My book on Overcoming Agoraphobia is released on Thursday 21 August. You can order at Amazon.co.uk and through Sheldon Press directly.

This book represents a milestone in my own battle in overcoming agoraphobia. It is an amazing feeling to know that you have overcome this debilitating condition and are now in the position to help other people on their own paths to recovery.

I will be taking part in publicity over the coming weeks to promote the book, I will be posting all the details on the Press and Media page.

When you’re agoraphobic, getting to see a therapist can be very tricky. A cognitive behavioural therapist is unlikely to be local and for most people this means deciding whether they can face a journey in order to get help.

 Cognitive behavioural therapy (CBT for short) is normally recommended for panic attacks and agoraphobia as it has the most evidence that it will work. But there isn’t enough therapists and waiting lists can be long. To address this problem, the goverment has introduced a computerised self-help programme. This is a real boon for agoraphobics – you can now get some help at home without having to go through a difficult journey.

The only programme currently recommended for agoraphobics, panic disorder and other phobias is called FearFighter. This programme can be accessed via any computer with an internet connection. Another advantage of a computerised programme is that it can be accessed instantly, cutting out the long waits for therapy. FearFighter has been tested through clinical trials and has proven to be an effective therapy.

Your GP simply prescribes you access to FearFighter and arranges for you to be sent a password to use the site. You also have some telephone support. There is a legal duty for all Primary Care Trusts to make this treatment available but of course, some can be quicker than others to implement a new treatment. It’s worth asking your GP to find out if it’s available in your area.You can also buy the programme privately, at a cost of £350 from the FearFighter website. You can also find out more about the programme there.

 I’d be interested in knowing how easy you’ve found this programme to get through your GP and whether it helped…

This week a new research study about antidepressants has been published which has been hitting the headlines.

 The study carried out by a team of researchers from the University of Hull analysed all clinical trails which have taken place for the following four antidepressants: fluoxetine, venlafaxine, nefazodone and paroxetine. All these antidepressants are types of SSRIs (selective serotonin re-uptakers). They are said to work by stopping receptors from taking up serotonin, increasing the amount of serotonin and therefore improving our mood.

All antidepressants have to go through clinical trials against a placebo (a dummy pill). The medicine has to demonstrate that it is more effective than a placebo before it can get a license to be used. The researchers looked at all the clinical trials for these antidepressants; some of these trials had been published and were already in the public domain. Some had not been published and the researchers used the Freedom of Information Act to get access to these studies.

After analysing all the different trials, the researchers concluded that antidepressants did not produce clinically significant improvements in mild, moderate and severe depression. Significant improvements were only found in the most severely depressed patients and this was said to be due to these patients been less receptive to placebo, i.e  they found the dummy pill less effective not the antidepressant more effective.

This raises lots of questions about antidepressant use, especially as the number of prescriptions have soared in recent years. Very briefly, these issues tend to focus around:

• GPs could be prescribing antidepressants too easily. However, GPs argue that due to the lack of ‘talking’ therapies and the long waiting lists, prescribing antidepressants is the main option. GPs also argue that they feel some patients need to take antidepressants in order to be receptive to psychological therapy.
• Are more people are getting depression? Again, experts in charities might argue that people are just more aware of depression now and are more likely to seek help – instead of opting for the English ’stiff upper lip’ response.

However, this also raises some different issues for agoraphobics and sufferers of anxiety disorders. In all this debate about the use of antidepressants, people seem to forget that they are not just used for depression. This particular study was looking at depressed patients yet antidepressants are also prescribed for panic disorder, agoraphobia, social phobia, OCD, anorexia and PMT. There are very few studies looking at the use of antidepresants for panic disorder (with or without agoraphobia).

 One such study on panic disorder  did take place though in 2006. This review of various studies compared the effectiveness of being treated with both psychotherapy and antidepressants compared to being just treated with either psychotherapy or antidepressants on their own. The results showed that the use of psychotherapy and antidepressants together was the most effective. However, two years later 60 per cent of patients had not fully overcome the condition with any of the treatment options.

