Do you struggle to leave the house without a friend? Are you frightened of what might happen if you get stuck on a busy train or in an elevator on your own? Do you feel a sense of panic at the thought of being left alone or in a large crowd of people? Do you do everything in your power to avoid these situations? If so, it is possible you may be suffering from Agoraphobia.
What is Agoraphobia?
At its simplest, Agoraphobia is a fear of experiencing a panic attack. A known complication of Panic Disorder, Agoraphobia can be described as the anxiety associated with being in a particular situation or place from which escape may be difficult or help may be hard to access if a panic attack does occur. Commonly known as a fear of open spaces, Agoraphobia is actually much wider reaching, and can lead to avoidance of any feared situation, including being alone at home or away from home, being in crowded areas, including shopping centres and even buses, trains and plains, or even being in an elevator or an a bridge.
How can I tell if I have Agoraphobia?
Agoraphobia is characterised by anxiety or fear about being in places or situations where a panic attack might occur. As with panic attacks and panic disorder, no two people will experience Agoraphobia in the same way. In order to avoid the anxiety, people suffering from Agoraphobia may completely avoid the situation, only enter the situation or place with a companion, or reluctantly endure the situation under duress and with extreme anxiety.
How common is Agoraphobia?
Approximately 2% of the population will experience Agoraphobia in any given year. Agoraphobia tends to be more common in females, and will usually start in their mid to late twenties.
If left untreated, agoraphobia can become a chronic and disabling disorder that can significantly interfere with an individual’s work and social functioning. Like other anxiety disorders, however, agoraphobia responds very well to treatment and successful recovery is seen with a variety of treatment programmes.
What are the Treatment Options?
Because Agoraphobia is based on a fear of panic attacks, similar treatments to those of panic disorder and panic attacks are used.
As always, it is important to consult a Doctor to rule out a medical condition if you suffer anxiety or panic symptoms. Some drugs and supplements can cause anxiety, so it’s best that you let them know about any prescriptions, over-the-counter medications, herbal remedies or recreational drugs that you might be taking. If a medical cause is ruled out, the next step is to see a psychologist who has experience treating anxiety and panic disorders, and more specifically, Agoraphobia.
The specific treatment approach will depend on the severity of the panic attacks, and whether they are happening in tandem with any other depressive or anxiety disorders. Treatment options for Agoraphobia tend to include exposure therapy, cognitive therapy, assertiveness training, group therapy and medication. As with anxiety, panic disorders and panic attacks, Agoraphobia has been found to respond very well to treatment, but the best results are found when people are motivated and willing to make a change to their lifestyle.
Some changes that have been found to reduce the intensity of attacks include:
- Utilising deep relaxation techniques, such as meditation or muscle relaxation
- Regular exercise
- Cutting back on stimulants, such as coffee and alcohol
- Learning to acknowledge and express your feelings, rather than ignoring them
- Using positive self-talk to create a calmer and more accepting attitude
How can we help with Agoraphobia?
At the core of Agoraphobia is the fear of panic attacks, which themselves are a biological fear response. The key to treatment is to develop strategies that help remove this fear so that the attacks no longer have the power to frighten you.
When you come in, your Psychologist will firstly make sure you feel comfortable and supported. They will then gain an understanding from you about how you are feeling and thinking, and what is happening in your life. You will most likely be asked to do some simple tests, and these will help to assess the severity of your Agoraphobia and associated panic attacks, and whether you are suffering any other symptoms of anxiety or depression.
You will also be asked questions to uncover what might be the causes and stressors in your life, and your Psychologist will work with you to devise a treatment plan that will suit you and your lifestyle.
After your initial session, you will have some insight into what the problem is, a plan for therapy for the future, and some initial strategies to help get you started.
If you're concerned about the possibility you may be suffering from Agoraphobia, Anxiety or Depression and would like to see one of our experienced psychologists, contact us today.
Male depression has been a very well kept secret until Terry Real published his book "I don't want to talk about it; Overcoming the Secret legacy of Male Depression" in 1977.
