How you choose to measure progress can make a world of difference in your recovery. It is a common mistake to judge a practice session as a failure if you feel too anxious. This is a mistake for at least 2 reasons:

1) Facing fear almost never feels good. Especially when confronting a new fear for the first tme.

2) People who suffer from agoraphobia tend to engage in black-or-white thinking and label experiences in extreme terms (success or failure, good or bad).

These two factors make it more likely for a practice session to be regarded as a failure rather than a success. This leads to a negative perception of progress toward recovery and can be very discouraging.

It is far more productive to measure your progress by what you are able to do rather than how you feel while doing it.

If you can venture just a little bit further from your safe zone than the day before, or stay in a feared situation just a little bit longer then you are making progress and your practice session is a success, no matter how you feel.

When you stay in situations despite anxious or panicky feelings, you show yourself that panic and anxiety are not dangerous and will not keep growing worse until you pass out or die. Over time, as you prove to yourself that panic symptoms are not physically harmful, they will eventually lesson.

Only you know your limits. Only you know how much anxiety you can tolerate as you practice facing your fears. But judging your progress according to what you can do, and celebrating each time you are able to do more as a positive victory, despite your feelings, will help you stay on the shortest path to recovery from agoraphobia.

I bet you can’t believe the title of this post. You probably didn’t know that there can be benefits to having agoraphobia (along with the obvious drawbacks).

But on tonight’s group phone call, this question was raised by someone -

“Why does it seem like I can only recover to a certain point and then my progress stops? It is like I have hit a wall I can’t get past.”

Here is a possible answer - sometimes the benefits of having agoraphobia outweigh the benefits of recovery. This idea is well supported by research. Psychologists have isolated at least 5 things that people may GAIN from having agoraphobia, and the fear of losing any one of these can block motivation to get better. Here are is the list:

1) Extra attention

2) Help or assistance from someone

3) Emotional support

4) Financial support

5) Closeness with someone you love

Does having agoraphobia cause you to benefit from any of these 5 things? And if so, are you willing to risk giving up this benefit to recover?

This is a question you must dig deep to ask yourself. It is a question that it is hard to hear from someone else because it can seem so accusatory. No one likes to admit, let alone be asked, that they might be gaining something from a a condition like agoraphobia and are having trouble letting that something go.

But if you are serious about recovery, this is a question worth asking yourself. And if you discover that you are deriving a benefit from agoraphobia, let it go.

Your freedom is worth the price.

Well, I am not a doctor - but I have a close friend who is a pharmacist. Plus, I have a little experience with taking meds as an agoraphobic.

Basically, there are 2 main types of medications doctors will prescribe for anxiety, panic, or agoraphobia:

1) Benzodiazepines like Xanax, Valium, and Ativan.

These are anti-anxiety meds and you experience a pleasant, calming, euphoria in about 20-30 minutes after taking them. But they can be addictive (physically) and you are likely to develop a tolerance meaning it will take more and more to do the trick as time goes on if you rely on them every day.

Another drawback with Benzodiazepines is that besides being potentially habit forming, withdrawing from them can cause the very anxiety symptoms they were meant to relieve. If you want a slower acting tranquilizer, but with fewer risks, you might ask your doctor about a drug called Buspar.

2) SSRI Anti-depressants like Zoloft, Paxil, Prozac, Luvox, etc…

You won’t feel the euphoria or relaxing feelings from these medications, but they are mood stabilizers known to block intense episodes of panic. Plus, they take care of depression that often comes with agoraphobia and anxiety disorders. I think doctors are putting people with anxiety on these nowdays because they help panic AND depression. But you don’t get the good, relaxing feeling from SSRIs.

Also, anti-depressants are known for having stronger and worse side effects than benzodiazepines, the nature of which depends upon the specific anti-depressant you take.

Whatever you do, avoid Effexor - it is an SSNRI anti-depressant that carries a major warning label about side effects. The problem is, doctors don’t always disclose this. I have heard many horror stories from people about the scary side effects of Effexor.

My position on medication is this - I found using Xanax helpful to calm situational anxiety to get through a bad time. Plus, carrying Xanax in my pocket gave me confidence as I practiced facing my fears (like going back to work or school) because I knew I could always get relief from anxiety if it got too far out of hand.

