thank you

I like your thinking, Nadia. You are doing a great job! 🙏❤️

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..

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. kzfaq.info/get/bejne/h815Z8l2yNSsYI0.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 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

I am so proud of you, Hayley. That’s so awesome that you are committed to working on this. Keep going!

Thank you for watching and commenting. I am glad that my videos might offer some help to feel like you are not alone.

I am the same ATM it's awfull and I really want to get better but I'm scared too do so 😢

Thank you ❤️

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 😊

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

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 ❤️

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.

Thank you Sarah 🙏❤️

Thank you for watching. Are you reading Abramowitz’s book? Great book!

I am glad to hear it helped. Good luck in your therapy. It gets easier as you go.

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. kzfaq.info/get/bejne/h815Z8l2yNSsYI0.html

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

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.

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.❤️

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. 😂

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

You’re welcome.🙏❤️

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

Hey….great work! I hope people read your comment and are encouraged 😊❤️

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

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.

You’re welcome 😊

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 :)

I am glad you found the video helpful. Thank you for your comment. 😊

Hi! You’re welcome 😊

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.

Thank you for watching 🙏❤️

Yes, people often misinterpret what they feel as dangerous and alarming. Anxiety symptoms are not harmful or dangerous.

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.

Thank you.😊

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.

That sounds terrible, Dlynn. I am so sorry that happened to you.

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

Hi Rob. That’s a heavy deadlift. Wow.

@@PaigePradkoTherapy Thanks, but it's really not.

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 KZfaq channel for my subscribers.

You’re welcome 🙏😊

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.

❤️

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.

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 :)

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

Thank you 🙏😊

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

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: kzfaq.info/get/bejne/d7yYpNiku92uXYU.html

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

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 kzfaq.info/get/bejne/qcBmaa1kvrGzn6s.html

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.

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.

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.

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.

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. 😊

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.

🤔

It is possible to do on your own, but of course a therapist trained in exposures can help. It sounds like you are willing to do the exposures and that is the main hurdle. Here are some pdf’s to help you: www.paigepradko.com/erp and www.paigepradko.com/bodyanxiety.

That’s a great question. Most people have developed a fear of certain body sensations like dizziness because of a different condition or experiencing that condition during a panic episode. This technique can help regardless of the way the condition started. It is recommended that you get your doctor’s approval. But, interoceptive exposure is the gold standard recommendation for treatment of panic disorder.

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 am so sorry that you are struggling with a fear of panic and agoraphobia. Exposure therapy is the most effective therapy, and this pandemic has certainly been horrible for people with agoraphobia and those with health anxiety and OCD. I am urging my clients to keep up exposures, even if they include a ride to the grocery store or a walk outside (if possible). To answer your question, I only meant “no benzodiazepines”, because they make exposures ineffective and have damaging side effects if taken long term. Some Antidepressants have been shown to be helpful in mildly reducing anxiety that can help overall with agoraphobia. Thank you so much for your question. 😊

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.

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.

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.

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.

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. kzfaq.info/sun/PL1lUhuKpYUYr5gYc3EnbBvR_oHz5h2jQK. 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.

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.

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 kzfaq.info/sun/PL1lUhuKpYUYoJdExc0g8zVZuekW2zhGG7

Joseph Le Doux’s book is not an easy read. But, he has research that backs up what he says. Avoidance behaviors is almost always thought to be negative when discussing anxiety. For people that avoid places due to anxiety and panic, their world gets smaller. However, LeDoux has shown that sometimes people can use avoidance as a positive way to cope in the moment. For example, if someone freezes up with panic at a party because they struggle with social anxiety, they could take a break and go outside for a moment. Then, they could come back into the party and try again. I think of proactive avoidance as ways to get yourself unstuck in the moment that allows you to continue making progress overall.

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?

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. 😊

I understand exactly what you are going through. Driving anxiety/ agoraphobia/panic disorder...it all goes together, is very challenging. But, it can be 100% turned around and resolved. It takes determination and commitment, patience, diligence and time. The biggest mistake I see is that people turn around when they are in what they consider too much panic. You have to stay in it until the panic decreases by half, before you can turn around. It is okay to pull over with panic, but, when you begin to calm down, go a little further, then pull over again, claim your new distance, wait until the anxiety drops, then go home. We do not want to teach the brain that you cannot do it. It is important to set the challenge day by day, and meet the challenge. Make sure you watch my Exposure video called 10 ways to make exposures more effective. I do work with clients out side of the state of Michigan as a consultant. Unfortunately, I cannot take insurance when working out of Michigan. At the moment, I am overbooked and am not accepting new clients. I will be working on ways to get more help out there for more people. Thank you for your message.

