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Dr. Keane
Dr. Keane, Therapist
Category: Mental Health
Satisfied Customers: 1379
Experience:  Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
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I believe have a problem Anxiety disorder (specifically

Customer Question

I believe have a problem Anxiety disorder (specifically during journey in public transport, pounding heart, loosing my foot at ground when I see the crowd coming in MRT, or going down using escalator with crowds) At work place reading reports, emails, documents while trying to understand the new contents or study, unable to concentrate due to sudden pounding of heart, giddiness, BP high, nervous tight all times)
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello and thank you for using JustAnswer. It does sound like you may have a combination of Agoraphobia and Anxiety from your description. May I ask, what is your specific mental health question that you would like an answer to in regards ***** ***** situation?

Customer: replied 1 year ago.
Hello Sir, what should I do to improve my mental health. I am unable to concentrate on any new studies or at works... It is affecting my daily life during the travelling in crowded areas. It's very specific. I am OK in normal walking outside.
Expert:  Dr. Z replied 1 year ago.

I definitely understand the difficulty here and you can try multiple treatment approaches, even combining a couple of them for true resolution of your problem. The Agoraphobia part of your issue is where you have anxiety in crowds and public places, which is what you described. Usually people with Agoraphobia do have other anxiety issues too and that is why your treatment is going to be systematic. The best solution for this would be a combination of a SSRI antidepressant like Escitalopram or Sertraline and a beta blocker like Propranolol. The SSRI antidepressant will lessen your anxiety and agoraphobia, but the Propranolol will be specific in lessening the physical symptoms of your anxiety and will also be best for treating the social and fear of crowd aspect of your Agoraphobia.

Now the medications only treat the symptoms of these disorders not the core causes, which is why you should consider entering into therapy with a psychologist or psychiatrist called Cognitive Behavioral Therapy (CBT) and Exposure Response Prevention (ERP). The combination of both therapy modalities is specific to lessen anxiety and phobias; these two therapy modalities will get at the core causes of your issues and will help provide long-term beneficial results without having to rely on medications.

Expert:  Dr. Z replied 1 year ago.

Please let me know if you have any other questions or concerns as I would be happy to continue assisting you regarding this issue

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