Overcoming Agoraphobia - Q&A

Overcoming Agoraphobia - Q&A

Karen Cassiday, PhD, ACT

Karen Cassiday PhD

Member Since 2004

Karen Cassiday, PhD, ADAA Past President's areas of interest are anxiety disorders in children and teens, social anxiety disorder, treatment-refractory OCD, and working with children and teens who suffer from both developmental concerns and anxiety disorders. Her research has focused on information processing in posttraumatic stress disorder and cognitive-behavioral treatment of anxiety disorders in children, teens, and adults.

Dr. Karen Cassiday is a lively, sought-after speaker and commentator on national media such as Nightline, The Today Show, Animal Planet, The Joy Behar Show, Huffington Post, public radio and many more. She is a TEDx speaker who shared her personal experience as a mother overcoming her own anxious perfectionism in the middle of Walt Disney World! She is the host of the Moms Without Worry radio show. She served as the President of the Anxiety and Depression Association of America and is the founder of the Anxiety Treatment Center of Greater Chicago, the longest-running clinic to first use modern exposure-based treatment for anxiety disorders in the Chicago region. She won the Anxiety and Depression Association of America’s prestigious Clinician of Distinction Award and is a Clinical Fellow. She is also a Diplomate and Founding Fellow of the Academy of Cognitive Therapy, served as Chair of the Scientific Advisory Board of the Chicago OCD Foundation/Beyond OCD, and has been listed on numerous Who’s Who lists.  She has published numerous scientific articles and articles on parenting and managing anxiety. Dr. Cassiday is dedicated to helping mothers overcome the cultural pressure to be perfect and to raise perfect kids. She enjoys using her expertise from over thirty years in the field to help families overcome the dilemmas of parenting in a high-stress digital world. Her goal is to help all mothers embrace the messy hilarity of parenting with unshakable self-confidence so they can raise kids who thrive!

Dr. Cassiday and ADAA

"My graduate school advisor, Rich McNally, suggested ADAA would be a great place to join as a student so I could present my research and network with other like-minded people who were really interested in researching and treating anxiety disorders.”

“ADAA has given me many things I needed at different stages of my career that were either unavailable or hard to find.  Early in my career, I was often the only professional who knew about evidence-based therapies for anxiety and I needed a place to be with my own kind without having to explain myself and combat skepticism. Then I needed inspiration from the ideas of scientists and other clinicians so I could improve my clinical skills. ADAA also gave me a multi-disciplinary group that mirrored my daily work life and that felt great. I have really enjoyed the opportunity to share my knowledge by giving presentation. Lastly, ADAA has given me the opportunity to serve humankind in a bigger way by sharing my leadership skills on committees, the Board and as president.”

“I have depended on my ADAA colleagues throughout my career to give me inspiration, encouragement and mentoring for my clinical dilemmas and business dilemmas. The friendly non-competitive atmosphere has made it easy to call up anyone to get their advice. I don't believe that my patients and staff would have fared as well as they have had I not been very involved with ADAA."

Overcoming Agoraphobia - Q&A

Share
No
Overcoming Agoraphobia - Q&A

My experiences have taught me that the world is dangerous. Can I get better?

You most certainly can get better.  Many people who have had bad or traumatic experiences find themselves stuck in assuming that the world and people are dangerous, but of course this is not always true.  Many people and many situations are either neutral or beneficial.  Therapy that helps people like you learn to correctly identify healthy people and healthy situations can be very effective at helping you develop the ability to selectively attend to information that shows you the goodness in the world and the helpfulness in taking risks.  Science shows us that people who take risks have the advantage not only in recovery but in life.  They learn they can recover, discover and create new relationships and situations that work better.  Please consider getting some therapy so you do not have to continue feeling scared.  

How does agoraphobia differ from PTSD and how are they related? How is it different from OCD?

People with PTSD and OCD can avoid the situations they associated with their anxiety.  What they are avoiding, however, is not the physical sensations of panic, but instead, they avoid to prevent themselves from re-experiencing the trauma or encountering the triggers for compulsions.  In agoraphobia, the fear is of having a panic attack.  In PTSD, the fear is of being traumatized and in OCD the fear is of having the obsession come true.  People with all anxiety disorders and PTSD can experience panic attacks and avoid situations they fear, only agoraphobics focus upon avoiding the physical sensations of fear because they misinterpret them as being dangerous.

Can panic attacks become phobias?

People with panic attacks can get phobic avoidance of all the situations they believe might bring on a panic attack and therefore can be understood to be phobic.  People with specific phobias can get panic attacks, but they fear the experience of seeing or coming into contact with things that relate to one specific trigger, such as bugs, tornadoes, flying, seeing holes, etc.

