Health

I’ve been agoraphobic – what I learned may help those with post-lockdown anxiety | Rhiannon Lucy Coslett


We have been trying to get the cat to go outside. You can tell a part of her wants to; she’s curious, certainly, but her fight-or-flight wins out. If you try to let her out of the building’s main entrance, she bolts back upstairs and sits in front of the door to the flat until she is let inside again. She feels safe in her home territory.

Perhaps being a lockdown kitten has affected her. Her behaviour reminds me of when I was agoraphobic. I desperately wanted a normal life, of going into the office on public transport, seeing friends, eating in restaurants, travelling. But any time I wanted to do these things my threat response was triggered; I became terrified, like a frightened animal. I believed that bad things happened when you left the house, and I had reason to believe that. I had been attacked, and then, several years after being successfully treated for PTSD, the Paris attacks set it off again: but this time it was full-blown agoraphobia. Home became safety to me.

As we venture out of lockdown and the world opens up, I have huge sympathy for those who don’t feel ready, especially those who have been shielding for so long now and may feel panicked by re-entering the world. UK charities have warned that the end of lockdown could trigger anxiety for many, especially those with pre-existing mental health conditions. Dr Tine Van Bortel, a senior research associate in public health at the University of Cambridge, said: “Lockdown has given people with mental health conditions like anxiety and PTSD permission to stay at home, and knowing that at some point you’ll have to go out again can actually trigger stress and anxiety.”

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When home feels like a place away from danger, and there is a very real risk of infection outside, “re-entry” syndrome makes sense. That’s not to say that millions of people will have developed actual agoraphobia as it is defined in the DSM-5 (the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders) – it is not simply a fear of open spaces but a fear of being in places that it might be difficult or embarrassing to get out of, or a fear of having a panic attack.

Nevertheless, what I learned from having agoraphobia – and being successfully treated – might be helpful to those who are feeling anxious about the easing of lockdown. Being kind to yourself is important, but not so kind that you allow your fears to win out, and give in to the desire become a hermit. Weighing up each potential exposure and putting a plan in place so that it doesn’t become too much can ease the feelings. Having people who are informed and understanding really helps, especially if you need to leave a situation abruptly.

Last weekend I met my mother outside King’s Cross station, but I had not been prepared for so many people being around. Though I don’t have agoraphobia any more and consider myself healthy, it was still a lot to process – I had moved from one extreme, my quiet neighbourhood, to another, a bustling city concourse, in the space of a relatively short walk. I found that my eyes were darting around a bit, “hazard spotting”, like they used to in the bad old days, when I thought I could be shot dead at any moment. “Do you mind if we go somewhere a bit quieter?” I said. And so we went and sat on a bench in a square.

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Some people will be embracing the loosening of lockdown with full enthusiasm, and I think it’s that disconnect that can be anxiety-inducing, too. When I was ill, I used to look at all the people going about their daily lives and oscillate between thinking, “what’s wrong with you? Aren’t you scared?” and wanting to be like they were, living without fear.

I had to put up with a lot of older people conjuring the blitz and IRA bombings and proclaiming that “we all just got on with it”, as though PTSD were some new-fangled craze the kids were doing. There remains a lot of ignorance about anxiety disorders, which just exacerbates the shame and embarrassment that sufferers can feel.

It didn’t feel great to need exposure therapy; to have to be accompanied to Topshop by a therapist, to have to spend many weeks getting the tube one stop from Tufnell Park to Archway, hyperventilating the whole time. But being exposed to the outside world in small doses really helped. I imagine millions of people are doing an informal version of this as I write. They might not be ready for crowds, but a quiet pint outside your local is manageable. Going to places at less busy times, or with a friend or family member who you trust makes a difference. Slowly, you build up.

It’s still bizarre to think that so many millions of people have spent the last year, on and off, as housebound as I was in 2016. Genuine agoraphobia of course needs proper treatment, but it did teach me that, just as your brain can create new pathways that associate the world as a frightening place, so can you rewire it to become habituated to society again.

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This weekend, I’m looking forward to a meal with a friend who I haven’t seen in months. As for the cat, she’ll go outside in her own time. I know she’ll love it once she’s there.



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