But ultimately, learning to relax and control your thinking is the way to lasting recovery from agoraphobia, Medication is not a cure and quits working when you quit taking it. My motto is “skills not pills are the answer to agoraphobia.”

Do you ever worry about the pace of your recovery from agoraphobia? Do you ever say to yourself: “At this rate, it could take forever to get my life back?”

When first trying to overcome irrational fear and anxiety it can feel like maximum efforts lead to only minimal results. If you feel this way, you are in good company.

I would be embarrassed to to tell you exactly how long it took for me to make it to the end of my driveway to get the mail without being overcome by a panic attack. I remember thinking: “If it takes this long to make 20 yards of progress, then I will be about 100 years old when I finally return to work or school.”

This sort of thinking can be demoralizing when you are working hard to overcome agoraphobia. In fact, it can make you feel like giving up. But knowing what to expect in the normal course of recovery from agoraphobia can help you avoid being derailed by discouraging thoughts and stay on the most direct path to freedom from fear.

Here are 5 Laws of Recovery from Agoraphobia that summarize what you can expect in the typical course of recovery from agoraphobia:

Law 1: The Law of Time:

It takes an average of 12-16 weeks to see significant progress if you are faithfully following a cognitive-behavioral treatment program.

Law 2: The Law of Momentum:

When it comes to recovery from agoraphobia, intitial progress will be harder to attain than later progress. In other words, things get easier and recover goes faster with time.

Law 3: The Law of Consistency:

No one heroic effort will set you free from agoraphobia. Freedom comes from practicing lots of little things every day.

Law 4: The Law of Inconsistency:

Don’t expect progress to be all forward. The road to recovery has its ups and downs, but a bad day does not mean you are further away from recovery than the day before.

Law 5: The Law of Aftershocks:

Expect to have some late panic attacks even after you are recovered. Most people do. This does not mean you will get agoraphobia again.

Medication was not a regular part of my recovery program. However, I did take Xanax on a limited basis.

I often carried two .25mg pills in my pocket to get me through a particularly panicky time. But I did not take Xanax every day.

My philosophy about medication is that pills are helpful when used on a temporary basis and combined with cognitive-behavioral methods. Medication can provide a window of opportunity to practice overcoming fear with the confidence that your anxiety won’t get too far out of control.

The danger lies in attributing too much of your progress to medication. People who attribute their progress to medication are less likely to make a complete and lasting recovery from agoraphobia than people who attribute their progress to developing skills.

Ultimately, skills not pills will set you free from agoraphobia.

But don’t be afraid to use medication temporarily, and under the supervision of a doctor, if it is part of a larger recovery plan.

I was asked a great question recently,

“If certain situations trigger panic, then why do we sometimes panic in a situation, and then are sometimes able to stay calm in that same situation?”

The reason why we react differently in the same situation s because panic attacks are not a purely automatic response. If I have written somewhere that situations trigger panic, this should not be taken as an absolute rule.

We may react differently in the same  situation because there are two sides of the brain at work when it comes to panic attacks.

Sure - panic attacks are partially triggered by emotional memories or associations formed in the right brain through experience. But your thoughts, which come from the left side of the brain, also play a role in determining whether or not you panic. Your thoughts can override a panic attack.

That’s why I recommend self-help techniques for agoraphobia that work on both sides of the brain:

1) Relaxation, visualization, and reconditioning to replace associations on the right side.

2) Learning to detect and replace panic-producing thoughts on the left side.

Of course, many other factors influence a panic attack, such as being tired. But these are the two major influences, associations and thoughts.

For most people with agoraphobia, the safe zone is either their home or a certain distance from their home. Much literature on agoraphobia recovery is written with this assumption.

Recently, I was emailed a very good question that challenges this assumption:

“Why did I have a panic attack when I went shopping just two streets away, but on another day I traveled 1400 kilometers without having a panic attack?”

The answer to this question lies in understanding how the safe zone develops. The safe zone is not always defined as a certain distance from one’s home in all  directions.

Phobias like agoraphobia develop through associations formed in the brain through experiences that are recorded as emotional memories. In other words, safe places are places in which someone with agoraphobia learns to associate safety through pleasant emotional experiences. Unsafe places are places in which a person learns to associate fear or danger through experiencing panic attacks.

