Agoraphobia- is anxiety about being in places or situations from which escape might be difficult or embarrassing and in which help may not be available in the event of having a panic attack or panic-like symptoms.  (DSM-IV, p. 396).

References used-American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4^th ed). Washington, DC: Author.
 

Internet Sites used Panic Disorders –

For information on Signs and Symptoms-

About.com-Panic/Anxiety Disorders- http://panicdisorder.about.com

All About Anxiety-Mental Health Net- http://anxiety.mentalhelp.net

Psych Central.com- http://www.grohol.com/disorders/sx27.htm

http://www.grohol.com/disorders/sx29.htm

http://www.grohol.com/disorders/sx28.htm

American Psychological Association - http://www.apa.org/pubinfo/panic.html

National Mental Health Association- http://www.nmha.org/pbedu/anxiety/panic.cfm

National Institute of Mental Health- http://www.nimh.nih.gov/anxiety/anxiety/panic/index.htm

Psychotherapy used in the treatment of Panic Disorders-

1. Cognitive Therapy- reducing negative thinking, irrational ideas, false conclusions about dying or going crazy, etc..
2. Behavioral Therapy- focuses on what one does, etc…
3. Cognitive-Behavioral Therapy- a combination of the two therapies and most widely used in the treatment of Panic Disorders.
4. Biofeedback-the technique of making unconscious or involuntary bodily processes perceptible to the senses in order to manipulate them by conscious mental control.

About.com-Panic/Anxiety Disorders- http://panicdisorder.about.com

All about Anxiety-Mental Health Net-http://www.grohol.com/disorders/sx28t.htm

Psych Central.com- http:// www.grohol.com/disorders/sx28t.htm

Mental Health Net- http://mentalhelp.net/psyhelp/chap5/chap5s.htm
 

Individual Therapy

Family therapy is usually unnecessary and inappropriate.
 

Relaxation and imagery techniques can also be taught in therapy.  These can be helpful during a panic attack to decrease immediate physiological distress and the accompanying emotional fears.  Discussion of the clients irrational fears of dying, going crazy, passing out, or embarrassment is often beneficial in the context of a supportive therapeutic relationship.

Group therapy can often be used just as effectively to teach relaxation and related skills.  Psycho-educational groups in this area are often beneficial.

Internet sites used-

Mental Health Net-http://mentalhelp.net/psyhelp/chap5/chap5s.htm

Psych Central.com- http://www.grohol.com/disorders/sx28t.htm

Anxiety-Panic Internet Resource-http://www.algy.com/anxiety/index.html

Biofeedback, a specific technique that allows the client to receive either audio or visual feedback about their body’s physiological responses while learning relaxation skills, is also an appropriate psychotherapeutic intervention.

For information call 1-904-732-7388 – (Biofeedback Society of Florida)

Or write :

Biofeedback Society of Florida

P.O. Box 23495

Jacksonville, Fl 32241-3495

Internet address- http://www.biofeedback.net/florida

Press E-Mail the President of the Society- Ron Rosenthal

For articles pertaining to biofeedback- www.dstress.com/articles.htm
 

Other interesting sites on biofeedback-

Biofeedback Research Institute- http://www.7hz.com

Biofeedback Certification Institute- http://www.netpub.sintl.com/bcia
 

      5 STEPS TO HELP WITH PANIC ATTACKS

1. RELAX- one-step that helps many get a handle on their panic attacks is to learn and practice relaxation strategies.  Changing your breathing patterns-slow down, get comfortable, and breathe deeply.  Scan your entire body- tensing and relaxing all your muscles. Take a mental vacation- mental imagery creates peaceful feelings.
2. CHANGE HABITS- sometimes it helps to make some changes in your daily routine, like adding exercise and reducing or eliminating stimulants like caffeine, nicotine, and sugar. Exercise burns off excess tension and eliminating stimulants prevents added anxiety.  Also if you bottle your feelings and worry a lot by yourself, pay more attention to your emotions and become more willing to express them to others.
3. DISCOVER THE POWER OF POSITIVE THINKING- another way of tackling panic attacks is to look at the way you talk to yourself, especially during times of stress and pressure.  Panic attacks often begin or escalate when one tells themselves scary things.
4. GET HELP- details about getting treatment and how to find the right professional help go to- http:// www.nimh.nih.gov/anxiety/anxiety.
5. KEEP THE FAITH- above all, have faith that you CAN learn how to handle panic attacks.

