fear of leaving house

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Hi all. i know i posted too many topics but this is a serious problem for me. I need to talk about this.

i get anxious when i need to leave house, i mean stepping out of house. I think too much about what will happen. if someone stares at me i get very self conscious. If someone crosses the road when im walking, i feel like an alien. I have something called agoraphobia. And social anxiety of course

I dont know how i can relax my mind.... all i know is it drives me mad

Are you in therapy of any sort?

Have you tried exposure therapy? Meaning exposing yourself bit by bit to whatever scares you until it’s not that scary anymore. In this case that would mean simply stepping outside for a few minutes. Until you get used to it. Then wait outside for a little longer each time. Maybe bring along an MP3 player to have the music entertain you and make being outside enjoyable. Then go out places with your parents. I went out with my parents in my early 20s and hated it. But this way at least you will be getting out. You will probably be more relaxed in your mid 30s after you’ve had lots of time to figure things out. And I’m sorry but, sometimes we must suffer a little bit to learn. It’s called life experience.

Talk to psychologist about agoraphobia diagnosis and treatment

I dont go to therapy or psychologist at the moment but only psychiatrist. She prescribes medications once a month. Its more like a drug dealer but i went to therapy for months earlier, it didnt work

Last edited by Highly_Autistic on 23 Jul 2019, 5:54 am, edited 1 time in total.

I think my fears are because of brain. overthinking causes this. My brain is screwed up

Treatment depends on cause of problem.

If the cause is phobia, then exposure therapy might be appropriate.
If the cause is PTSD, then EMDR works well.

As somebody with PTSD treated with exposure therapy, I can tell you it set me back years.

It is very difficult to explain this to family doctors, who got one memo but not the other.
I don't say "agoraphobia" any more although it's a handy quick way to describe the problem.
But 'phobia' plunks me right into exposure therapy, which is a disaster (same with meds).
It's misdiagnosis; we need another word.

Agoraphobia is a type of anxiety disorder in which an individual fears and avoids places or situations that might cause them to panic and feel trapped, helpless or embarrassed. They fear an actual or anticipated situation. These situations can include open spaces, public transit, shopping centers, being in a crowd, or simply being outside their home. The anxiety is caused by fear that there's no easy way to escape or get help if the anxiety intensifies. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again. People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. They may feel that they need a companion, such as a relative or friend, to go with them to public places. The fear can be so overwhelming that they may feel unable to even leave their home.

I would characterize agoraphobia as fear of having another panic attack. Entering a state of “tonic immobility” can be very traumatic for an individual. They experience a frozen state where their body physically shuts down; they even lose their ability to speak. It is a state of total and utter helplessness and it is extremely scary. The ghost of this event lingers within them and a repeat of this event must be avoided at all cost.

One tool to combat agoraphobia is therapy called Systematic Desensitization Therapy (also known as Graduated Exposure Therapy). Once you learn the cognitive distortions, practice noticing when they show up in your thought processes and challenge them. This will help to make the systematic desensitization exposure therapy process easier by giving yourself the tools you need to work through it.

Those experiencing anxiety often focus on cognitive distortions; such as all-or-nothing thinking/polarized thinking, overgeneralization, mental filter, disqualifying the positive, jumping to conclusions (mind reading), jumping to conclusions (fortune telling), magnification (catastrophizing) or minimization, emotional reasoning, “should” statements, labeling and mislabeling, personalization, control fallacies, fallacy of fairness, fallacy of change, always being right, and heaven’s reward fallacy. These distortions, while common and potentially extremely damaging, are not something we must simply resign ourselves to living with. For example, someone with panic disorder may engage in the distortion known as "catastrophizing", by predicting a negative outcome for an event that they don't yet know how it will turn out, this negative prediction can actually make it more likely that what you fear will happen. "If I go to the store I know I am going to have a panic attack". You don't know that. For any situation that you do not know what the outcome will be, there is always a positive, neutral and negative possible outcome. With mental illnesses, you tend to focus on only the negative possible outcome.

A fear response can be “unlearned” by using systematic desensitization techniques. Generally this method involves three steps, which are: relaxation, constructing an anxiety hierarchy, and then pairing relaxation with the situations described in the anxiety hierarchy. As one individual relates:

I helped my ex gf [ex-girlfriend] overcome her agoraphobia, when I met her she had not left her house in years. Within a month I helped get out and slowly overcome her anxiety using CBT systematic desensitization exposure therapy I had learned to treat my own anxiety (though I didn't have agoraphobia rather social anxiety).

