Phobic and anxious

Thanks for writing.

The distress and the sincere desire to get better expressed in your letter touched me. I know how devastating anxiety attacks are and how frightened and alone agoraphobia can make one feel. It is good that you have talked to your parents and are looking for help. Agoraphobia can be successfully treated. There are many different treatment plans out there for you so don't give up the search for help. Rather then recovering, think in terms of learning how to reduce and deal with your anxiety so that it is no longer so debilitating as it is now for you.

Usually the first step is to reduce anxiety thought medication and/or behavioral supportive therapy. Techniques include various forms of exposure to the events, situation(s), places that frightened you, or systemic desensitization whereby under the guidance of a therapist, exposure makes use of your imagination to visualize the places you fear. Self- help groups can also be quite beneficial. Concealing the attacks and feeling that you are not normal will only increase your anxiety. Involving you family in the therapy can be quite helpful too.

One technique important in coping with anxiety is deep breathing. Other ways that can help you relax include yoga, tai chi, relaxation techniques like visualization, physical activities like swimming and massage therapy. You might start off with videotapes at home until you feel competent enough or safe enough to take classes outside of your home. Your boyfriend and/or family could join you in learning one of these techniques to increase your motivation and make it more fun.

During a panic attack without realizing it, you are focusing on the future, the fear of having a panic attack, the fear of fear. These fears are called the "what if's"? "What if" I faint in public or go crazy, etc. As soon as you start to become anxious, try deep breathing. Concentrate on the present, repeating words to yourself that calm you down. Try out a few until you find one that helps you; for example: "it is just a panic attack, I will be fine in a short while." These techniques take time and practice. You probably will need professional help in order to guide you and give you the necessary support. Your boyfriend may feel too closely connected to you to be able to give you the advice you need.

Learn to breathe deeply to control anxiety. When people are anxious or frightened, they take rapid, shallow breaths or hold their breath. Agoraphobics and others, with constant high levels of anxiety, breathe this way all the time, using only the upper chest and drawing in and out through their mouth. Relaxed breathing is from the diaphragm, which involves taking slow, rhythmic breaths. Breathing is directly related to how we feel: shallow-fast creates anxiety, slow-deep equals calmness. We can lower our anxiety by consciously learning how to breathe deeply. Until it becomes natural for you it is best to start practicing deep breathing at moments when you are least stressed. Deep breathing is easiest in a lying down position. Remember to breathe very slowly. Imagine a balloon in your stomach as you inhale. Focus on your breathing as you slowly exhale. Always wait a few seconds between each breath. Start off with only 3 deep breaths and try to practice often both sitting and standing. You can learn deep breathing in yoga classes or with a therapist.

Though anxiety appears to be the main problem it may mask underlying childhood traumas, unresolved grief or past conflicts. You mentioned that your anxiety attacks began when you were 5 years old. Did something happen back then? The event might have been a small one which, as a child, your imagination magnified. I also have the impression ("I want my life back") that your anxiety has become worse recently. What happened around the time that these attacks increased? While working to reduce the symptoms, it is important to explore and treat the underlying issues. Psychotherapy may help to discover what is bothering you. It may also help you gain self-esteem and confidence in your ability to function in the world. People with agoraphobia are frequently so caught up with their panic that they do not relate to their own emotions. They are not conscious of what causes their fears. You could keep a journal and write down everything that you remember thinking just before an attack.

Remember to keep looking for the right therapist for you. To reduce anxiety attacks, it is very important to have a therapist that makes you feel safe. If you were, for example, to buy a new dress, you might search several stores until you found the right dress. Rather then giving up on therapy, make an effort to search out for the right therapist. Medication can also take time and require a trial and error period. I hope that I have been of some assistance to you on your journey to get better.

Sincerely,

Gloria Horowitz, MSW