What are the techniques we can use to overcome the physical symptoms of panic? Do these same techniques work for the mental symptoms?

Interoceptive exposure, or deliberately inducing the physical sensations of panic is the best way to get started on learning not to fear a panic attack.  Using real life exposure to the situations panic attacks make difficult to encounter, such as driving on a busy highway, going places with out a phone or being in a place you cannot easily exit is a great way to do additional exposure so you reclaim your ability to live freely.  The most important thing you can do for your mind is to learn that panic attacks are benign, self-limited and a false alarm.  If you read Reid Wilson's Don't Panic, you will get an excellent explanation of why all the physical symptoms of anxiety are benign.

Why does crying help soothe me when I’m having a panic attack?

Adults cry in response to any strong emotion, whether it is anxiety, anger or good humor.  We know that crying acts like the pressure release valve on an Instapot that reduces some of our distress.  I would never worry about the fact of your crying, but only assume it means that your anxiety level is high.  Many of my patients get teary-eyed when they talk about or experience their anxiety and this is completely normal.  

How do I overcome my agoraphobia and  panic in the context of driving? It feels so unsafe to have these symptoms when behind the wheel.

I have good news for you.  When we test people's reflexes and ability to think during a panic attack, such as putting them in a driving simulator, they do just fine!  One of the symptoms of a panic attack is to feel as though you are impaired and unable to process information.  Many people mistake this sensation for losing their mind, going insane or being unsafe to drive, parent or engage in normal activities.  It is so safe that I do not feel afraid of being the passenger in my patient's cars when we begin driving practice.  I even have my patients acutely hyperventilate to try and induce a panic attack while we do driving practice so they can learn they can still drive.

To get better, you need to practice driving.  You might start with a trusted friend as a passenger and drive easy routes that you gradually lengthen.  Then progress to more difficult routes.  The goal is to do repeated driving so you do it many times until it becomes easy and boring.  An experienced exposure therapist can help you do this if you are unable to practice on your own.

Depression is making it harder for me to recover, what do I do?

Approximately 80% of people who have continuing anxiety disorders end up getting depressed.  It is important to get professional help when depression makes it difficult or impossible to recover.  My suggestion would be to find a therapist who treats depression and anxiety and to consider speaking with someone who can prescribe medication for depression.  You do not have to stay stuck.  Many of my patients also experience depression and we treat both.

How do I find professional help to start getting better?

You are already at the right place.  The Find a Therapist section of this website can help you locate a therapist who is experienced and familiar with scientific treatment.  You should expect to get better.  To do that, you need to find someone who will directly help you learn to face, tolerate and overcome your agoraphobia instead of just talking about how you came to be agoraphobic.  
 

Watch Dr. Cassiday's Overcoming Agoraphobia webinar presented live on May 12, 2022

Karen Cassiday, PhD, ACT

Karen Cassiday PhD

Member Since 2004

Karen Cassiday, PhD, ADAA Past President's areas of interest are anxiety disorders in children and teens, social anxiety disorder, treatment-refractory OCD, and working with children and teens who suffer from both developmental concerns and anxiety disorders. Her research has focused on information processing in posttraumatic stress disorder and cognitive-behavioral treatment of anxiety disorders in children, teens, and adults.

Dr. Karen Cassiday is a lively, sought-after speaker and commentator on national media such as Nightline, The Today Show, Animal Planet, The Joy Behar Show, Huffington Post, public radio and many more. She is a TEDx speaker who shared her personal experience as a mother overcoming her own anxious perfectionism in the middle of Walt Disney World! She is the host of the Moms Without Worry radio show. She served as the President of the Anxiety and Depression Association of America and is the founder of the Anxiety Treatment Center of Greater Chicago, the longest-running clinic to first use modern exposure-based treatment for anxiety disorders in the Chicago region. She won the Anxiety and Depression Association of America’s prestigious Clinician of Distinction Award and is a Clinical Fellow. She is also a Diplomate and Founding Fellow of the Academy of Cognitive Therapy, served as Chair of the Scientific Advisory Board of the Chicago OCD Foundation/Beyond OCD, and has been listed on numerous Who’s Who lists.  She has published numerous scientific articles and articles on parenting and managing anxiety. Dr. Cassiday is dedicated to helping mothers overcome the cultural pressure to be perfect and to raise perfect kids. She enjoys using her expertise from over thirty years in the field to help families overcome the dilemmas of parenting in a high-stress digital world. Her goal is to help all mothers embrace the messy hilarity of parenting with unshakable self-confidence so they can raise kids who thrive!

Dr. Cassiday and ADAA

"My graduate school advisor, Rich McNally, suggested ADAA would be a great place to join as a student so I could present my research and network with other like-minded people who were really interested in researching and treating anxiety disorders.”