Counseling and Mental Health Center, The University of Texas-

Internet site- http://www.utexas.edu/student/cmhc/panic.html

National Mental Health Association-

Types of medications used in the treatment of Panic Disorders

1. Anxiolytics or Anti-anxiety- Examples- Xanax or Klonopin
2. Anti-depressants- Tricyclics-Tofranil, MAO Inhibitors-Nardil, SSRI’s- Paxil.
3. Buspar can be used in placement of Xanax –advantage-non-addictive.

Medications are not usually effective when used alone.  Mostly they are used in combination with therapy.

For more information check about uses, dosages, and side effects with a pharmacist or physician.

Internet sites used for medications-

Paxil Mental Health Weather Station-  http://www.panicattack.com/ocd/paxil/index.htm

PsyWeb- http://www.psyweb.com/Drughtm/klonopin.html

PsyWeb- http://www.psyweb.com/Drughtm/Xanax.html

Anxiety Relief Center- http://www.anxiety-relief.com

Dr. Bob’s Virtual En-psych-lopedia-http://uhs.bsd.uchicago.edu/dr-bob/tips/panic.html#English
 

Alternative Therapies

Reference- Treating Anxiety and Stress Naturally- http://depthome.brooklyn.cuny.edu/career/ANGST.htm
 

For Depression- Sam-e, and St.Johns Wort.

Reference- About.com-Panic/Anxiety Disorders-Reference Library for Alternative Therapies A to Z.

http://altmedicine.about.com/health/altmedince/library/weekly/bllibrary.htm

Other alternative therapies are also listed at the above internet site.  This site is interesting to explore.

Self Help Resources

Local bookstores have an abundant amount of literature on this subject.

A few examples-

An End to Panic: Breakthrough Techniques for Overcoming Panic Disorder, by Elke Zuercher-White (June 1998).

Anxiety and Panic Attacks: Their Cause and Cure: The Five Point Life- Plus Program for Conquering Fear, by Robert Handly, Pauline Neff  (June 1990).

Anxiety, Phobias, and Panic: A Step-By-Step Program for Regaining Control of Your Life by Reneau Z. Peurifoy (September 1995).

Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic by David H. Barlow (August 1998).

Popular internet bookstores-

Amazon Books- http:// www.amazon.com

Barnes and Noble Books- http://www.barnesandnoble.com
 

Of other awareness is testing on line for personality, anxiety, coping, and interests.

A few internet sites-

Personality Tests on the WWW-

http://2hw.com/tests/personality.phtml

Ask a therapist on line-

http://www.psychology.com

Keirsey Temperament Test-

http://www.keirsey.com

Online Psych-

http://www.allhealth.com/conditions/mental0,4264,39,00html
 

For more valuable resources

Other Important Facts

• Major Depressive Disorder occurs frequently (50%-65%) in individuals with Panic Disorder.
• Some individuals may develop a Substance-Related Disorder as a consequence, treating their anxiety with alcohol or medications.
• Co-morbidity with other Anxiety Disorders is also common.
• Separation Anxiety Disorder in childhood has also been associated with this disorder.

Additional Local Information

Public and Private Information and Referral Line for Human Service Systems

Baptist Healthcare- http://www.bhcpns.org Health Source Online, Find a Doc, Laurus Health –information on diseases, medication, etc..

Lakeview Center Inc.-Private and Non-Profit,

Adult Stress Treatment Program-850-434-4866

Baptist Christian Counseling Center-850-469-7689

Avalon Center for Group and Individual Counseling-850-623-9434

Healthcare Source- Physician Directory-850-434-4080
 

Lutheran Services Florida- Religious Base for Counseling of Individuals, Teenagers, Adolescents, and Families

Catholic Social Services

West Florida Regional Medical Center- http:/www.westfloridahospital.com

Alcoholics Anonymous- 850-433-4191-Central Office-Schedule for Meetings
 

Also check the Sunday Pensacola News Journal (Health Section)- for a list of support meetings and informative classes available.