Dear Kirsten,

Up until four years ago I was fully functioning, I had a good job and friends, had my own flat and had plans for the future.

I'm now at a point where I can't go out of the house, it's been getting worse over the last four years and now it's so bad I don't know what to do.

I can manage sometimes to get to the shop on the corner for milk but most of the time I rely on deliveries.

I had to leave my job, they understood for a bit but it was really obvious I wasn't going to be able to cope with coming back.

I get really funny if people talk to me, I feel like I'm going to faint and while people are talking to me.

I get really conscious of how odd I must look, like people will see how anxious I really am and think I'm odd.

Then I think I won't be able to speak or I will make a fool out of myself so I run away if people try to talk to me.

I can't imagine a future, this is so far from how I used to be. I have been told by my parents that I need to go to the GP but I'm worried because I won't be able to get there and even if I did I couldn't speak and then I worry about how I will have looked and if I could get away from the room.

I don't know what to do - I don't know what's wrong I just know I feel scared all the time.

Name withheld

Kirsten says: I think you are describing agoraphobia, a really debilitating form of anxiety or panic disorder whose effects can range from rendering people utterly housebound through to making people feel panicky if they feel trapped or in large public spaces.

I can absolutely hear how much this has taken from you and I want you to know with support you can work to recover from it.

Agoraphobia is described as an extreme, irrational fear of entering crowded spaces or of leaving one's home, or being in places where it is difficult to escape.

It's more likely to effect women and most people develop it alongside other types of anxiety when they are aged 18-35.

Celebrities such as Kim Basinger, Barbara Streisand and Woody Allen have all talked publicly about their battle with agoraphobia, it was even rumoured that Freud himself struggled with something akin to it.

The difficulty with very strong irrational fears like this, is that we develop safety behaviours and those safety behaviours whenever we are still doing them, work to maintain the irrational thought that something is wrong.

We can end up trapped in a vicious cycle where the very thing we think is helping us is actually keeping the panic going.

I feel as though there might be more information which would be useful to know - did you have any other anxiety issues prior to this happening? Was there any loss or trauma that happened for you in and around the time you developed symptoms? Agoraphobia can stem from a traumatic event, the brain can react by making us believe situations are continually unsafe when really, they are not.

Being able to get to the corner shop is a real achievement, I know it must feel like everyone can see how anxious you are, its unlikely that they will notice, at the very worst - if they did notice they will feel compassion for you, they will think of times when they have felt like that, or of the people they know who feel like this. Anxiety feels overwhelming on the inside, often on the outside the external signs are minuscule.

One of the best steps you can take is to understand what agoraphobia is, there are some really helpful websites such as No panic (https://nopanic.org.uk/agoraphobia/) that have some good resources. A large part of dealing with any anxiety condition is tolerance of the distressing feelings, we naturally want to avoid things that feel distressing and when we do that, we change our behaviours, making the condition worse.

Fear is just a feeling, it can be a very strong one but also one that we can learn to tolerate.

Please speak with your GP, they will be able to speak with you over the telephone - or ask your parents to make contact on your behalf, they will be able to refer you to a mental health team that can begin to offer you the right support. Once you get to the right support, they will be able to help you address the thoughts that are causing this intense panic and from there together you will be able to start to take some steps forward.

All best wishes

Kirsten

Kirsten Antoncich FRSA

UKCP Psychotherapist