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Interoceptive Exposure Therapy |
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- čas přidán 13. 10. 2019
- If you have never heard of Interoceptive Exposure Therapy, you must watch this video right away!
Interoceptive Exposure Therapy is one of the most effective techniques for curing panic disorder when it is triggered by an internal body sensation like a rapid heartbeat, dizziness or breathlessness. The exposure to the same body sensations that initiate panic allows the brain to stimulate new neuropathways. These new neuropathways are then no longer associated with panic and danger, but with messages of calm and safety.
It is very powerful technique, but it is challenging. I do recommend that you consult with an experienced therapist in your area and even your Physician for medical clearance.
Here is a FREE PDF for you:
Why Do I Feel That in my Body? Explanations of Bodily Symptoms Due to Anxiety, Stress and Panic
www.paigepradk...
I do have a different video that covers exposure therapy in general, when your panic is initiated by an external cue, like a grocery store or driving or seeing a dog. Interoceptive Exposure Therapy," is specifically used when panic is initiated by internal cues or body sensations.
See if any of the examples in the video are relatable to your situation or someone you love. Please comment and let me know if you have tried Interoceptive Exposure before or what your thoughts are about the technique. And don’t forget to subscribe and let me know if there is a particular topic that you would like to hear me talk about on a video. Until next time, I will see you in session :D
#PaigePradko, #ExposureTherapy, #interoceptiveExposuretherapy, #interoceptiveexposure, #exposuretherapyforpanic, #exposuretherapyforpanicdisorder, #exposuretherapyforagoraphobia, #treatmentforPanicdisorder, #agoraphobia, #exposuretherapyforanxiety, #exposuretherapyforbodysymptoms, #ExposureforPanicattacks, #treatmentforpanicattacks, #treatmentforagoraphobia, #CalmSeriesforAnxiety
Here is the link I mentioned about the study about Panic Disorder and Exposure therapy from the University of Michigan --
medicine.umich...
Please feel free to follow me at the social media sites below:
/ paigepradkotherapy
/ paige.pradko.therapy
/ paigepradko
www.paigepradk...
I would love to hear your comments and questions below. If you would like your question considered on an upcoming Q & A video, please let me know. Thank you for helping me spread mental health help and education.
Until next time...I will see you in session,
Paige
If you need help,
I guide you step by step in Interoceptive Sensitivity Reduction Training (Exposures) in my new PANIC Course.
👉👉👉www.paigepradko.com/panic
👉👉👉Here is a FREE PDF gift: What to do when Panic Strikes: FACE Fear
paigepradko.com/facefear
👉👉👉Panic Attacks Quiz
www.paigepradko.com/panic-quiz
👉👉👉Why Do I Feel That in my Body? Explanations of Bodily Symptoms Due to Anxiety, Stress and Panic
www.paigepradko.com/bodyanxiety
thank you
My home has become my "safe spot" /"safe place". I feel calm and in control there.
I am trying to push myself to go on trains, long walks and to the mall.
I challenge myself step by step and I try not to feel guilty or bad about not being able to function like I once did.
When I am outside, I try to think logically about the situation.
"What could happen now that could not happen inside my home?" "Why would something happen now, when I felt so calm at home". I try to convince myself that it's only in my head and it's my nerves and my brain that try to trick me.
I am not more safe at home even tho my brain likes to think that I am.
I am just as safe outside. I am safe wherever I chose to go because God is with me. And He is with you too.
Whenever you feel like you're not in control - don't forget that God is.
He is always in control. He is the one that keeps you safe when you are sleeping and the one that kept you safe in your mothers womb.
In every situation that you lack control, He is there. He keeps us safe. He keeps the whole world safe and from not burning up from the sun.
You don't need to be in control all the time - you just need to trust God. ❤️
I like your thinking, Nadia. You are doing a great job! 🙏❤️
I literally feel like I'm living in a nightmare, EVERYTHING triggers my panic attacks. I feel like I'm either constantly having a severe ground breaking panic attack hundreds of times a day or I'm in a state of true terror of everything. Just walking to my fridge to grab water I'll have mental breakdown. Everything i do is hell, nothing seems real anymore because i don't feel anything but anxiety and panic. I don't even remember the last time I've been truly happy. I want to say there's hope but I've been like this for so long it's my normal, it's tiring, it's killing me and I'm only 27. I wish I wasn't so overwhelmed with anything and everything :( I wouldn't even know where to start using this technique.
I am so sorry that you are experiencing this. Have you been to see a psychiatrist and a psychotherapist? It sounds like you may have an over production of adrenaline and cortisol. Almost like you are in a constant state of fight or flight. My recommendation would be to continue to work with your physician and therapist and watch my series on Calming the Body, you can find it on my playlist page. All of the techniques in that series are research recommended ways to calm down the fear center of your brain. Practice all of them every day. I hope you feel better soon.
I am also extremely anxious everyday. I have agoraphobia. I feel like the anxiety is too much to handle. I can't work or drive or go anywhere. It sucks. I pray to God to help me.
hi everyone ,if anyone else wants to uncover tips for dealing with panic attacks try Bablim Reduce Fear Booster (should be on google have a look ) ? Ive heard some decent things about it and my neighbor got excellent results with it.
How are you doing now?
Hi. Just read what you are going thru..My heart breaks for you as I have been going thru panuc disorder with agoraphobia and each day for 20yrs are debilitating..Quality of life is just trying to get thru each day..I did cognitive therapy but would like to try this new therapy..Its fight the fears instead of flight..It is hard to do to face the fears everyday..but I try and I hope you are feeling better and got the help you need..Your in my prayers..I dont wish this panic disorder on anyone..Pls let me know how u r doing..Keep the faith..
Hang in there everyone. I'm currently in the grip of completely debilitating and humiliating panic. My life is destroyed by this. This was a very informative video, and I will follow the instructions. Thank you so much.
Hi Erik. Thank you for such a supportive comment. It will inspire many people. Interoceptive exposures are a way to create new safety learning…new neuropathways in the brain. For people with panic disorder that at times can develop into agoraphobia, interoceptive exposures can retrain their brain to not associate different body sensations with panic our fight-or-flight mode. I thought you might be interested in this video as well. czcams.com/video/QgI4fEcnH0Y/video.html.
I know it’s some time later, how have you gone with it? My life has been destroyed by this too. I went from being so happy and free, going on random trips around the country to now being housebound. I panic every time I leave. I have a young child too so it’s hard 😢 I don’t want to live like this.
@@salasala5418 Hi, actually I'm doing so much better. For me the thing that helps the most is facing my fears. There is a book called "Don't Panic" by Reid Wilson. This book has brought me back from the depths of panic a few times now. He talks about facing your fears with a new attitude. Please buy the book or audio book and give it a shot.
I started crying watching this video, I've searched so long for why doing some things created fullblown panic attacks, talked to multiple nurses and doctors and no one explained it. Just understanding that this is a phenomenon and that I'm not completely crazy helped so much. Thank you, Paige.
I am so glad you found it too. Some people can do this on their own and some need help walking through the process. I have a program that takes you through the process of interoceptive exposure therapy. Here is more information on some resources and my panic course:
PDF: What to do when Panic Strikes: FACE Fear
paigepradko.com/facefear
Panic Attacks Quiz
www.paigepradko.com/panic-quiz
Your Panic Attacks Are NOT the Boss OnLine Course
www.paigepradko.com/panic
Thank you for this! I have been dealing with panic attacks since around 2014 and have been off and on antidepressants for them. I came off effexor in June of this year after being on it for years. It’s been a struggle to face these scary panic symptoms. I’m afraid of the heart racing side of it so being able to retrain my brain to not be afraid is a goal of mine. I’m trying so hard. It’s not easy but I appreciate this reassuring video to know I’m not alone!
I am so proud of you, Hayley. That’s so awesome that you are committed to working on this. Keep going!
I am panicking watching this even, that’s how I have been living I am afraid to try to fix it
I am the same ATM it's awfull and I really want to get better but I'm scared too do so 😢
Thank you so much for making theses videos, so many of us can't even make it to therapy so having therapy bought to you is extremely helpful. I've just turned 18 and I'm kinda doing this all alone, so it's nice to know that other people struggle with it too and I'm not as alone as I feel
Thank you for watching and commenting. I am glad that my videos might offer some help to feel like you are not alone.
You literally saved my life. Thank you with my whole heart. I did flooding exposures and it cut my agoraphobia around half in a month. Looking forward to live life again but DPDR still persists
Thank you for this video!!! I’ve been pretty much bedridden by my panic disorder and heart rate worries for two weeks now and I really was scared to move . Not eating or anything but then this video popped up in my recommended and it’s honestly inspirational! I got fed up with myself and just got up and made an exposure plan and started today! I plan to keep going until my heart rate no longer bothers me! And I actually feel good after doing the exercises!
You are inspiring! You will motivate so many that read your comments. Here is a pdf called: Why Do I Feel That in my Body? Explanations of Bodily Symptoms Due to Anxiety, Stress and Panic
www.paigepradko.com/bodyanxiety.
You are courageous person.. you really are, as you made a plane and immediately started doing it without procrastination.. i don't want to say that i am jealous.. maybe a little bit 😅
I have that little sneaky problem of fear of failure it's really deep in me, and it is messing out with my life
I have social anxiety. Maybe now i am more courage to face it,
Today i was singing, saying poems, and running after birds in the street 😂😂 beside the sea and it was amazing
Isn’t this lady just amazing??!!