Since then a number of prominent Psychologists have written and educated our profession of Psychology about this condition, the most recent one being David Wexler.
In his book "Is he depressed or what?" David describes how male depression shows itself differently from normal depression.
Men who appear "successful" can often mask their depression with workaholism, substance abuse, withdrawing from their intimate relationships, and defensive and sometimes aggressive behaviour with others.
Depressed men are more likely to talk about physical symptoms such as headaches, insomnia and stomach upset rather than emotional symptoms.
If you are one of these men, you may also be aware of feeling stressed or tired, but not be aware of much else emotionally.
To simplify a generalisation, while women tend to think and process their emotions when they are depressed, men instead tend to act, so they turn to an activity that they enjoy or they distract themselves from their bad emotions.
While distraction can come in very handy at times, the pattern of avoiding uncomfortable emotional states often leads to avoidance, minimization and acting out. There are 4 ways a man will usually avoid feeling bad:
The 4 Characteristics of Male Depression
1. A discontent with yourself
2. Antagonism and blame towards others
3. Exaggerated behaviour
4. Avoidance and escape
These can also overlap with some of the normal depression symptoms of pessimism, despondency, sleep and appetite disturbances, but usually are features on their own as a way of fending off an underlying depression.
1. Discontent with yourself
One of the primary features of Male depression is a profound unhappiness with yourself.
If you have experienced a loss in your life, a demotion, a business failure, a relationship ending, a reduction in financial assets or any other kind of loss, it can be difficult not to take it personally, and feel shame and self-criticism.
It can also be a further blow to your ego for those around you to be diagnosing you with depression, which is the antithesis of being a strong male.
Although this occurrence may be temporary and/or based on circumstance, it can be difficult not to see as a personal failure.
2. Antagonism and blaming others
In these larger situations where you feel a failure, or even smaller occasions when you are feeling somewhat powerless, hurt or threatened, it can be all too easy to get tripped up with unknown vulnerable emotions that you are not really aware of, and find yourself responding by "puffing yourself up" to go on the offensive.
On so many occasions then, it can feel like your emotional survival depends on fending off any other experiences that make you feel worse about yourself or more hopeless of the future. The best defence it seems is a good offence.
So when you smell danger, as in situations that might make you feel bad about yourself, you proactively go on the attack.
And often the ones you attack are those closest to you, including your partner.
The movie "Good Will Hunting" is a great example of a man who goes on the offensive and attacks his girlfriend, when she has asked him to move to California with her, which brought up his insecurities and had him feeling like he had to defend himself by attacking her and telling her he didn't love her.
Another form of blaming and antagonistic behaviour can be expressed through suspiciousness and mistrust.
When you are feeling insecure and worried in a situation with a partner, it can be all too easy to blame her for being untrustworthy, even if she isn't, which over time can then become a self- fulfilling prophecy of mistrust and betrayal.
It is important to understand how this happens, as many men are capable are changing this pattern when you know how and why it is happening.
3. Exaggerated behaviour
When you are not aware of your underlying bad feelings about yourself and depression, your typical response may well be to prove you're a man with exaggerated hyper-masculine behaviours.
This can be by seeking out excessively stimulating experiences, or drinking to excess, or taking drugs, or going out looking for a fight (desperately looking for something to be angry about), or wanting lots of sex.
4. Avoidance and Escape
When you realise that you are deliberately engineering to keep yourself away from any situations in your life that you don't want to be in, you are using avoidance patterns in your life. Some go as far as systematically (or unconsciously) refusing to put themselves in situations where they may get hurt or suffer loss, like in relationships at all.
A little bit of this is normal for men, but too much of it can signify underlying depression which can seriously destroy their relationship.
This avoidance, although a drive for emotional protection for a man makes sense in some way, but it is very corrosive to both yourself and your relationship.
To help you assess if you are suffering from male depression take our Male Depression Quiz.
The overwhelming majority of depressed men who recognise and deal with their condition do so because their partners have recognised, encouraged and at times insisted on it.