@@PaigePradkoTherapy thank you so much for your reply. Please message if you are ever accepting new clients. I will be viewing your other videos and will continue to challenge these symptoms. Thanks so much!

Good question. I used to do a lot of stopping.

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. 😊

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?kzfaq.info/get/bejne/mrano92E3qrJo2Q.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!

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 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.

I have done several videos on how to do exposures and on agoraphobia. I have had several requests for a video on emetophobia....so that one is on my to do list. I hope you are doing better.

Hi Carlos. You may send me a message through PaigePradko.com 😊

You will want to do what you can to trigger your fear, otherwise the exposure may not be effective. If doing the exposures at work triggers the fear and anxiety, then that would be preferable.

It sounds like you really like the feeling of being grounded. It makes you feel safe. Your brain has a faulty belief that you are unsafe if you are in an open space or on a plane. So, you treat this by giving your brain lots of opportunities to experience open spaces, and learn that you are indeed safe. You can create a variety of exposures to accomplish this. Here are some videos on how to do Exposure Therapy kzfaq.info/sun/PL1lUhuKpYUYqRtx-_xbr5gofDxBYIBdq0

What you are experiencing is possibly caused by an activated sympathetic nervous system, or your fight or flight response. Sometimes people experience this body reaction in new situations, like a new job. But then, after time, it calms down. The main treatment in these cases are to not avoid going places or doing things. There is a bathroom most places if needed. But, what your brain needs to learn is that you can cope and adjust and handle these new situations and you do not have to avoid them. I also add daily techniques like meditation and diaphragmatic breathing at least once a day to activate the parasympathetic nervous system.

I am not sure if I understand what a pds attack is, but it is quite common to have a fear of using a public restroom. Maybe you could help me understand more about what a pds attack is. For a fear of using a public rest room, I would suggest developing a hierarchy of exposures including watching video clips, creating exposure scripts and then creating behavioral exposures where you begin to go to public restrooms. I am not sure which exposure videos you have seen, so, I will copy you on a playlist. kzfaq.info/sun/PL1lUhuKpYUYqRtx-_xbr5gofDxBYIBdq0

@@PaigePradkoTherapy thank you for your response! i meant a ibs attack. (Diarrhea where there was no toilet and i was far from home sorry for the nasty details) now i am agoraphobic because i am afraid i will have one again, even if i didn’t have any attacks after that one time

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.

Hi Susannah. Interoceptive training would be very helpful for what you are describing and it is the evidence based treatment method for panic symptoms. Here is information on my training program that walks you through the steps of how to recover from panic symptoms even if those symptoms occur at night as nocturnal panic disorder. www.paigepradko.com/panic

@@PaigePradkoTherapy I am so grateful of you reply I will most certainly looked this up. Yes I am starting to think I am also experiencing at night nocturnal panic disorder. I had been to the doctors to get tested for sleep apnea but didn't have it, so I ended up putting down to the menopause but after watching your videos this makes so much more sense. Thank you so much for your help.

Hi Sehar. I actually do not recommend interoceptive exposures for people with asthma as the hyper ventilation exercises may bring on an asthma attack. You would want to make sure you have a doctor’s approval. I would recommend other forms of treatment for someone with asthma such as response prevention strategies.

Hi Cayla. Ask yourself…what are your deepest fears in this area. Is it that you will have an accident and be embarrassed? Then, humiliation is the fear. Is it a fear of not being in control when a rest room is not available? Is the fear more related to not liking the sensation of not going to the bathroom when you have an urge. So, not responding to the urge is the discomfort. I have my clients identify all of their core fears…(fear of humiliation, not having control to respond to an urge) and then creating different exposures that target those fears. Maybe eat and drink things to give you an upset stomach and then go to a public place and do not allow yourself to use a restroom for a certain length of time, or stand in a long line and ask a person an obvious question while at the same time while not responding to an urge to use a restroom. There are many ways to combine exposures to hit your core fears.

Hi Ashley. With conditions like dpdr and having visual snow, the key to treatment is to allow the experience without trying to NOT notice it or avoid it or be frustrated or anxious when it occurs. As you know, the more you try to not have it or notice it, the more annoying it becomes. Many people use interoceptive exposures for dpdr. I tend to use a more response prevention approach to dpdr symptoms. I teach strategies of allowing and not resisting the awareness and then using the I. A.M. technique. Here is a video on the I. A.M. technique. You can apply this technique to body symptoms and somatic awareness kzfaq.info/get/bejne/b9R1dpuqrs2qe5s.html

Thanks so much for taking the time to reply. Yes, this makes sense. I’ll have a look at the video

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” kzfaq.info/get/bejne/aLFnhbJomN61ink.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

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.

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