I have become very fond of your videos. I have anxiety that developed in Sept 2018 after having intense and sudden vertigo. I'm 21 now and 115lbs. It triggered so much aniexty that I'm a completely different person now than I was a year ago. It pretty sad when I think about it. I would get so dizzy and developed brain zaps at night so intense I thought I was going to die. My first doctor was annoyed with me cause he said I'm too young and fit for anything for anything physically wrong with me. He said its aniexty. It was how he said it because I looked to him for help and he did not give me a plan to go from there. I eventually found a new doctors a few months later and she is amazing. Belived me and wanted to rule out any physical issues before saying it's anxiety. My anxiety quickly turned into health anxiety after many many tests came back normal. Heart ultrasound, head and neck MRI, extensive blood, EEG. This surprisingly did not help me at all because it convinced me I was crazy and I felt like no one believed me when I say that what I'm feeling is REAL and it is continuing to get worse. I've actually stumbled into depression. Your videos gave me a glimpse of hope because I understand health anxiety so much more. I've cried and cried and felt hopeless because I want to so bad go to therapy but I cant afford it. I honestly NEED it. I now have access with your videos. You are very very much appreciated by me and so many others. Thank you so much for posting these videos. You have no idea how happy and hopeful I feel after watching a fee. I feel heard and I feel like I can start trying to get through this.
Your comment really touches my heart. You, and people like you, are the reason I make these videos. I wish experienced therapists were available to everyone suffering, but they are not. You have been through so much. I want you to know that recovery is 100% possible. Sometimes when we feel different body sensations the fear center of our brain gets activated. Then, we have more fearful thoughts and the panic response gets even worse. There is a way out. It is a combination of treatments that I explained on the health anxiety videos and you may even need to add Interoceptive Exposure Therapy as well. Practicing daily breath focused meditation and square breathing really helps to calm down the fear center. You can find those videos in the Calm the Body series on my playlist page. Thank you so much for such a thoughtful comment. Let me know time to time how you are doing.
Hey, how do you do?
Hope you are doing well 😊
I am mostafa, i have anxiety and you are not alone 💪♥️
It's hard but you can do it you are special most people with anxiety are kind i think, all people that suffer in the world are special because when they fight and win that thing would have changed something in them
Would make them have something to live for ..to help others like them
And that is the most beautiful thing in the world ❤️
I went through Xanax rehab last year, Paige. Doctors cut me off completely from 6 mgs a day, to nothing. I rehabbed myself. I have so many inspirations from this journey. Would be glad to talk about it.
Hi Cindy. I am amazed that you were able to do that. Wow. You are an inspiration but that seems dangerous to be cut off without a slow method of reducing your dose. Glad you were able to recover.
@@PaigePradkoTherapy absolutely! I still can't believe that someone would put me thru it. Didn't realize that the therapist was overdoing the amount. Basically no one wanted any part of the situation. That's why they wouldn't help me wean off.
And Also I just want to say that no safety behavior really is important. I used to carry my pills in my bag and feel safe to go everywhere, but one day somehow i had a panic attack in public and the pills didnt work, I immediately went back to agoraphobia again and couldnt go out. Same things happened to the books about curing anxiety, my phone which has soothing audios in it, safty people, even hospitals. All these crutches did help me to be able to go out for a period of time, and when it failed, I would attmept to change onebecause I don't want to get stuck at home. Now I understand why my setbacks constantly shrink my world. Thank u so much for this video.
You’re welcome and thank you for sharing your experience. It is funny what we do to try to feel safe and end up sabotaging ourselves.
dizziness, ringing sensation in ear.. and my mind is worrying machine.. but now I know what to do.. with my panic disorder, because of your videos doc.. it really help me alot special with our place, we don't have specialist psychologist like you doc.. so thanks again for your videos.. I can really relate most of your videos doc.. its like you know how I fell with this mental illness.. thanks again doc..
I am so glad that you find the videos helpful, Rommel. You may like the video that I just posted today about What Happens to Your Body During Anxiety and Panic. czcams.com/video/QgI4fEcnH0Y/video.html
I have agoraphobia and have been diagnosed with anxiety and social phobia. This has been a great help! In my country I have never heard of this type of therapy and it sounds very useful. I will start applying it, since what starts my panic and anxiety attacks are the rapid heartbeat and heavy breathing. Thank you very much for giving this information to the whole community, you have really given me hope to get ahead.
Hi Luan. I am sorry that you have those challenges in your life and healing is also a challenging process. If you go to my playlist page, you will find playlists for agoraphobia, exposures and social anxiety to help you.
@@PaigePradkoTherapy Thanks!!
@@luang.4051 hey, hope you are doing well
Me too, sadly i have social anxiety, this son of a bitch has taken away lots of things lots of joy in my life.
But i decided that this isn't going to last
So are you with me..
Two together always better than one
For the last few years, my fears of going down the stairs or escalator, driving on the edge of the bridge, riding down inside a glass elevator, has become strong. I have to take deep breaths and talk to myself. I just feel I'm going to fall.
This is incredible and aligns so well with the book "Exposure Therapy for Anxiety" that I've been reading. It's so helpful to hear a professional explain it. Thank you so much!
Thank you for watching. Are you reading Abramowitz’s book? Great book!
thank you for this video! i have agoraphobia and i’ve been wanting to start exposure therapy but this video informed me of the safety behaviors i’ve been doing that could have possibly slowed or stopped the effectiveness of the exercise
I am glad you found the video helpful. Thank you for your comment. 😊
I've suffered with Anxiety/Panic Disorder and Depression for nearly 13yrs and now suffer from Agoraphobia due to the physical symptoms of this. I've never had really any help from the NHS Scotland and my illness has got so bad I had to give up work and I never leave my home now, this video was good and I wish I had this done with my Psychologist/Dr
Hi Andrew. I am so sorry that you have been suffering with this for so long. The good news is that we do have the ability to retrain our brain at any age. That really is amazing...any age, we can change, no matter how long we have been agoraphobic. I will be sharing more help for people with agoraphobia later this year.
i didnt go back to my doctor coz ive sense no empathy at all. he just gave me clonazepham and antidpressant without asking how things went. He even just laughed when i asked him if i have GAD. Thank you for your videos. Im now eager overcoming my fears and anxiety. Im done with my depression last year and settled with my self hatred. Now i have new things to fix inside me. Thanks for the help.
I hope the videos help you, Chris. If you go to the playlist page, the videos are organized by category. I’m sorry that your doctor did not have much empathy.
I'm excited to try this! I have panic disorder, social phobia, and agoraphobia. Ive had some form of anxiety issues since i was very very young. Ive had multiple cases of 100 suds score anxiety attacks and fainting when in crowds/clubs/festivals. Ever since I started working from home my panic attacks have gotten much more intense. I began to realize I had created a comfort zone and would experience extreme discomfort the further I got from home. I have recently used small doses of xanax whenever I knew I would be entering an anxiety inducing situation. If I didn't do this id often escape to a bathroom stall to calm myself when panic arose. I now know that this escape and hiding is counterproductive. My goal is to entirely conquer the fear of panic attacks so that I no longer feel fearful of going out and living life.
I am glad that you found the video. I have other videos on agoraphobia and also 10 ways to maximize exposure that I hope you check out. The condition you describe is challenging, but can be reversed if you take an approach and attitude that you simply will not surrender. Exposure therapy is effective, but takes time and persistence. It is not perfect and you are not expected to complete exposures in a perfect way. Just keep at it...and accept the good and bad exposures along the way. Wishing you the best.
I have been housebound for over a year now with agoraphobia due to anxiety and panic attacks. I'm improving month by month with baby steps.. no medication as I gave myself a phobia with tablets. Silly phobias arose like not been able to be home alone, needing a light on to sleep etc. Only until I truely accepted my anxiety for what it was.. just anxiety that I started to feel I was getting better. It's just the agoraphobia that's taking longer than I thought. I have to have my house in my view when I go outside. I am definitely going to try this technique because I will not let this be the boss of me. Thank you for your videos :)
I love your attitude to work on this little by little. Every exposure makes a difference. I have a playlist on exposure videos that I hope can help you continue to make progress. Keep up the good work!
@@PaigePradkoTherapy thank you I will definitely look at them :)
Going to bring this up with my therapist as a new way to deal with my panic attacks
It is the evidence-based method for the treatment of panic disorder. If you need help at a deeper level, I do have a course that walks you through exactly what to do that you can combine with therapy. www.paigepradko.com/panic
Thank you. This helped me SO much. I'm about to start interoceptive exposure therapy and I wanted to get more information on it before my appointment.
I am glad to hear it helped. Good luck in your therapy. It gets easier as you go.
Definitely going to try to incorporate this! This video definitely answers some questions I had about how to control exposure to symptoms to some degree.
I glad that this video offered you some new information about exposure therapy. It is one of the more difficult techniques, but it is crucial when one has panic associated with internal body sensations. Thank you so much for your comment 😊
I have been dealing with severe agoraphobia and panic disorder that recently got unbearably worse for the past two weeks and it feels like there is no hope. But I'm willing to try these tips out because I feel so miserable, I have panic that lasts for hours and it happens multiple times a day. Thank you!
Hi Andy. I am so sorry. I hope the videos help. I will be offering more help in this area this year including a course for people with agoraphobia and panic disorder and zoom coaching sessions for help with exposures. Feel free to join my newsletter if you would like to be notified when this help becomes available: paigepradko.com.
@andyv2071 You are courageous person.. you really are, as you made a plane and immediately started doing it without procrastination.. i don't want to say that i am jealous.. maybe a little bit 😅
I have that little sneaky problem of fear of failure it's really deep in me, and it is messing out with my life
I have social anxiety. Maybe now i am more courage to face it,
Today i was singing, saying poems, and running after birds in the street 😂😂 beside the sea
Hope you are doing well
@@mostafasoliman6745 I dont like to say im courageous, rather, determined to let this be the reason I cant live my life. im almost 22! I have been through TOO MUCH to let my mind be the reason I dont thrive. its been 7 months since I posted that and I am still suffering those panic attacks, but they're a little less frequent and a little more manageable. it takes a long time to get on the right track but im doing what I can, while I can :)
nausea and dizziness triggers my panic attacks, and also chronic pain.