So where does this leave agoraphobics and anxiety sufferers? At the end of the day, most of us just want to feel better and we’re not too bothered about how we get better, just as long as we do. If we take an antidepressant and this helps us, does it matter that it is down to the placebo effect? If I take antidepressants, do not think they will work and then to my surprise find they have helped, is this down to the placebo effect?

There isn’t one answer for everyone. Some people find antidepressants helpful, some don’t. Some people have a few mild side-effects to start off with and others don’t. My personal advice is: If you haven’t tried antidepressanst before, if you’re housebound or suffering from anxiety and are very unhappy about your situation then they are worth a try. There are a few rules I would suggest when taking antidepressants:

• Ask for psychological therapy as well – cognitive behavioural therapy is best, or counselling if waiting lists are too long.
• Don’t get too worried about side-effects and do not keep reading the leaflet which comes with the medication! Most side-effects are mild and go away after a couple of weeks.
• If your side effects aren’t mild then change to a different antidepressant. You could try and different brand and have few side-effects, it is worth trying another brand.
• Antidepressants take a while to work – they are not instant. You need to take them for at least a month before seeing any sort of improvement and it can often take longer than this for you to notice an improvement. Any side-effects should wear off in the first couple of weeks, it is important to stick out the treatment and get through this period.
• Have regular check-ups with your GP and discuss any concerns you have about side-effects with them.
• Do not suddenly stop your medication. Speak to your GP first.

I’d be interested in hearing your views about antidepressants. Did they help you at all?

Is agoraphobia a female-only condition? Female agoraphobics greatly outnumber men with agoraphobia and I think it’s interesting to think about why this is.

Some experts think that men are mre reluctant to seek help so we just don’t know that these male agoraphobics are out there. A study in America showed that men were more likely to mask their symptoms by drinking alcohol rather than seek help.

Other researchers think that the traditional role of a woman being ‘at home’ means they are more prone to agoraphobia. Or could female hormones be playing a part? Although Pre-menstrual syndrome (PMS) still isn’t officially a ‘real’ condition, no woman doubts that it exists! There is very little research in this area but there are indications that the female hormone progesterone can have an effect on serotonin (the hormone in the brain associated with depression, anxiety and other related conditions). The female hormones progesterone and osetrogen fluctuate during our monthly cycle and go through huge changes during pregnancy, after giving birth and the menopause.

This could be one reason why women are prone to agoraphobia and why our panic attacks can be worst before a period and at certain times in our lives. One way to see if PMS is affecting your agoraphobia is to keep a diary. Monitor your anxiety levels on scale of 0-5 (zero is completely calm, 5 being total panic), note when you have a panic attack and when your period starts. After three months, you should be able to see if there is a link.

When I spoke to the Natural Health Advisory Service when I wrote my book, they told me they had once carried out a survey which showed a high percentage of women with PMS experienced agoraphobia in the run-up to their period. This isn’t the same of course as a clinical study but all points towards a link between female hormones and anxiety levels.

If you think PMS or the menopause are playing a part in your agoraphobia there is a lot of help out there. A good place to start is with Natural Health Advisory Service and the book No More PMS by Maryon Stewart, available on their site.

Welcome to Overcoming Agoraphobia.com

This site has been launched in conjunction with my book ‘Overcoming Agoraphobia’ being published this August by Sheldon Press. Watch this site for pre-ordering details.

I’ve started this site to create an online community for everyone who suffers from agoraphobia or who has overcome the condition. I will also be keeping you up-to-date with the latest news, research, treatments and developments to help you overcome panic attacks and agoraphobia. Plus of course, you’ll be able to ask me questions and share your own experiences.

 I know just how isloating agoraphobia can be and this website is a small step that will hopefully help you find support.