I worked with her to create a hierarchy of anxiety provoking situations having her rate them from least anxiety provoking to the most anxiety provoking. We started at the easiest situation and gradually worked our way up the list over the weeks. I would ask her to start with something as simple as walking by a window in her house (which should would even avoid). I asked her to rate her anxiety out of 10, and would ask her again at 15 seconds, 30 seconds, 1 minute, 5 minutes, 10 minutes, 15 minutes.

I would tell her that it is physiologically impossible to maintain the same amount of anxiety level indefinitely, that her anxiety would drop over time, even if only by a few points, but as it dropped I made sure she was aware of it and was mindful of the decrease in her anxiety levels over time. We would repeat the scenario again and again until that scenario no longer paralyzed her. Her anxiety levels never went to zero but that isn't the point.

Eventually we moved to going outside when there was no one around, to going outside in the car to where there were a few people to walking around the neighborhood etc. etc. repeating the steps above. Anxiety is either improving because you are actively working on your anxiety by exposing yourself to anxiety provoking situations or it is getting worse because you are actively engaging in avoidance behavior. Each time you expose yourself to an anxiety provoking situation it gets a little bit easier the next time. Conversely each time you give into your anxiety and avoid that which makes you anxious, the next time you encounter the same situation, your anxiety will be a little worse.

Gosh that felt like a slap in the face.
Did anybody notice I'm trying to say that fear of going out is not always agoraphobia,
it could be PTSD-based, in which case desensitization is harmful?

You make an excellent point and this is a serious concern: people suffering from PTSD are often misdiagnosed anyway and can easily end up in therapies that would cause a lot of added harm: hopefully more awareness will help with this in the future.

I agree that a fear of going out isn't always agoraphobia. Agoraphobia is a fear of panic attacks while in public / exposed spaces. Social phobia is more a fear of the interaction between people. Being afraid to leave the house isn't technically either of these, if you are afraid of leaving the house when there are no people outside and you aren't afraid of having a panic attack during the experience. It sounds like you are just plain "scared", or worried about embarrassment, without a worry of panic. I don't know if you've ever had a panic attack while out of the house, but you didn't say so.

I'm the same way and I fear leaving home but I'm not worried about "panic", I just loathe feeling vulnerable or visible outdoors. I wish I could be invisible to avoid judgement. I call it agoraphobia but who knows what it's truly called, unless they broaden the definition.

I agree with Clara that PTSD-based fears need a very different treatment, if indeed this is your cause. If you have a combination of PTSD and phobia, it gets more complicated.

EMDR didn't work for me but it has worked for many other people with fears. I recommend that you consider the option. I have also found that going outside at night helps. Where I live there aren't many people around and I can walk (with my dog, mind you), in the dark without feeling like people are staring at me. I guess that's a type of desensitisation but it's at my own pace and I'm not being pushed by a psychologist when I'm not ready. I find night time much easier than the day, even if it's just sitting on my step for a brief moment in the dark. Again, if you aren't ready for that and don't want to do that, please don't. It was just my experience. If PTSD is causing your reluctance, then this approach may not be ideal.

Is it easier for you to leave the house if you aren't alone?

Psychiatrists love to dispense medication and push us along, but if your meds aren't helping I hope you can be referred to another professional for help (psychologist, OT, social worker, etc).

I didnt step out of house for 1 week.

Also i have nothing to do outside because im friendless and jobless.

You can take a walk and see Nature. That’s something to do.

You don’t need friends and a job to enjoy Nature.

How can one access help when one can't leave the house or call anyone? If I could access help I wouldn't need it!!

I have this problem too. Sometimes it feels like I am exposing myself when I go out, and I get anxious and self-conscious whenever I catch other females staring at me no matter how 'normal' I try to be. I bet you're the same; you probably do your best to look and act normal when out in public but you still get stares from people. It is frustrating.

I have to walk 2 miles to work, because the bus is too unreliable (due to the heavy congestion of traffic in my city), taxis are too expensive and I don't have a car. But sometimes I get all anxious before the walk, like I can't face it. I don't want to see people or having to keep stopping for cars pulling out of turnings or hearing loud motorcycles roar by. But there is no alternate route. And I worry that something bad might happen, like I might get hit by a car (even though I have good street skills), or I might be raped or murdered (as it has happened in my city in broad daylight), or even the smaller things like somebody might stare at me or I might trip over.
Before going out I spend ages checking myself in the mirror to see if I look OK. Social approval is very important to me and I don't want to be a figure of ridicule. Being judged by strangers in public feels more scarier than being judged by my friends or family for some reason.