As Terry Real has said "Depression is one of psychology's greatest success stories. 90% of those who seek treatment report substantial relief."
So please don't hesitate to call us.
For help with either Male depression or normal depression, please contact us at HartPsychologists. We have Psychologists to help you in all capital cities and more: Sydney, Melbourne, Brisbane, Adelaide, Perth, Canberra, Gold Coast and Sunshine Coast.
You don't need to suffer on your own.
Most people agree that high self esteem is central to good mental and physical health and overall life satisfaction, and is very important in motivating a person to work hard and succeed. When we overcome any anxiety and/or depression our self esteem usually soars.
In addition, those with high self-esteem tend to be friendlier, more expressive, more active, more self-trusting and trusting of others, and less troubled by inner problems and criticism.
How lucky you are if you have high self-esteem!
What is High Self Esteem?
Self-esteem is a realistic, appreciative opinion of yourself. Realistic means accurate and honest. Appreciative means positive feelings and liking.
You view yourself and others as equals and everyone is on a level playing field, and you are equally respectful of yourself and others.
You take honest ownership of those things that you are responsible for (but not those things that you are not responsible for)
Poor Self Esteem
When you have poor self-esteem, you feel less than others and feel shame about it. You hold an unrealistic and unappreciative view of yourself, and see others as better than you.
You also can tend to take on responsibilities for not only you own doings, but those of others too.
How does high Self Esteem differ from Narcissism?
It is important to understand the difference between high self-esteem and grandiosity or narcissism.
When you are grandiose or have narcissistic tendencies, you have an unrealistic and very appreciative view of yourself.
You believe you are more important or better than others, and like to be on top, therefore putting others below you.
In addition, you tend to blame outwards towards others, not wanting to take responsibilities for your own actions.
So how does our Self Esteem develop?
Our self-esteem is most greatly influenced by our parents and caregivers.
As babies and children, we have crucial emotional and attachment needs. These include a need to be listened to and emotionally validated; to have our feelings, needs, wants and intuitions accepted and encouraged, and to be emotionally supported in growing and fulfilling our desires and goals.
When these needs are fulfilled we grow up fully nurtured, and aware of our feelings, needs, wants and intuitions, as well as those of others, and tend to grow more fully into our full size, with an accompanying natural high self-esteem.
However most parents, in varying degrees of course, do not realise that these are the important needs of their children, and as well, often have a raft of other issues that they are already dealing with, so may not be able to fulfil many of these roles for their children.
As a child, we view our parents as almost God-like, and when our emotional and attachments needs are not met, we usually blame ourselves. We perceive that there is something wrong with us and we develop limiting beliefs about ourselves. This is where our lower self-esteem originates, as we become stunted from emotional undernourishment.
But the good news is that at any stage of our life, we can heal and grow our Self Esteem, and as Psychologists, this is a very common role we can play in people’s lives.
But first, let’s check how your Self Esteem is:
The Self Esteem Checkup:
With each statement, rate from 1 – 10 how much you believe each of the following statements. 1 means you completely disbelieve it. 10 means you completely believe it.
- I am a worthwhile person -------------
- I am as valuable as a person as anyone else -------------
- I have qualities I need to live well -------------
- When I look into my eyes in a mirror I have a pleasant feeling -------------
- I don’t feel like an overall failure -------------
- I can laugh at myself -------------
- I am happy to be me -------------
- I like myself, even when others rejects me -------------
- I love and support myself, regardless of what happens -------------
- I Am generally satisfied with the way I am developing as a person-------------
- I respect myself -------------
- I’d rather be me than someone else -------------
Now place your number of the following scale:
Total lack of SE Total fullness of SE
Now ask yourself, how often do you feel restricted in your daily activities because of difficulties with self esteem?
1 2 3 4 5
Always Often Sometimes Rarely Never
If you have scored low scores on either of these, please consider contacting us, as our Psychologists Australia wide, are very experienced in helping you develop your self-esteem.
Phone our friendly receptionists on 1300830552 to or email us an enquiry to find the right Psychologist for you, nearest you.