I am sorry to hear that, Laura. If you need more help, I have a process where I help people recover from panic disorder. You can find out more here: www.paigepradko.com/panic
Panics can be stopped by spotting the dangerous thought we are attaching and by braving the sensations.
Yes, people often misinterpret what they feel as dangerous and alarming. Anxiety symptoms are not harmful or dangerous.
I can only speak for my own experiences. I used to have horrible panic attacks and extreme social anxiety. I was told to try exposure therapy. Forget that! I tried and tried to meet people and socialize..guess what happened? I was judged by the people. Once they realized, or I told them..it was a nightmare! I was already fearful of people..but to be labeled, called names..made fun of..NOT! Now I’m worse than ever. I now have Agoraphobia..there is now way Im leaving my house. I’m sorry to be so negative. I hope others have better luck.
That sounds terrible, Dlynn. I am so sorry that happened to you.
"Bear the discomfort and comfort will come".
❤️
This is
Exactly what I have. Wasn’t aware of this therapy. I will try asap. I feel encouraged to go somewhere by the end of the night.
I am so proud of you for being willing to do what it takes to heal. Exposures are difficult, but, they work. It is a process…it takes time…but this is how to train your brain. Be determined, but also patient.❤️
Thank you for this video. Will try it. I have been facing this for years! I came to know today that this feeling has a term. Thanks making me feel I am not alone and that this can be treated.
I have the same problem except that it's triggered by heavy (400lbs+) deadlifts. Can't wait to try this!
Hi Rob. That’s a heavy deadlift. Wow.
@@PaigePradkoTherapy Thanks, but it's really not.
A rapid heartbeat or skipped beats will start my anxiety and then I’ll have to try and calm before the panic kicks in. Usually running with the breathlessness is my main problem or if I’m eating I’ll get a palpitations then anxiety. I just don’t know where to properly start but I’m determined to put this all behind me
I am so sorry that you are experiencing this. Our brains can associate certain body sensations with fear and danger. We have to therefore experience the sensations on purpose and teach our brains that we are not in danger. This takes repetitive exposures. It is challenging, but, it works. I do it along with my clients in session and it seems to help them get started if someone else is also getting their heart rate up right along with them. But, they do learn to do the exposures on their own too. Thank you for your comment.
@@PaigePradkoTherapy Thank you for your response god bless
Paige Pradko LPC NCC my only question is during the panic and madness what do I tell myself
This is a wonderful question and one that every client asks. Saying calming phrases to yourself actually lowers your level of anxiety and is thought of as a safety behavior that reduces the effectiveness of the exposure. But...how do you get through it...right? This all depends on the client and their ability to tolerate their body symptoms. If you need a phrase like...I can do this...you can use a phrase to begin the exposures. Eventually, you want to have a goal of just tolerating the body symptoms without trying to calm yourself down with a phrase. Most clients do begin with a phrase...just to get themselves to do the exposures.
Paige, your videos are really fantastic. Thanks so much for all you do.
Thank you ❤️
It is Definitley a diagnosis.
( just one you have not experienced yet; or that's un the DSM
🤔
I will try these, thank you doc. I really hope this video would be effective since I also have these symptoms.
This is describing my triggers to a tee . I have felt so alone and in a mental prison . My anxiety started with a fear of a Dr taking my blood pressure . I had a panic attack and he didn’t understand it and was in fear of my high heart rate which in turn made it worse . Now I can’t even go to a Dr . I am a mess 🥺
Hi Asher. I am so sorry that happened to you. It sounds like you possibly are experiencing health anxiety and panic disorder in combination. If you need more help, you can reach me at PaigePradko.com
You’re amazing. This is so hopeful to a problem I thought no one else had. I don’t like the feeling of my heart and pressure on my chest makes it worse. Especially after a heart palpitation pretty intensely around a week ago it’s been pretty bad. I’ve already made so much progress and are able to have a weighted blanket on my chest without pinching myself lol thanks!
Hey….great work! I hope people read your comment and are encouraged 😊❤️
So thorough, clear, and comprehensive. Thank you so much!
Thank you Sarah 🙏❤️
Thank you sooo much for the video. I have the same dizziness like your young client. Actually I have cervical spondylisis. For that I faced a extreme dizziness. But afterthat I couldn’t forget that horrible experience. I'm 24 only. My job has gone for this shit. I Have that same symptoms which your client have. I'm housebound from last 8 months. I couldn’t go to any doctor for corona lockdown. Whenever I went outside I carry dizziness medicine. But last 8 months I couldn’t go out. Hope the exercises in your video help me ♥♥♥🎀🎀🎀🎀🙏Thank YOU
I am so sorry, Torsa. That sounds very difficult. I am hoping you can find a therapist that is skilled in how to do exposures. If you do not have that support, continue to challenge yourself in small ways every day. Every little exposure helps. I wish you the best.
Hey @torsa Please try Anulome Vilom (Alternatively nostril Breathing) And Kapalbhathi Pranayama on slow rate ..
You can learn these from you tube.
It will help.
.
STAY BLESSED BY DEVINE 🙏🙏
You're not alone! I'm feeling the same thing too
Awesome presentation. I also use this method with my clients, but now I have a better perspective - thanks
You’re welcome, David. I have always done these exposures with my clients in session. It is a little more difficult being online, but, it helps when they see you do it too. I love doing the exposures for increasing your heart rate, but, I am not a fan of spinning in your chair. 😂
The heartbeat sound in the video triggers panic for me :( I have phobias/panic surrounding heart events because I have arrhythmias. Thanks for the information on this type of exposure therapy. I've never heard of it. I'm trying to free myself from this agoraphobia issue since all the anxiety therapists are full for months. It's hard enough as it is going through this with someone helping, but because of covid and everyone being booked, this is what I have to do.
Hi Paige. I am sorry about that heart beat noise. I have worked with hundreds of people over the past 20 years with panic disorder related to heart symptoms like arrhythmias. I do these interoceptive exposures with them with the approval of their cardiologists, then they do them daily at home. It is the evidenced based treatment method for panic related to heart symptoms. I have a course on health anxiety where I help people with your symptoms at paigepradko.com, and will have more help for panic and agoraphobia coming out later this year.
Please make a video about feeling disoriented
I am so sorry that you are experiencing this. It does sound like dp/dr. The recommended treatment is interoceptive exposures, but this can be difficult and not always helpful. Here is a video that I made on dp/dr, but I need to do more: czcams.com/video/AVhqusVwJ-Q/video.html
What exercises can I do for sickness? Every time I step foot out the house I have a panic attack and I’m sick 🤢. Even the thought of going out makes me physically sick
Go down the street using safety measures like a dog or a friend then return back home each time going out further street by street until you’re exposing yourself to the outside environment more. Gradually you should see improvement, Hope this helps.
I walked down the end of the street. I made sure to wear my headphones and block out everything. I did well with it, now that I’m home I’m a little anxious feeling.
I really feel for you, mines affecting my bowels and similar to you even the thought of leaving house make me run to the loo
Paige I LOVE this video! thank you so much for this exposure therapy idea! thank you thank you!!!
So glad you watched the video. If you need more help, I have a course where I guide you through this technique and more:
www.paigepradko.com/panic
I am 38 years old now, my panic att.+anxiety started when I was about 10-11y. old,and agoraphobia with depresion get their peack when I was about 20 years old. I am on a lot of medications-they help a litlle. Strange thing-Last few months I was watching cartoons an so(to make me not to think about reality that I dont live last 20 years,just survive day at the time-I didnt have a p.a.for a apr.10 days..), and now I look on title of this and get panic att.right now! Now I am pissed off,to be honest...why cant I even watch the video???
Btw. excuse me for my poor english,I am from Croatia and I have never learn English,this is what I have pick up from years traped in my room....
I wish all the best for all people that are strugling with any of mentall illnes, sometimes it feels like is bether not to live at all.
How do you do this with something like dissociation/realization? That is my main trigger.
University of Michigan describes several approaches. Here is the link I left on the description of the video. medicine.umich.edu/sites/default/files/content/downloads/Panic-Disorder-Exposure-Treatment.pdf
@@PaigePradkoTherapy do you have a phone number or a email address I can get reach you at? I have some questions
@@PaigePradkoTherapy Thank You So Much Paige Pradko Madam .. SOO NICE OF YOU .... Arjun
Same how are u doing now?
@@Jaymagna I've had CPTSD for the majority of my life and the agoraphobia panic issues started around 2013. I still struggle with it daily. I am able to drive and ride short distances nowin 2014 i couldn't even go get my mail. but I will never be cured or be 100 percent normal. Sadly that's just how it is.
I’m nervous to start my exposure therapy . I’m fine driving in town but once I get one the freeway or a backroad I start to have derealization and intrusive thoughts :/
Hi Megan. Driving exposures take time. Keep challenging yourself little by little. It is to be expected to have a bad exposure once in awhile…but, keep going. Don’t let that stop you. Here is a video that may help on driving exposures czcams.com/video/sZ66J3YKOow/video.html
Another great video and tuition.
Glad you found this video. I left you a message under my Nocturnal panic video.
@@PaigePradkoTherapy I saw that. I’m very grateful to you. I’ll check it out. Thanks and best regards.
A
Thanks for your videos. Your are helping people!!!!. Never thought, I would be in the position I am in (anxiety about anxiety due to repeated traumatic events, crazy insomnia, Covid not helping). Regarding exposure therapy, my anxiety is always with me no matter what I am doing. It is just a matter of what degree and triggers are everywhere. There are many, day to day activities (a/k/a living a normal life) which ratchet up my anxiety to unbearable levels, ultimately preventing me from living the life I want to live. I have been working on exposure therapy for a while. When I push myself outside of my comfort zone and expose myself doing day to day activities, I try to just acknowledge the anxiety as just thoughts, but it rarely seems to diminish. Any advise/feedback (taking .5 mg Ativan at night for sleep for a long time, done all sorts of therapy). Again, thanks for your help channel as you appear to be a kind, knowledgeable person).