In most cases, a person with agoraphobia experiences panic attacks in so many places away from home that the fear generalizes - and most places outside the home become regarded as unsafe. In other cases, the fear does not generalize and certain places are recorded in the brain as unsafe due to panic experiences, while other places remain perfectly safe.

In summary, panic attacks are most likely to occur in places where the brain has recorded a memory of panic, regardless of the distance from home. If the fear does not generalize, places in which a person has not experienced a panic attack are less likely to trigger one.

This is a common question for parents with agoraphobia, especially if they have young children. If have agoraphobia, it’s natural to feel concerned about your children developing anxious or phobic behaviors from watching you.

The best information and advice for people in this situation is written in a book called “How to Help Your Loved One Recover From Agoraphobia” by Karen Williams (in Chapter 5 “How Agoraphobia Affects the Family”)

Here is a summary of what the chapter says:

There is some evidence that phobias, including agoraphobia, are passed on both genetically and by modeling (though experts disagree on the strength of each influence). So trying to hide agoraphobia from your children, or not talking about it won’t really protect them.

According to Dr. Arthur Hardy, who spent his life treating agoraphobics including Karen Williams (the author), “it helps children to be allowed to take part in the recovery process.” Dr. Hardy believes that this helps keep children from becoming phobic themselves. If you have agoraphobia, he suggests that you allow your children, if they are old enough, to help you in positive ways such as goal setting and practicing facing your fears.

But even if your children are not old enough to help in the recovery process, the best thing is to model recovery from agoraphobia and not avoidance behavior.

Also:

- Make sure your children know they are not to blame for your anxiety and panic attacks, that you are not mad at them, and they had nothing to do with the cause of your problem. Children have a tendency to blame themselves or feel guilty when a parent has a problem like agoraphobia that they don’t fully understand.

- Make sure your children have permission to be angry at the way agoraphobia makes you act sometimes, and give them a chance to talk about it.

- If agoraphobia is keeping you from paying the amount of attention to your children that you feel they need, communicate the reasons why the best you can and arrange for your child(ren) to receive attention from another source, such as a close relative or trusted friend. This will help keep your chidren’s self-esteem healthy, and keep them from feeling rejected.

Of course, the level of communication you can have with your children about agoraphobia will increase with their age, but “with a little attention and sensitivity on the part of the parent, children will come through this crisis better than most parents think they will” (quote from the author).

“Can agoraphobia be cured?”

“Will I ever be able to get completely over it?”

“Will I ever live a normal life again?”

Though it exists in many forms, this is the number one question I have received from visitors to the Agoraphobia Help website. And the answer to this question is yes!

Agoraphobia CAN be completely cured and you CAN get completely over it. I am living proof of this.

Agoraphobia is highly treatable because it is not a mental illness. Anxiety disorders and phobias, of which agoraphobia is both, consist of learned thoughts and behaviors. The good thing about learnd thoughts and behaviors is that you can unlearn them.

I am not saying that it’s easy to unlearn panic or irrational fear, but it can be done if you do the right things consistently over time.

If you have agoraphobia can lead a normal life again. In fact, research says that about 90% of people who practice cognitive-beavioral therapy (CBT) on a consistent basis either recover from agoraphobia completely or have a significant reduction in symptoms.

Today, I emailed a survey to everyone on my list asking this question:

“What is Your Biggest Question About Agoraphobia?”

I had about 45 responses within one hour, and the questions keep coming in. I want to answer as many or all of the questions that I can - and here are the ways I am going to do it:

1. Through the weekly Voice of Hope Messages (sent each Friday people on my mailing lists).

2. In the monthly Agoraphobia Report Newsletters.

3. Through regular posts on this blog.

4. During upcoming telephone seminars.

I am going to be offering telephone seminars very soon, to give you a chance to get on the phone with me and ask questions. These teleseminars will also give me the chance to go deeper and share specific, step-by-step details about agoraphobia recovery for those who sign up.

If you sign up for the Agoraphobia Report Newsletter, you will be notified of all the above. Also, if you have a question about agoraphobia click on “Questions?” and submit it. I will do my best to respond.

I care about your recovery from agoraphobia.