“ADAA has given me many things I needed at different stages of my career that were either unavailable or hard to find.  Early in my career, I was often the only professional who knew about evidence-based therapies for anxiety and I needed a place to be with my own kind without having to explain myself and combat skepticism. Then I needed inspiration from the ideas of scientists and other clinicians so I could improve my clinical skills. ADAA also gave me a multi-disciplinary group that mirrored my daily work life and that felt great. I have really enjoyed the opportunity to share my knowledge by giving presentation. Lastly, ADAA has given me the opportunity to serve humankind in a bigger way by sharing my leadership skills on committees, the Board and as president.”

“I have depended on my ADAA colleagues throughout my career to give me inspiration, encouragement and mentoring for my clinical dilemmas and business dilemmas. The friendly non-competitive atmosphere has made it easy to call up anyone to get their advice. I don't believe that my patients and staff would have fared as well as they have had I not been very involved with ADAA."

Use of Website Blog Commenting

ADAA Blog Content and Blog Comments Policy

ADAA provides this Website blogs for the benefit of its members and the public. The content, view and opinions published in Blogs written by our personnel or contributors – or from links or posts on the Website from other sources - belong solely to their respective authors and do not necessarily reflect the views of ADAA, its members, management or employees. Any comments or opinions expressed are those of their respective contributors only. Please remember that the open and real-time nature of the comments posted to these venues makes it is impossible for ADAA to confirm the validity of any content posted, and though we reserve the right to review and edit or delete any such comment, we do not guarantee that we will monitor or review it. As such, we are not responsible for any messages posted or the consequences of following any advice offered within such posts. If you find any posts in these posts/comments to be offensive, inaccurate or objectionable, please contact us via email at [email protected] and reference the relevant content. If we determine that removal of a post or posts is necessary, we will make reasonable efforts to do so in a timely manner.

ADAA expressly disclaims responsibility for and liabilities resulting from, any information or communications from and between users of ADAA’s blog post commenting features. Users acknowledge and agree that they may be individually liable for anything they communicate using ADAA’s blogs, including but not limited to defamatory, discriminatory, false or unauthorized information. Users are cautioned that they are responsible for complying with the requirements of applicable copyright and trademark laws and regulations. By submitting a response, comment or content, you agree that such submission is non-confidential for all purposes. Any submission to this Website will be deemed and remain the property of ADAA.

The ADAA blogs are forums for individuals to share their opinions, experiences and thoughts related to mental illness. ADAA wants to ensure the integrity of this service and therefore, use of this service is limited to participants who agree to adhere to the following guidelines:

1. Refrain from transmitting any message, information, data, or text that is unlawful, threatening, abusive, harassing, defamatory, vulgar, obscene, that may be invasive of another 's privacy, hateful, or bashing communications - especially those aimed at gender, race, color, sexual orientation, national origin, religious views or disability.

Please note that there is a review process whereby all comments posted to blog posts and webinars are reviewed by ADAA staff to determine appropriateness before comments are posted. ADAA reserves the right to remove or edit a post containing offensive material as defined by ADAA.

ADAA reserves the right to remove or edit posts that contain explicit, obscene, offensive, or vulgar language. Similarly, posts that contain any graphic files will be removed immediately upon notice.

2. Refrain from posting or transmitting any unsolicited, promotional materials, "junk mail," "spam," "chain mail," "pyramid schemes" or any other form of solicitation. ADAA reserves the right to delete these posts immediately upon notice.

3. ADAA invites and encourages a healthy exchange of opinions. If you disagree with a participant 's post or opinion and wish to challenge it, do so with respect. The real objective of the ADAA blog post commenting function is to promote discussion and understanding, not to convince others that your opinion is "right." Name calling, insults, and personal attacks are not appropriate and will not be tolerated. ADAA will remove these posts immediately upon notice.

4. ADAA promotes privacy and encourages participants to keep personal information such as address and telephone number from being posted. Similarly, do not ask for personal information from other participants. Any comments that ask for telephone, address, e-mail, surveys and research studies will not be approved for posting.

5. Participants should be aware that the opinions, beliefs and statements on blog posts do not necessarily represent the opinions and beliefs of ADAA. Participants also agree that ADAA is not to be held liable for any loss or injury caused, in whole or in part, by sponsorship of blog post commenting. Participants also agree that ADAA reserves the right to report any suspicions of harm to self or others as evidenced by participant posts.

RESOURCES AND NEWS
Evidence-based Tips & Strategies from our Member Experts
RELATED ARTICLES
Block reference
TAKING ACTION

With the #MeToo movement and the rising numbers of people affected by mental health, romance…

Advertisement