Hi Jay. I think that many people can relate to what you are expressing. I am so sorry that you have been dealing with this for so long. There is evidence that taking a benzodiazepine daily, even a small dose for sleep can make exposure therapy and all forms of therapy less effective. I did quite a bit of research on the effects of benzodiazepine after noticing that my clients taking them made little to no progress in therapy compared to my clients that were not taking benzodiazepines. Any changes in your medications will of course need to be slowly and carefully medically managed.
Not sure how to ask this but its about agoraphobia. I feel like in the video a lot has been talked about the physical sensations related to fear, anxiety and panic attacks.
However... My whole life i have been doing just that and things have not really became easier (school, taking public transport, talking infront of crowds, approaching strangers, etc)
I have huge anxiety and self esteem issues, but regardless i always pushed myself. I went to school and later college, got a degree despite being terrified most of the time. And I am working in a job where i have to work under lots of stress making important and quick decisions. I even regularly hold presentations infront of crowds and i appearantly come off as very confident and competent.
So i suppose i got good at masking and coping (temporarily) with the fear. I invested a lot into meditation and yoga and i notice the physical symptoms and i try to stop them. I have at least not noticed the symptoms of anxiety in stressful situations, i just "function". But the moment i relax it feels like the world is coming down and it takes me quite some work to calm myself down. And this happens again and again and again.
My biggest issue, however, is definitelly not physical but mental. I worry so much about how im perceived and i simply cannot make myself not care about these things. It is so bad that i dont even want to cross the street because im worried i might upset the driver who wants to rush back home, and i dont want to upset anyone because being disliked feels like the worst thing on earth. I have quite some trauma too, so i have been repeatedly physically and verbally abused... And so one would assume im "used" to these frightening situations but it hasnt dulled me down at all.
So i am seriously wondering. would i need to desensibilize myself by asking people to yell at me, or to humiliate myself on purpose. Or what would the desensibilization in this case look like?
Because like i said years of going through stressful situations telling myself im fine, has not changed that i fear rejection. Its so intense that every interaction with another person feels utterly miserable and terrifying to me. And yet i go and act like im fine and talk to people on a daily basis, even those who are rude and raise their voices. But somehow it just never feels any easier, even though i established health coping mechanisms that help me through these times.
Lilly, I want to cry reading your post. I am so sorry that you are suffering so much. Of course I cannot diagnose you and this is not a client/therapist relationship, but my heart hurts hearing your story. It sounds like you have suffered trauma and the impact of that trauma has manifested into severe social anxiety. You are able to get through situations at work, but suffer internally from shame and a fear of being disliked or humiliated or hurt. My advice is to find a therapist that you can trust that is trained in IFS, Internal Family Systems. Sometimes EMDR therapy can be effective too, but not as effective if the trauma occurred in childhood. If therapy is not an option at this time, know that when you are triggered with emotion, your body and brain are reacting to your past, more so than your present. You need to comfort that part of you that is hurting and reassure that hurt part of yourself that she is loved and worthy and safe.
@@PaigePradkoTherapy Thank you greatly for your reply, i very much appreciate it.
In regards to therapy i have to say that i have tried, but at this very point in life i feel like my trust has been somewhat broken and i feel tired of going to therapists. I have seen a few for a longer period of time each time, and it hasnt worked out yet....
It isnt easy to get an available therapist, but i have tried and eventually gotten into therapy after free counceling told me it would be advisable. They made me feel heard and understood but they were overwhelmed with my issues. Which was too bad.
The first therapist i spent a year with but i felt completely missunderstood. She was a behavioural therapist and she would want me to act "fine" and didnt even seem to care about how i feel. Her motto "fake it until you make it", not believing i could do that and it wasnt why i was there. Her telling me my past didnt matter and i shouldnt talk about it, because i was just re-victimizing myself. After a year i quit because i felt anxious seeing her because she would raise her voice with me.
The second therapist, appearantly didnt fully believe what i was telling her, either i wasnt as anxious as i told her, or i she couldnt help me. She was talking about IFS, but it felt wrong to me even hearing about this. And after a few months she told me she cant help me.
The third therapist finally seem to care and understand and he diagnosed me with OSDD-1b. Which i felt explained why the way the previous therapist talked about my inner voices felt wrong and insulting. But because of his work load he had to let me go, which was seriously a pity. And im hoping i could possibly go back, however, he does EMDR which now i dont feel like i want to try again.
The fourth therapist did EMDR with me, and after trying for 6 months i quit therapy because the EMDR always caused intense flashbacks which lead made me completely unable to function for the following few days to weeks. I felt like the therapist herself was being unable to pull me out of these flashbacks, but each EMDR session made me relive a traumatic past, and than made me feel like the past was reality and i was completely derealized and depersonalized for days trying to pull myself together.
I just feel tired. I feel like i want to just move past my past at this point and that just being it. I dont want to relive things, i dont want to even talk about them anymore, which i really wanted to do initially. After i shared all my trauma with the fourth therapist i feel like my hope is gone. I hoped if i tell someone that would fix me. But it only helped so much, my fear of people persists.
I feel like opening to a therapist was something very scary and i dont want to be hurt again. It made me feel like im too broken to be fixed, and yet that im fine and i dont need therapy - both at the same time.
I cannot imagine going through all of that, Lilly. I feel like everyone, even therapists have let you down. I am so sorry. I wish I had the answers to help you. I do not blame you for not wanting to relive your trauma. It seems that a caring relationship with a therapist that you can trust and feel safe with would be better than your past experiences. I hope that you can find a safe relationship with yourself and then someone else. Practice grounding and self soothing and safety exercises when you feel emotionally overwhelmed or triggered. Sometimes, it helps when we learn our triggers (for you it sounds like when you fear someone doesn’t like you), and then learn your emotional cycle (what you experience emotionally and how long it takes for you to feel stable again). Once you understand the triggers and your reaction cycle, it becomes easier to cope. Thank you for sharing your story.
I have agoraphobia. I already tried many of these techniques and I am only slightly recovered.
Agoraphobia is a very challenging condition. I work with my clients with agoraphobia for quite a long time, one step at a time, to heal. I use many different techniques and therapies to treat them. We set new goals every week and negotiate those goals. It takes enormous determination and commitment and none of it is easy. Even if you are slightly recovered, I want you to know that your efforts have mattered, and every step forward is a huge success. I am going to work on more videos for people struggling with agoraphobia and hope that you can give me some feedback when you watch them in a few weeks. Thank you so much for your comment.
@@PaigePradkoTherapy I subscribed and will look for your new videos. Could you please watch a few of my exposure videos on my channel and comment with your feedback?czcams.com/video/dPwpzSyDes0/video.html
Maybe you'll see something I'm doing wrong and correct it.
@@BeingBetter I have watched your videos and I think you are doing a great job. There are a few things that you can do to make your exposures even more effective. First, say out loud how anxious you are or what level of fear you have before you start an exposure. Rate yourself (0-100). If your fear level is below a 50, you need to add something more to the exposure to make it more fearful...for the exposure to be effective. You could add things like saying that you are going to get out of the car, or think and say fearful thoughts, or decide to get out of the car and do 100 jumping jacks...anything to make the exposure more challenging and keep your fear center activated. Second, I like the way you process your exposure afterwards. Say out loud what you learned from doing the exposure, what your fear or anxiety level was during and after the exposure. How it always seems to be more difficult than it really is, etc. The next suggestion is to do your exposures in as many different times of day, places, with people and without people...try to mix it up as much as you possibly can. Doing the same exposure over and over doesn't give us any more benefit. And finally, take a nap after the exposure. During sleep, a protein synthesis happens that helps our brain learn from the exposure. You are doing an incredible job, but you can tweak the exposures to get a little more out of them. I have a video coming out on Agoraphobia next Monday, and then another video on how to get even more effective exposures...hopefully the week after that. Keep up the great work!
It’s very helpful! Thank you very much!
You’re welcome.🙏❤️
Ur video lecturers r very useful.
Thank you.😊
Hello! Thank you!
Hi! You’re welcome 😊
Thank you
You’re welcome 🙏😊
I feel like I am gonna die 😢 I am afraid of doctors I can’t leave my room it’s been years, I am 38 I can’t do this anymore. It’s everything that makes me scared I just don’t know what to do anymore because I am sure it’s my heart nobody has a heart rate of 178 resting but I can’t get help. Meds are not helping
Christine, I know you are scared and suffering and do not know what to do. Take a deep breath. You do not need to change all of this right now. But, you can change. You will have to be willing and able to accept being uncomfortable at times. But, you will need to work and challenge yourself at your pace. Exposures help...they do not have to be perfect exposures...but, the more exposures the better. I suggest that you get a therapist’s help, or a support group to help guide you. But, if no support is available, become an expert on how to do exposures. Read everything you can get your hands on. Watch more videos. I have lots of videos on exposures and more coming. You can move forward little by little. I have seen agoraphobic people completely heal and actually travel the world. You can do this...one step at a time. Start with finding support and reading about how to heal from agoraphobia. Keep us updated. ❤️
Noting gonna happen to tu its a just panic or noting relax and create b. Complex in your body
How are you?
