Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Welcome to Just answer !
1) Since when are you experiencing such situational phobia ?
2) What sort of remedies have you tried so far to manage this condition ? Any medications ? Therapy ?
I will get back to you once you reply to my queries.
Hello, thanks for the inputs. kindly please answer the first question as well that is since how long have you been struggling with situational phobia ?
Thanks for the valuable inputs.
Well the phobia that you are talking about is called as Agoraphobia that is defined as phobia of open spaces which are crowded with unknown strange faces and it evokes a sense of dread , dizzy spells, feeling discomfort , anxiety ,etc
So you have two co-morbid psychological conditions most likely to be related to each other and these are PTSD and Agoraphobia. Now both of these are clubbed together under the same class of disorders and that is Anxiety disorders , so this helps us in formulating a formidable treatment plan to counter both of these disorders at the same time .
So the treatment plan that works best for managing such anxiety disorders is Drug therapy coupled with Psychotherapy ( counseling ).
1) Drug therapy is essential to kick start the recovery and to maintain serotonin levels in your body within the normal limits which tend to become abnormal in such anxiety disorders. Plus drug therapy is till date considered as first line of management for managing PTSD and Agoraphobia , so why not to use the best plan of treatment.
You have mentioned that you have tried paxil, while paxil is a decent drug but is known to become ineffective after a while because of development of resistance against within the body , plus it comes with it's own set of frequent side effects like nausea. vomiting, constipation / diarrhea , decreased libido , weight gain, etc.
So I believe what you need here is a formidable anti depressant which is most suited to your conditions and comes with least side effects and that drug is Lexapro( escitalopram ) at dose of 10-20 mg / day , to be taken as a single morning dose.
This drug needs to be coupled with an anti anxiety drug such as Klonopin ( escitalopram ) at dose of 0.5 mg twice a day , to be used only for 2-3 weeks initially and then stopped. This drug will provide instant allaying of anxiety and feeling of dread that accompany you almost always in the situations mentioned above.
However Lexapro alone needs to be continued for at least 4-6 months to recover fully from these conditions.
2) Psychotherapy ( counseling ) -- Well psychotherapy , also known as counseling in colloquial language is to be used in your case in order to teach you coping skills and strategies so as to make you emotionally stronger and to overcome your emotional traumatic past and help you to learn how to cope with stress in your life in future.
The best counseling technique used for both PTSD and Agoraphobia is called as CBT ( Cognitive Behavioral Therapy ) to be sought from a Clinical psychologist and it may span over 12-16 weeks , with flexible once a week sessions.
So the combination of Drug therapy and Counseling shall finally get you past your PTSD AND AGORAPHOBIA , so please discuss this with your doctor and get started on it so as to appreciate the results yourself.
I hope this helps.
Wish you all the best.