Therapy

The therapeutic measures depend on the form of claustrophobia and on the individual experience of anxious situations. The aim of a therapy should be to minimize the patient’s suffering and to get rid of the avoidance behaviour. Thereby, both a treatment without medication and a pharmacological (medicinal) therapy strategy can be used.

The combination of both measures is often the most promising option. Antidepressants and benzodiazepines can be used to treat anxiety disorders of all kinds. Although the former are actually used to treat depression, they have the same anxiety-relieving and sedative effects as benzodiazepines.

Antidepressants, unlike benzodiazepines, need to be taken for 2 to 3 weeks before a therapeutically effective level of the drug is reached in the blood. Benzodiazepines such as Lorazepam (Tavor®) are reserved for the treatment of acute situations because of their rapid action. However, there is a risk of dependence, which means that long-term therapy with appropriate drugs is not possible.

Therapy with so-called selective serotonin reuptake inhibitors (SSRIs) such as citalopram has proven to be successful, especially in agoraphobia. In individual cases, beta-blockers, which are normally used in the treatment of various heart conditions, can also be prescribed. The purpose of this is to decouple the physical symptoms from the mental symptoms – the mental experience remains, but there is no longer any palpitations or tremors.

Most patients already feel more secure in the presence of the doctor.In order to strengthen this feeling, a relationship based on trust must be established between the patient and the doctor. The most important thing is to convey to the patient that their fears and related problems are taken seriously. Behavioral therapy, the success of which is based on a good doctor-patient relationship, can try in various ways to alleviate or even reduce the fears.

Cognitive Behavioral TherapyCognitive Behavioral Therapy attempts to provide the patient with an understanding of how fears arise. The patient learns how the feeling of fear is triggered and maintained by his own behavior. With the information learned, the patient can better understand the processes during an anxiety or panic attack and thus reduce them.

Due to the educational concept of this form of therapy, group therapies are often offered. These are also part of sociotherapeutic strategies and are intended to reduce the social withdrawal of most patients. Systematic sensitizationA further possibility is systematic desensitization.

This is intended to make the patient less sensitive to stimuli that trigger anxiety. The treating physician achieves this by confronting the patient with appropriate stimuli. First of all, the patient has to put himself in an anxious situation in his thoughts.

Later he is confronted with real situations until a so-called stimulus satiation occurs. In the process, the affected person is brought “out of the cold” into a situation that triggers anxiety. Without the possibility to flee, it should be recognized that the fear will subside by itself if the person remains in the situation.

In addition to the confrontation method, relaxation exercises can be learned. For example, certain groups of muscles are rhythmically tensed and thus mental relaxation is achieved. While in most cases the already described behavioral therapies achieve an improvement, patients who are resistant to therapy may need a deep psychological treatment.

This takes a lot of time – usually several years. The aim is to uncover the inner conflict that causes the anxiety disorder. A precise knowledge of the patient’s life on the part of the doctor or therapist and a high level of trust between both parties are prerequisites for a goal-oriented depth psychological therapy.