Wonderful video!I was wondering if you could give us more exercises to practice for rapid heartbeat and catastrophe thinking. Thanks
Hi Carla. You read my mind. I have been working the past few months on an online class for health anxiety and panic disorder. It goes much deeper into what to do when you are triggered by a rapid heart beat or palpitations or catastrophic thinking. I received so many requests for therapy and knowing I cannot meet the demand, and people like you, likely need more than a short video....so ...I am making the class. I am almost done with the writing, now I have to film. I hope to have it out to you in the next month or two. If you go to my website PaigePradko.com, you can send me a message with your email and I will notify you when it is available. I will also post it on my CZcams channel for my subscribers.
Thank you so much!!
You’re welcome 😊
Super mam
Thank you 🙏😊
Thank you.
You are awesome.
Thank you for watching 🙏❤️
Hi Paige
Thank you again for all your excellent advice. I have many questions about exposure therapy I hope you don't mind me keep asking you about it.
I have been out to the local town twice once on Monday and once on Wednesday. Both times I had extremely intense panic attacks as intense as I have ever had. The first time I stopped the car calmed down and returned home. The second time I completed the task but I did do a little deep breathing to calm down however my thoughts accompanying it were " if the GP is wrong and I die from a heart attack because my heart isn't strong enough I have no choice now but to accept it". Once I got to my destination my panic subsided. In the past when I have done exposure work I have calmed my body by breathing deeply and slowly, I have accepted I may have a panic attack and I have reassured the limbic part of the brain that the environment is not dangerous. This has worked for me in the past and I have been out without having a panic attack through controlling my thoughts and breathing. I understand how this type of exposure fits in with the way the primitive brain works i.e showing it that is not a life threatening situation and thereby showing it that it doesn't need to protect me resulting in the amygdala no longer being triggered in that situation.
I don't understand how getting really anxious without showing the limbic brain that I am safe, works. Doesn't it just heighten your sensitivity to the stimulus and make it something the amygdala thinks it needs to avoid? I was generally calm when I was at home but since doing the last exposure I am agitated and I was unable to sleep. Is this normal and will it subside? I am worried that I may start having panic attacks at home if I am always agitated after each exposure.Also how do I do the cognitive restructuring after the exposure?
Also I am in the vulnerable category and therefore have been isolating for the past 20 weeks this is the first time I have been out and I was in the car with someone who is outside my household do you think that has exacerbated the anxiety?
I don't know if you are interested but the two therapists which have helped me the most up until now have been Dr. Claire Weekes and Dr David Burns.
Yes, I am very familiar with both therapists and authors. I was trained by David Burns early in my career. Researchers in exposures do not recommend cognitive restructuring until ALL exposure therapy is completed and you have no exposures left to do. Not just after one exposure. When researching how new neuropathways are formed in the brain, they found that safety behaviors like breathing calm down the amygdala in exposures and make the new neuropathways weaker and therefore not as lasting. Robert LeDoux, a neuroscientist, explains this in his book on Anxiety. We want the amygdala to learn on it’s own from the experience in the exposure. You make the exposure weaker when you give yourself calming messages or do breathing techniques. All you have to do is the exposure and stay in it until you notice your anxiety coming down. But, if you need to calm yourself down by breathing to get through the exposure, than do that until you can work your way up to not needed to. It is most important that you calm down by at least 50% before you turn around and go home. Some days you will be more anxious afterwards than others. Sleep as soon as you can (within 6 hours) of the exposure.
Hi Paige,
That's amazing that you have trained with Dr.Burns.
Thank you for taking your time to explain the process to me. I understand it much better now. However I found I was that agitated after the panic attack that I couldn't sleep. Will this defeat my recovery? Also do I have to reach the top of my hierarchy ladder before doing any cognitively restructuring and would the restructuring be on the lines of CBT.
When I am doing the exposure work do I have to focus on the feeling and thoughts that are going on at the time of the in panic attack or do I just carry on with what I am doing and ignore the panic and thoughts? I want to get it right because I am so worried about making my agoraphobia worse having gone through all the trauma of exposure therapy.
Finally do you think Dr. David Burns TEAM therapy will be useful at the cognitive restructuring phase or do you have to use other cognitive tools?
You actually have really great questions and I hope others can learn from them too. You do not have to think anything at all when you are in the exposure. Right now, you are activating your amygdala and all you have to do is stay in it long enough to feel your anxiety go down on its own. When people do exposures and cannot get anxious enough...I might have them add anxious thoughts to get their SUDS score (Anxiety level) to go up higher, before it drops. But, you are already getting your SUDS score high enough. If you feel like an exposure was too much to handle, create an easier exposure to do. But, the higher your anxiety level...the better, stronger and faster you are rewiring your brain...if you are able to stay in the exposure. As I said before, I like my client to vary their intensity of exposures...the more variety of types and durations and intensity of the exposures, the better. The research on CBT and exposures shows that all CBT including cognitive restructuring weakens the exposures. Researchers in the field recommend either not doing any at all...because exposures are really what works....or waiting until all exposure therapy is completed. Even then, research shows that it adds no value to treatment. I realize this makes CBT therapists like myself very uncomfortable. But, I have adapted my treatment with this research that has been confirmed many times.
one of my external cue is sitting in the middle portion of church during service... back of the church is okay-ish... damn i hate this
I am so sorry, Javier. Many people with panic disorder and/or agoraphobia or social anxiety often use a safety behavior of sitting somewhere that feels less threatening and easy to exit. You can begin to challenge changing this behavior in a variety of settings. Every time you challenge yourself you are taking back your freedom.
bless you and this channel, I suffer from panic disorder, depression and agoraphobia. This is helping me to have hope and tools to cope with life, I'll try IET, can i do more than one trigger exercise in parallel?
Yes, you absolutely can combine exposures. Try to be as creative as you can and continue to surprise your brain by constantly changing how and where you do your exposures. If you are interested in learning more, I am working on an online class for people with agoraphobia and panic disorder. It will be about 8-10 more weeks until the class is available. 😊
I am currently bothered too by my body sensations that makes me anxious. I know that exposures can help me overcome this but I am afraid to start nor I don't know how to start it.
Hi Ally. I am sorry that you are struggling with this. If you would like help, I do have a course that takes you step by step through recovery: www.paigepradko.com/healthanxiety.
Hey! Don’t know if you’ll see this but wanted to try reach out and get some advice if possible. Since the age of 17 I’ve been mostly house-bound due to panic disorder. Started off with a panic attack here and there at college. The main trigger for me was my breathing. Hyper focussing on it and then getting the feeling that I couldn’t breathe, and with that a fear that it’d kill me. Eventually they got so bad I dropped out of college. Then i suddenly started having them everywhere more and more until I secluded myself to just my house. I wasn’t completely free from them at home, but the feeling of being at home made having them more comfortable. 21 I tried my best to overcome, I managed to get a job 2 min away and I can still go other places as long as I’m comfortable / familiar with them, but I don’t tend to go outside of that circle. I’m comfortable within it - but it’s no way to live my life and I still have the panic attacks, especially when I try push myself to try something new or push my “comfort boundaries”. Now it feels like I can’t go so far without the fear of stopping breathing / getting that panic attack. Again, I do still get them but far less frequent because of how small I made my circle and how much at bay I keep myself from these situations. How do I break that? In this period I’ve also done CBT, been on medication and tried almost anything else you can think of, but it’s like my mind is stubborn. I want to beat it, I just don’t know the best way to approach it. Any help would be really appreciated 🙏
Hi Danny. I am sorry that you have been dealing with this for several years. From your description, it sounds like it began with somatic awareness OCD. That is a type of OCD where you become hyper aware and conscious of an automatic body process like breathing, your heart beating, blinking or swallowing. But in your case, the breathing became to feel like you couldn’t catch your breath, because your fight or flight symptoms were activated by your nervous system. It feels like it is difficult to get a breath in, when what is really happening is that you are over breathing and hyperventilating and have too much oxygen. Holding your breath and slow exhales correct this problem. But your body self corrects itself naturally. My advice would be to treat both conditions. First, learn what to do for panic symptoms, and second, learn what to do for somatic awareness ocd. I have courses that give you the tools to treat both conditions.
I suggest learning how to move through a panic symptoms, and practice very specific interoceptive exposure techniques. I have a panic course where you would learn treatment specifically for your breathing issues. Your past therapy treatment should have included interoceptive exposures as this is the evidenced based treatment for panic disorder. If you did the type of CBT Therapy where you talk about changing your distorted thoughts, that will unfortunately do nothing for panic disorder. Here is a link for my panic course. www.paigepradko.com/panic.
After the panic course, you will learn how to gradually treat your agoraphobia. But, that is the final stage of treatment. First, you have to tackle the breathing symptoms and fear. This work takes time. These conditions are treatable. I also recommend following my newsletters at paigepradko.com for more help.
@@PaigePradkoTherapy yes! When I was 13-14 I also had swallowing issues, ever since that age I’d always kept a bottle of water with me to help with it. Crazy how finding a solution for that, my mind started to focus on the breathing instead. Thank you so much for enlightening me on somatic awareness. Never knew there was a term for it, I only recently got the panic disorder part nailed down. Most my life I thought it was a form of anxiety. Your course looks amazing and as soon as I have the money, I’ll look into signing up 🙏❤️
Hi , I want to try this . Very good video. I feel dizzy when I stand up or when I don’t eat on time. I take with me food when I go out and I make sure that I eat before going out. I don’t have diabetes now just I had 3 times in pregnancy. I am very confuse I feel dizzy because my sugar is going down or because panic attacks. I want to be a normal person like before. Thank you for the video 🥰
I am sorry you are experiencing this dizziness. It is important to find out if it is due to hypoglycemia or anxiety, because treatment is very different. I wish you the best.
can u help me my panic attack come and depersonization whever i drive my car away from home the more far the more panic and symptoms and drperdinalization and feeeling losing control
I am sorry you experience dpdr while driving. I want to encourage you to continue to drive and welcome the dpdr symptoms to be there. You may also want to practice having the symptoms on purpose. Here is a video to help: czcams.com/video/-Xem4AFRwU4/video.htmlsi=RbtfIGzae3pfhjbE
What do you do if you have a fear of vomiting? I don't know how to lessen my fear of that. As soon as I feel dizzy or nauseated I feel like I am going to throw up and that causes spirals of panic.
