake up in the morning? Is a decongestant your last resort for dealing with hay fever? If meds ARE recommended, theres no good reason to let things get worse while you wrestle with whether youre at the last resort yet. No wonder there are so many anecdotes of meds not working, when people wait till the situation is totally f**ked up before they will use them.

Indeed. I blame scientology for this

Seriously though, quite a few psychological disorders have brain chemistry as their root. This is a fact, and is not disputed by any serious non-scientologist scientist. Correcting them using psychiatric medications can be very effective. Not all psychiatric medications have significant side effects, either ... and many have much more significant benefits than their side effects.

But it depends on quite a few factors, and do your research first. Know what the side effects are, and you can make informed decisions based on this

[Spec]

Usually, is this medication permanent? If not, when the treatment stops, are there any side effects?

Spec.

[lord of the mark]

Originally posted by snoopy369


Indeed. I blame scientology for this

Seriously though, quite a few psychological disorders have brain chemistry as their root. This is a fact, and is not disputed by any serious non-scientologist scientist. Correcting them using psychiatric medications can be very effective. Not all psychiatric medications have significant side effects, either ... and many have much more significant benefits than their side effects.

But it depends on quite a few factors, and do your research first. Know what the side effects are, and you can make informed decisions based on this

sure, im all for doing research, and being informed, and certainly I dont think folks should RELY on meds and ignore therapy, life style changes, whatever.

What galls me is folks who think - Im depressed or suffering an anxiety disorder. Wont get meds its not the last resort, let me try taking walks in the sunshine. Oh, I lost my job, I'll try therapy, but it wont be frequent, because I cant afford it any more. Oh, I can hardly get out of bed my home is a mess, ive lost all contact with the world, im suicidal, hey maybe I should try meds? Damn, Ive taken an SSRI, and I still dont have a job, and my home is a wreck, and ive lost all my friends, damn this SSRI hasnt solved my problems, SSRIs are the suxors.

[lord of the mark]

Originally posted by Spec
Usually, is this medication permanent? If not, when the treatment stops, are there any side effects?

Spec.

Im not actually a doc (I could play one on TV though) I dont know any general rules about the treatment of agoraphobia, and my knowledge of general anxiety disorder is heavily anecdotal. My understanding is that anxiety problems can be alot more chronic than depression, and some folks probably would be best off being on SSRIs or similar meds permanently. OTOH i suppose if someone could use the time on meds to make changes to their environment, their life, to reduce stresses and sources of anxiety, that could reduce their symptoms, depending on how much their anxiety is triggered by externals. So then they wouldnt need meds anymore. Though i find anxious people can always find SOMETHING to be anxious about, no matter what their life position is.


As for side effects, most of them are associated with taking the med, and IIUC go away when the med is gone. Although the most common side effect is weight gain, and that obviously doesnt just disappear - you have to do all the usual weight loss stuff to get rid of it. Sounds more like youre worried about a rebound or "addiction" type effect. From what ive read amon SERIOUS types there isnt any addiction effect from SSRIs (old style tranquilizers are of course a totally different story) . There may be some rebound, but thats usually dealt with by easing off the med, and doing so while in weekly therapy.

[Jon Miller]

Originally posted by lord of the mark
I still dont see why meds are "last resort". Is coffee your last resort to wake up in the morning? Is a decongestant your last resort for dealing with hay fever?

Yes and Yes. Very last resort.

I do think that things should be used when they can still act... but chemistry shouldn't be used unless it is really needed.

JM

[lord of the mark]

Originally posted by Jon Miller


Yes and Yes. Very last resort.

I do think that things should be used when they can still act... but chemistry shouldn't be used unless it is really needed.

JM

well at least you're consistent. Lots of folks arent though.


But you dont know what is really needed, unless you try everything else first. And since depression and anxiety disorder are dynamic things, which make real life worse, and then are worsened by real life in a vicious cycle, waiting to be certain doesnt seem like a winning strategy to me.

[Zkribbler]

Originally posted by Jon Miller
This sounds like a situation where a psychologist could help. At the very least identifying the issues is important and should be something they can assist with if she can't identify them on her own.

JM

I think Jon has spotted the best solution. To the uninitiated, agoraphobia sounds like a silly disease, but it can be quite debilitating.

[Aeson]

Originally posted by lord of the mark
What galls me is folks who think - Im depressed or suffering an anxiety disorder. Wont get meds its not the last resort, let me try taking walks in the sunshine. Oh, I lost my job, I'll try therapy, but it wont be frequent, because I cant afford it any more. Oh, I can hardly get out of bed my home is a mess, ive lost all contact with the world, im suicidal, hey maybe I should try meds? Damn, Ive taken an SSRI, and I still dont have a job, and my home is a wreck, and ive lost all my friends, damn this SSRI hasnt solved my problems, SSRIs are the suxors.

More often than not the problem is the other way around. I was on an antidepressant before I ever even knew I was depressed. I wasn't sleeping well, went to a doctor, he sent me to a psychologist, he talked to his psychiatrist colleague, and voila... I get Zoloft and some sleeping meds. (Then shortly after, some nasty reactions to the Zoloft, Anaphranil. And nothing changes...)

Most of the kids I knew in hospitals were that way too. Showed some abnormality (personality?) and their parents and/or shrinks had never taken the time to actually try to address the problems, the kids get pills for symptoms. The kid is acting out, it's ADHD, so you give them ritalin... timid and shy, anxiety, give them paxil... closed off and despondent, depression, well that's what prozac's for... moody, bipolar, lithium will fix that right up... yah, right. The sad thing is that it was rather obvious what the problems were in most cases after just a few minutes of talking with the kids... a lack of parental involvement in their lives, or parental abuse, were by far the most common problems... but that years of meds and avoidance had left meds and hospitalizations as the only options.

Chemical imbalances can exacerbate things, and meds can help address that... but that is usually only a small part of the problem. (The really nasty stuff like schizo and psychotic aside...)

As for coffee... I've never drank a cup in my life. I've had caffeine in sodas occassionally, but never drank them for the caffeine except since I was a teenager, and then only on road trips. Don't do that anymore either, fruit juice (and not eating drive through crap) keeps me more alert anyways. I haven't even taken an asprin or tylenol in over a decade.

Meds are for when the other options don't work. The difference between what I mean when I say that, and your "timeline" is that you're including avoidance of any treatment until it's too late. Of course that's not going to work, but it isn't a problem inherent with wanting to try other options before meds. A good therapist, given some time, will figure out if you need meds or not. And that time is necessary before anyone could know the right meds anyways. That's why it's the last option. (At least common option... hospitalization, ECT, restraints... those come later still of course.) There's just no point in skipping the analysis process and starting with the "cure".