Hi Laura. The fear of vomiting, emetophobia, is very common in people with panic disorder. The treatment is ERP, exposure and response prevention therapy. Doing exposures that make you feel dizzy and nauseous is exactly what you want to do. It is difficult but you will find over time that you will get less reactive, less fearful and those sensations will no longer trigger panic. Do your best to work up to longer periods of exposure and tolerating those symptoms to the best of your ability.
I also get anxious when going to the doctor, because I never feel like any of them have any answers or solutions. I don't feel like I'll ever get any help and feel normal.
Unfortunately, if your symptoms are anxiety based, not many medical providers are trained in how to help you besides prescribing sedatives. You are not alone. Many people feel misunderstood when experiencing anxiety based symptoms. But there are treatments like interoceptive exercises that are effective when practiced the right way.
What is your take on hydroxyzine for someone with really bad anxiety and panic disorder?
Hi Emily. I do not know too much about the medication but I am seeing it used for anxiety and sleep problems and from what I have witnessed and read it seems to be a much safer option than something like a benzodiazepine. I do not know if it impacts the learning process during an exposure. It is fine to use a medication with the initial exposure if needed. But, I do think better safety learning and increased tolerance takes place when one is able to eventually do an exposure without the use of a medication.
Hi Paige. Thank you so much for this video. I am in counseling now for recurrent derealization/depersonalization caused by panic and trauma. My counselor talks to me all the time about "flight, fight, freeze, and flock" and how when I'm in a freeze state, the only way to fully come out is to face the anxiety. It's challenging, but I'm happy with my progress.
Just curious, what is your opinion on antidepressants and panic disorder? It makes sense that Benzos would prevent the necessary anxiety given how fast acting they are, but can exposure therapy be effective for patients taking SSRI's and other antidepressants?
First, I am so happy that you are in therapy and making progress. Derealization symptoms are very challenging and frightening, but you can fully recover. Your question about antidepressants is a great question and one that many may have. Antidepressants can be helpful for many disorders that require exposure therapy including anxiety, panic, trauma and ocd. However, antidepressants vary, and so do individual’s reactions to those medications. Therefore, there is an element of trial and error with antidepressants. I am not aware of any research demonstrating that antidepressants make exposure less effective. I appreciate your thoughtful comments.
What if anxiety was caused by medications now I have severe panic disorder, depression, depersonalization, and nothing helps?
Hi Leah. I am so sorry that happened to you. I have worked with other people that experienced the same thing. There is a new book called, “The Waiting Room” by Jennifer Swantkowski, where she describes exactly what you are describing. You can find it on Amazon.
How do you practice this for fear of ectopic heartbeats where you cannot induce them since they come randomly?
Hi. That’s a great question. Cardiac health anxiety is one of my specialties and it is a bit more complicated than this video covers. I go into the treatment in more detail in this video called, “My heart is scaring me” czcams.com/video/2K7RO73xQZE/video.html. After a full cardiac work up, which most clients have had before they begin treatment with me, we may begin treatment with identifying everything they do now when they feel these heart beats/palpitations or sensations and what they avoid doing in response to them. We work on changing all of their behaviors that are reinforcing the anxiety associated with them. Sometimes we may do interoceptive exposures if we can mimic the sensations in some way, but this is not the first step in treatment. If you are in need of more help, here are some resources that may be helpful: Health anxiety assessment
www.paigepradko.com/healthanxietyquiz
OnLine Course: Rapid Recovery from Health Anxiety
www.paigepradko.com/healthanxiety
Thank you for this video ma'am Paige.Of all the videos I've watched regarding agoraphobia and panic disorder, yours really helps. However I am a bit hesitant on doing the exposure therapy which requires to be really anxious in order to create a new neuro pathway. Will you give me an advice on how and where to start exposure therapy effectively? Thank you ma'am Paige.
Hi Dohn. This is challenging, but you can work your way through exposures gradually. My advice is to write down what triggers your fear, and what you think your core fear is. Then, think of ways that you can gradually trigger your fear and not do anything to reduce your anxiety. It will come down on its own. If an exercise is too scary to do alone, ask someone to do it with you. Eventually, you can work your way to doing it alone.
Hi Paige,
I read one of the other comments and they asked about stopping off on the way to their destination. I can be anxious all the time until I reach my destination. Do you suggest stopping off many times so the amygdala can get used to the places on the way? If I don't will that amount to escaping and will the amygdala interpret this as a dangerous place? Thank you.
Good question. I used to do a lot of stopping.
the video gave me a panic attack lol I’m completely unable to function anymore and I don’t know what to do, I have such bad health anxiety now and I constantly think I’m going to die. I just want to be normal again.
Yes, this is a challenging type of exposure. Start with exposures that are a little easier. Make a list of activities and places that you are avoiding. And slowly work on challenging yourself. Start small and as your confidence build, you can increase your challenges. Therapists specializing in this area of exposures can help you.
hello, ive been dealing with this since i was a child and i'm 28 now, i've been doing avoidance my whole life and now i'm actively trying to help myself, i tried spinning around for dizziness but it made me SO dizzy i feel physically sick, i had to stop halfway through and sit down, should i continue, is that a good thing? is there a way to combat the sickness? am i moving too fast? any tips would be great, thank you 😵
You have been dealing with this most of your life. I recommend a more comprehensive approach. There are specific ways to practice these exposures for success. I have a course that walks you through step-by-step what to do to practice interoceptive exposures and recover from panic disorder and high anxiety. You can find out more and enroll here: www.paigepradko.com/panic
Hello what triggers my anxiety is a tingling numbing feeling and I get a full blown anxiety attack. Any thing that could help with that?
That tingling, numbing feeling is a normal feeling when experiencing high anxiety. The blood flow changes and is taken away from our hands and feet and face and skin and is redirected to our heart and major muscle groups. This blood flow redirection is meant to help you survive if you have to fight or flee. I wonder if you can begin to normalize these sensations as something that naturally occurs when the body is anxious and is only temporary and not dangerous at all. If the sensations cause you more anxiety…it will prolong your time in fight or flight. Try to tell yourself that this tingling is normal and nothing to be alarmed about…it will pass when my brain feels safe.
Hi do I also have agoraphobia I just want to stay at home I have full concentration on my studies at home than class lectures moreover when teacher calls students for explanation of answer on stage my heart beat fastens, can't breathe have pain in stomach what should I do?
It sounds like you may possibly have social anxiety. You can develop agoraphobia if you do not challenge yourself to go out and away from your safe places. Please make it a priority to expand your environment and challenge yourself beyond your safe zones. It gets easier the more often you challenge yourself.
Hello, thank you for the informative content about Interoceptive Exposure Therapy for Agoraphobia, I had this symptom for the past 2 years living in constant fear everyday now I am seeking professional help but my doctor is working with me on cognitive behavior therapy, my symptom is triggered by the thought of leaving my house to anywhere or me just being alone (anywhere outside my house) rapid heartbeat commence first then followed by sever pain in my stomach that I have to use the bathroom for most of the day and sometime the panic attack make me vomit. I had to quit my job, never drove again or went outside the house alone, this happened after a series of trauma. I would like to know what kind of exercise I should use in my case to start the treatment.
I am so sorry you have this challenge, yet it is possible to recover. You will have to slowly train your brain that you are safe when you leave your safe areas. I am working on more help for people with agoraphobia that will be available online in the coming months. Try to do some kind of exposure every day to challenge yourself and train your brain that you are safe. It is not dangerous, only uncomfortable to have panic symptoms like you described. These symptoms will all dissolve as your brain learns that you are safe.
Hi I had a heart attack now I don't want to leave the house and be on my own
Hi Tracey. I am sorry and I understand how that has created fear in you. Somehow, I have created a sub specialty in treating patients that have had heart attacks, appropriate treatment and now their cardiologists have declared them healthy. Yet, their anxiety rules their life. I am going to do a future video on this fear including what to do. Exposure therapy is required to create new neuropathways that include body sensations without triggering fear and anxiety. For most of my clients, we create multiple exposures doing different activities and situations, with people and without people, to learn that they are fine. They learn to welcome the anxiety and do not have any avoidance behaviors like insisting on not being alone. It is a process, but, you can learn to change your anxiety reaction and regain your life. Thank you for sharing your experience.
You say that you should make yourself very anxious and not use reassurance during the exposure therapy. And most exercises are about a minute on, then a minute rest. During the minute "doing the exposure" is that when you should let yourself feel as much anxiety as possible? And then what do you suggest doing during the one minute rest? Should we be deep breathing or thinking? Should we refrain from safety behaviours during the rest? Also, at the end of the cycle, is there an activity you suggest that should follow the exposure exercise? Thanks :)
Great questions. During the exposure exercises, just concentrate on the exposures themselves. You will then want to do them in different locations and different times a day, if possible, because it strengthens the exposure. During the rest period, just rest. But, do not do any deep breathing techniques for relaxation during the rest period and exposure is more effective if you do not talk during any part of the exposure. Refrain from safety behaviors all of the time, not just during the exposure. And afterwards, just go on with your day as normal. I have read some research that naps help with exposure learning, if taken shortly after exposures. So, try a nap. 😊
Dear Paige
I first felt this a month ago, i am diagnosed with acid reflux, i get this side sudden panic attack in middle of my sleep without a reason, or sometimes a dream triggers it. Sudden heart rate and shortness of breath. Can you please help me out it happens only at night after i go to sleep, i was a weed smoker for tge past 8 years and i suddenly stopped 40 days ago when i first fept thr panic attack, please help me out, i am no lomger having any withdrawal symptoms, but these nocturnal panic attacks happens everyday. Please help me out Paige.
That sounds like nocturnal panic. Have you seen my video on that topic? I hope some of the techniques here can help you. It does take time to help our brain and nervous system to calm down after we have been chronically numbing it. It may overreact for a while before it calms down. czcams.com/video/kObRmmFI01k/video.html
@@PaigePradkoTherapy
Dear Paige
I am not having nocturnal panic attacks anymore,its been two weeks without it,
But the fear is there inside me wheather it will come again.
I have one question. You mentioned about how sometimes people like to throw themselves into the deep end for exposure and this is ok. What i'm unsure about is why my anxiety has worsened to the point it has now. It started with an open space fear, where i would have to speed over strips of open fields. in massive panic. this to me sounds like exposure therapy, but did all of this not work since i was responding to it wrong? writing this i think that was the case. My most recent fear i faced though was on a plane (out of no where, i never had an issue with planes). I panicked, i had a huge panic attack, and this has created me to have agoraphobia and i cannot drive 15-20 minutes away from the house without the panic beginning, and extremely overwhelming derealization thats crippled me for 4 months.
WITH ALL MY MUMBO JUMBO ASIDE.
I just want to vent that a lot of my anxiety comes from how much worse can this get.. whats the next step. this terrifies me.
Intense anxiety, panic and agoraphobia are all very challenging and terrifying. What you are describing sounds so difficult and I understand why you feel discouraged. I want you to know that I have witnessed people get their lives back that felt trapped by panic and agoraphobia. It is a process...you have to have determination to not give up...even when you have bad exposures or setbacks. You have to commit to exposures. Start by writing down everything that you avoid....everything that you can think of...these will be the basis of your exposures. Watch all of my videos on different types of exposures. My most important video on Exposures is called “10 ways to Maximize Exposure Therapy”. I do recommend working with a therapist that specializes in anxiety disorders and agoraphobia, if this is possible. I will be working to consult people in the near future as well. Recovery is absolutely possible.
Paige Pradko LPC NCC thankyou. Sorry for answering the rant/question. I discovered you last night and your methods are now in my anxiety journal. Will check the rest of your videos out
This is exactly what happened to me as well! I have never been afraid of planes! I'm not afraid of heights and not afraid of plane crashing. My fear is that I will get a panic attack in there and have nowhere to hide which causes that panic attack. It's a evil cycle. And yes, all year last year I was forcing myself out of the house. I can finally go out now without having full blown panic attack but I still feel fear and I don't enjoy myself at all and it's torment and exhausting. Everything is a huge challenge. I hope you're doing at least a bit better now though :)
i think the best way to defeat panic/fear is to challenge yourself to feel it more intensely in the moment. so, not necessarily exposing yourself to things, but when you are exposed, or when you are alone (think of it as practice, you can imagine things in your mind to cause fear/panic), and you feel anxious sensations, you can focus on them specifically and try to intentionally intensify them with your mind, like literally try to make it more intense, and it will actually decrease it or make it vanish/disappear. i think this is the real key, and possibly the only thing that can/will work for people. what really works for me is choosing a particular sensation (like super nauseous feeling in my stomach) in the moment or when it's about to arise, or when i'm thinking of something causing it, and trying to focus on it with all my attention and try to cause it to become more stronger with my intention, and it sort of turns into excitement and dissolves, but it takes practice. i think this can defeat fear because you're telling yourself to run into it in the moment, rather than avoid it, so you don't need to expose yourself, because this can cause more damage, but you need to do the right things at the moment of whenever you feel any anxiety. the right thing is to focus on it and try to cause it to happen more, which will in reverse cause you to feel less anxious. i hope it works for you, and all of us.
The noise at 3.55 triggered one. Haha. Irony
I will have to check out what the noise is in the video. One time my husband dropped a pan on the kitchen floor when I was filming a video. We tried to cover it up with music. Maybe this is the video where that happened. 😂 Good exposure practice.
@@PaigePradkoTherapy haha no, it was intentionally, the bouncing heart beat. Exposure it was!
Hi Paige,
Thank you again for your advice it is the best help I have had for agoraphobia. I was wondering could someone with agoraphobia just decide to carry on with their life and learn to live with panic being there without acknowledging or reacting to but with the knowledge that panic is not dangerous? I have heard some people are cured just by knowing that panic attacks are not dangerous and then just accepting them. Does this result in permanent cure? The biggest problem I have with panic and anxiety is when I hear how detrimental it is to your health. I then have a problem accepting it. What do you think about anxiety and its impact on health? Does exposure therapy have the same detrimental effect on health with all the cortisol released into your body? How does exposure differ from just living with panic attacks because it doesn't change your thinking about it?
Also what about caffeine I avoid drinking Pepsi before I go out incase it causes a panic attack. Is this a safety behaviour? I have read research which found that caffeine strengthen the new pathways during exposure do you know anything about this and should I have caffeine whilst doing exposure therapy?
What happens if I naturally start using reassuring thoughts that calm my amygdala down how do I prevent this?
I find it hard not to use traditional CBT methods because it enabled me to travel large distances without panicking. It feels safer and more comfortable than this quite harsh method.
Are you allowed to use mindfulness and staying in the present during an exposure and can I remind myself why I am doing exposure, the purpose of it, while I am doing an exposure? Thank you so very much for your time and wonderful advice. You have given me hope of a better life.
I love your description of carrying on with their life whether they panic or not. This is a life of saying yes, and I fact this person will be cured of agoraphobia because they are having constant exposures, which is exact how we retrain the brain. And yes, this can result in a permanent cure. Panic is not going to hurt you, physically, and we have to continue exposures whether or not our brain decides to panic. I wouldn’t worry about what ever thoughts your brain is having. Just do the exposures. We cannot stop thoughts, but we do not want to add them in intentionally. I do use mindfulness techniques at times to ground clients that find their exposures too difficult. If you can just use your senses to remind yourself where you are...what do you see, hear, feel, smell, taste. But, researchers may again call this a safety behavior. It is okay in the beginning, but eventually just let our amygdala learn by the exposure experience without adding anything to it to calm us down works best.
I have a question, I have severe panic attacks when travelling.I was once homebound twenty years ago but have pushed myself to small trips. I finally travelled about five hours away and a ferry this summer twice because my mom is ill from cancer. . My problems is the anxiety never really goes away the whole time im gone.My chest is tight, feel like im going crazy, head races.. just entire time panicky cause I want to be home. I had to take clonazepam for the first time in ten years, I went twice on the trip and both times it basically stayed really hard most the time, altogether three weeks I was gone. Felt panicky whole time, couldn't relax... any suggestions, it made me so disappointed I thought I would get over it once I got there etc. I have to go back again as my mom is still ill, I tried twice last month and went in full blown panic both times and cancelled cause I know what Im in for non stop anxious the whole time im there, its soooooooooooooo hard on me. Entire time chest tight, feel verge of going crazy, anxious can't sleep. So going there doesn't mean just a panic attack means non stop stress hard core for weeks..
on ferry I had non stop ones to the degree constant diarrhea, extreme nausea, full on fear of going crazy, couldn't eat while away, like hard core non stop.
I am so sorry you are dealing with this and it can be confusing and overwhelming. And, I am so sorry your mom is dealing with cancer and I hope she is improving. You were very brave and so courageous to do what you did to see your mom. Basically you were flooding yourself by traveling, taking the ferry and visiting your mom. Exposure work takes time. If you had stayed on for several more days or weeks, the symptoms would ease up, but may they would not yet be eased up for additional travel. I would recommend that you work on exposures daily. Those exposures should include doing all kinds of activities and driving and going on ferries and putting yourself in every kind of situation that you can that might trigger your anxiety symptoms. Your job is to do the exposures and tolerate whatever symptoms come up. Your focus should not be on getting rid of your symptoms, but getting better and better at tolerating whatever shows up. Your fear is more related to your symptoms than anything else and therefore, doing exposures that induces symptoms and practicing allowing the symptoms will train your brain to no longer fear the symptoms. This is what will help you to recover. I have a program for people with agoraphobia coming out soon. If you are interested in more information, you may sign up for my newsletter at paigepradko.com. It will really help you because I cover lots of different exposures for what you are describing.
I get like a nervous gut feeling. That’s a huge trigger for me. How would I work through that?
Hi Melissa. The purpose behind interoceptive exposures is to purposely recreate our triggers (sensations) and then go about our day tolerating the symptoms and not doing any avoidance behaviors. This trains the brain to habituate to the symptoms and also creates safety learning and increases your ability to cope with discomfort as well. Sometimes it gets tricky coming up with ideas to create the sensations that trigger us. I have had several past clients that avoided going places due to stomach upset and feared they would have chronic diarrhea and not be near a bathroom. Our exposures increased and expanded as we went. They eventually were going places after just haven eaten with a full belly and then they did not search out bathrooms or plans of escape and managed to increase their time and distances. I wonder if you could do your best to figure out how to best recreate your discomfort in your gut and then challenge yourself to go out, away from your safe zone without safety behaviors like looking for restrooms or bringing certain medications or water or food to comfort you. This takes time, but if you are persistent, you can make great progress.
Thank you for this video, Paige. I have "experienced" panic disorder and agoraphobia for the last 30 years. After trying different types of therapies, recently, I decided to take it all into my own hands and use the many videos and resources that there are online to get the seed of agoraphobia out once and for all. I am doing loads of relaxation meditations and gradual exposure therapy, however, I am focusing on my internal sensations when I go out because what I fear most is the fear feeling, the lurch of panic I feel in my chest. My question is when I do the exposure is there a line between the anxiety sensations and when the panic gets a grip. Should I be tolerating the panic lurch itself or the feelings that precede it?
Hi Esther.
I am so impressed with you that you are so determined to beat agoraphobia. Please go to my website and join my newsletter because I have so many new resources for people with agoraphobia and panic coming up in a few months. Go to paigepradko.com to join and I will keep you updated.
Now to answer your question. The most important thing about recovering from agoraphobia and panic is to stop fearing high anxiety and panic symptoms. I know you hate the feeling, but it will continue to come until you stop being afraid of it. At first…just act “as if” you are not afraid, and then it will get easier to just give in, stop trying to resist it and avoid it….and even do your best to welcome panic. I know it sounds crazy, but as long as you fear panic, you are making your brain stay in fight or flight. As soon as you stop being afraid, the panic will stop. You have the power….and the power is in welcoming all symptoms because they are not dangerous. This is how you recover. I have lots more to share. 😊
@@PaigePradkoTherapy Thank you, Paige. Yes, I am seeing the light at the end of the tunnel for the first time in 30 years as I now recognise that the fear is within, not outside. So I affirm that I can tolerate the sensations and though, it's hard, there is a willingness to grit my teeth and bear the sensations. I also feel that once I do start to truly tolerate them, I'll start to tolerate all sorts of situations that have nothing to do with agoraphobia. I believe I will see it as a gift later on.
Yes…you are seeing the light…you are amazing and will continue to make progress.
My trigger is my tummy tightening / cramping up but idk how you could approach that
You could try doing different exercises where you tighten your abdomen until it feels similar to what you experience.
Hi Paige,
I was wondering which areas of mental health you can apply CBT to for example can you use it to overcome excessive worrying?
Also how do you know when you are over agoraphobia and do you have to do exposure therapy each time you encounter a new situation for example if you manage to travel abroad do you have to do exposure for each different country you travel to and how would you do that?
The part of the therapy I don't understand is if all your emotions come from the way you think why doesn't CBT work in overcoming agoraphobia?
Finally what do you think about antidepressants. Are they useful in treating agoraphobia or do they reduce the effectiveness of rewiring the brain? Is there any literature on this therapy so I don't have to keep troubling you about it? You are very patient but I do feel I am taking advantage of your good nature.
You do have many great questions and I may use them in a Q & A video in the future. Here is a playlist where I talk about when to use CBT and when to not use CBT. czcams.com/play/PL1lUhuKpYUYr5gYc3EnbBvR_oHz5h2jQK.html. Basically, it is helpful to use CBT for Generalized Anxiety Disorder, GAD, for general worry, negative thoughts, ruminating and Depression. Cognitive Restructuring is not helpful for exposures used in the treatment of phobias, panic disorder, agoraphobia, and OCD. I still use it with social anxiety, but the research points to exposures again being most helpful. The science behind it is understandable when you look at the anatomy of the brain and how the amygdala learns. The amygdala learns fear through experience and association, not what you tell it in the form of thoughts from the cortex. We can tell ourselves not to panic all day long and the cognitive message has very little effect on the amygdala. But, an experience of exposure to the feared situation teaches the amygdala that nothing bad happened. We have to teach our brain through experience and associations. You can read more about the brain science behind it in Robert LeDoux’s book, Anxious, and Michelle Craske’s research papers and videos and Rewire your Anxious Brain by Catherine Pittman. Although Pittman’s book is a bit outdated on some of the recent research involving relaxation methods and exposures.
One can fully recover from Agoraphobia. My clients are recovered when they take on an attitude of, “Yes, I will do that and go there”. And, they continue to take on this attitude any time they feel the slightest feeling like they want to avoid something. They no longer think of outings as exposures, but, they know that they need to continually be aware of facing their fears and eliminating any avoidance behaviors.
If you were traveling, take on the attitude that you will go and see what ever you want to see and do not let avoidance behaviors sneak in. You take on an attitude of, “Yes” I can and will do that. Of course all of this has been so challenging with the pandemic and my agoraphobic clients have had to find creative ways to challenge themselves and not lose ground.
Hi Paige,
Thank you for all your great help
When carrying out exposures during this pandemic how do you know if you are experiencing a normal fear of catching COVID 19 and how do you know when it is caused by agoraphobia? The only way I can see of overcoming this is by going to remote places but isn' this reinforcing that some areas outside the home are dangerous? Thank you for your help.
Yes, covid makes all of this more difficult. My clients are instructed to follow CDC and government guidelines about covid, and do their exposures within those guidelines.
I have panic attacks in my sleep I don’t know why but it’s not every day what can you do to help me
I am so sorry. Here is a video where I talk about nocturnal panic and what to do. I hope it helps you.
What about body sensations I can't even function when that happens
Interoceptive exposures are recommended for bodily sensations whether it is a racing heart or palpitations or difficulty breathing or dizziness, nauseousness, etc. We have to take every opportunity to teach our brains that there is nothing to fear when we feel certain bodily sensations. I have my clients get approval from their physicians and then we begin by doing them together. You can ask someone to do them with you after medical approval before you try them on your own. If you need more help, I offer a course for health anxiety that focuses on treatment for bodily sensations. www.paigepradko.com/healthanxiety.
Hi Paige,
I just wanted to clarify something with you. Does a panic attack, resulting from the fear of having a panic attack when I'm out, originate from the PFC or does it originate from the amygdala. It feels as though it comes from my thoughts about having a panic attack and also thoughts of feeling vulnerable(due to being underweight) when I am out of my home which is a controlled environment, specifically a controlled temperature. Also before I had panic disorder I had a fear of travelling alone for fear of being attacked. Does this need to be addressed to overcome the agoraphobia? Also where do I find your weekly videos the latest video I can find is 3 months old?
Thank you Paige for all your help.
This is actually a very complicated question. I have not attempted to explain complex anatomy and the functions of the amygdala in a video. I tend to keep it possibly over simplified in my videos. It may be something I may try in the future, but there are neuroscientists that can do a much better job. The amygdala takes in sensory information from the sensory thalamus and from numerous other connections like the brain stem, the hippocampus (memories), the sensory cortex, the prefrontal cortex, and more. To answer your question about where your panic attack originates from is difficult to say. If your brain has associated something in the environment with panic, the panic may originate in the sensory thalamus or the hippocampus from a previous traumatic memory. I have also read that the amygdala itself can contain fearful memories. And we can also have a fearful thought and that can travel to the amygdala as well to initiate panic, although this is a slower process than the other pathways. As much as you would like to resolve your fearful thoughts, you will never achieve certainty and therefore it is more helpful to accept the uncertainty and anxiety that the thoughts cause, and allow your brain to learn through exposures.
To answer your question about new videos, I am looking for a person to do my graphics before I can upload any new videos. I am also working on a few writing projects that I would like to finish before I get to my new videos. Thank you for asking. I think you are becoming quite knowledgeable yourself and may consider a career helping others based on what you learn going through yourself. 😊
Muscle pain around my chest triggers my panic ,I start thinking and getting scare about checking my bp and heart rate and I start to ocd about it, its very tiring...
Yes, I understand. Muscles in your chest tighten up when we feel anxious. Once one can accept and allow the sensations associated with those muscles tightening, and not give themselves more alarming thoughts and also not check on body symptoms, the anxiety will fade. It sounds easy, but it is a learning process to allow anxiety symptoms to be there, without creating more fearful thoughts about those symptoms.
I have agoraphobia. I also have anxiety with internal feelings like dizziness, rapid heartbeat or palpitations, etc. Should I complete the interoceptive exercises and make good improvement with that before working on the external exposure therapy? Or can they be worked on together? I have worked on driving and getting out of the car but still can’t go in stores or church or far from the house if I am walking outside. I have had panic attacks at the pediatricians office so my husband takes my kids now. I spent my sons high school graduation in a parking deck after dropping him off because I couldn’t go in. My second son had a bad accident and ended up in the icu for a few weeks and my husband had to stay there with him. I did push myself to go in the hospital a few times and spent one night but it was torture. I thought I was going to pass out the whole way up to the room and back to the car. I need to get better to be there for my boys and my husband, I feel so bad that I am not doing my job and hiding from everything. This has been going on for about 5 years now.
Hi Kristina.
I am so sorry you are experiencing this and I cannot imagine your pain not feeling able to fully engage in life and be at significant events with your kids. There is treatment and there is a path to healing. It takes dedication and perseverance, because it is difficult. I will be giving general advice that includes getting the approval of your physician. I typically have clients begin with interoceptive exposures if they have not been out in awhile. If you have been out on occasion, you are one step ahead of the game. My recommendation is to begin Interoceptive exposures daily for rapid heartbeat and dizziness. Once you have made progress in these areas, I want you do do the same Interoceptive exposures around the house, in the garage, with people there and without people. Then, can you do the exposures outside, maybe in the backyard. Then, maybe try them in a park. You can have someone with you at first, then try alone. So, what you are doing is you are taking the interceptive exposures and moving them around to different environments. You can go at your own pace, but, try to mix them up. Then, you can begin to have different environment exposures like going to the store. Driving exposures are sometimes part of treatment as well, but, this depends on the person. Do not be worried about exposures that go “bad”. These do not set you back, and they are to be expected once in awhile. Just begin again the next day. There is no rule about working on one type of exposure at a time. If you are able to do Interoceptive Exposures and Exposures Outside of your home, then it is wonderful to mix them all up. If you find yourself too overwhelmed, then bring it back down a bit and work your way up more gradually. I am working on an online class for people with agoraphobia to help people through it. Please go at your own pace. Every exposure helps. I have a few videos that may help overall with exposures. Do not worry about doing something wrong. Just try your best to change things up to keep your brain learning with each exposure. Agoraphobia and Exposure Playlist czcams.com/play/PL1lUhuKpYUYoJdExc0g8zVZuekW2zhGG7.html