View Full Version : Every time I leave the house I feel like I will have an emergency and be helpless?
I fear becoming housebound because there's so many places I won't go, but I push myself to go into town to see a friend for coffee. But I get anticipatory anxiety thinking how anxious I get when they aren't on time and it's like I can't handle being there by myself, waiting. Whether i wait in my car or wait inside the cafe, distraction doesn't work. The anxiety get so intense that every time someone walks by I just want to tell them I need help. I always feel like I am having a medical emergency and time is of the essence. That thought alone makes the panic a thousand times worse. Distraction doesn't work because I can't do it effectively, I am still 100% scared. I feel lightheaded and like my skull is expanding at the back of my head but that feeling travels all over - back of head, temple, jaw, cheek, top of head. And the longer I have to wait, the worse it gets. I am traumatised by one episode where I wasnt meeting a friend and just going to the shops alone and by the time I parked, I couldn't even get out of the car, I felt horribly weak and on the verge of a seizure or something. Yet I pulled out and got the hell out of there so I rationalize I couldn't drive my car if I was having a seizure; the thought of getting out and going into the store triggered the horrible weakness. Still, I can't shake the fear of having no help when I am out alone in public.
I'm so terrified of these feelings because they make me feel like I always need an ambulance. When I am alone and panicking I can't even use my phone. Then I start having feelings of unreality and want to freak out. I've had these feelings so often but it doesn't change the fear that this time it's a medical emergency.
Does anyone else have this specific fear? I've never liked attention or needing help and I feel this kind of anxiety is an extension of that- I go out alone and feel like I need help, even if there's nothing anybody can do. I have this huge fear of not getting immediate help from a real problem but this has gone on for years. What has kept it going is different symptoms have manifested, related to whatever new health obsession I have.
So I combat it by staying at home but like I said I still push myself but the anxiety is intense when I do as I feel like I am unsafe and incapable of getting help. I used to go on family holidays and walk 40 minutes sight seeing while everyone was asleep in the motel- I dont know how this happened. I guess I'm just looking to hear that other people have these feelings and fears (ie urgent medical help and OH NO what if I don't get it and then the panic is just a million times worse because I had that damn thought) anyone? Thanks for reading.
You're not alone. I literally can not remember the last time I left my house on my own. I'm the same with sleeping, I feel like if I'm asleep something bad will happen and no-one will wake up or notice which of course leads to insomnia and heightened anxiety. Have you visited your GP? Xxx
You are not doing the distraction right. Most people don't. It has to have six or more elements to block the anxiety. You have to recognize those six things, not just look at them. Focus has to be on them so the anxiety is dropped. Read stacking in top tips.
I will check out top tips - thanks Davit. You're absolutely right I am not doing it right, I still have enough room in my mind to "check in" with my symptoms and that is causing more panic. It all starts with "I don't feel quite right..."
Sorry to hear it dreamies, we will overcome this nonsense. I can fall asleep alright but I wake up in the night with at least one attack a night. I've seen a GP and psychologist and I told myself recently if my bloods came back fine I would have no excuse not to get in my car and go out. Well it came back fine and I am still obsessed with all the diseases/illnesses that can kill you suddenly (despite my lack of risk factors) and I can't go out. The GP said to just go out, don't think, that's impossible. I am full of anticipatory anxiety before I go anywhere. I get in my car and my eyes start to hurt and I fear passing out or losing my vision while driving.
It did help me to make a list of my fears, thoughts and symptoms prior to leaving, then coming home and writing underneath it what ACTUALLY happened, and I was leaving the house for some small reason every day with this exercise but it all went to hell when I stopped doing it. I just haven't learned to let panic wash over me. I fear the atracks too much to cope with them outside my house.
Doesn't help I've had horrible attacks out, and worse ones at home which made me think "lucky I didnt have that while I was out" which only reinforces my anxiety about leaving the house. I just feel totally incapable of being in my car alone, shopping alone. I feel like I have some undiagnosed illness and I'm terrified to be away from home. I'm a nervous wreck being home alone as well. Just that feeling of helplessness panic gives me - I can't cope with it. I feel like I've lost the ability to tell the difference between my anxiety and a real medical emergency. And I can't stop fearing my symptoms because it literally feels like I am just about to disappear if I don't get HELP RIGHT NOW.
Or I tell myself "I will go here, park here, run in quickly, get out" and that works until for some reason I can't find what i need or don't get served right away, then I have a horrible attack because I set myself up for it. I'm scared because I've had lots of therapy and I don't do what they say - I can't just go out. I'm terrified I won't get the help I need - and it always feels like I need help. Before I get into a store I am already lightheaded and then comes facial numbness or any of my 1000 different sensations. The only thing I never tried is medication. Can you still be housebound with medication?
Last sentence, yes you can.
If I gave you an exercise to do for three weeks, would you do it? At three weeks you would leave the house with only mild anxiety, At six weeks you would leave with none and at nine weeks you would wonder why you ever had a problem.
---------- Post added at 20:32 ---------- Previous post was at 20:31 ----------
I rather expected to get jumped on for saying you are doing it wrong.
Absolutely yes! I can't live like this anymore. Every day I don't go out is pushing recovery far into the distance. I would be very grateful:) there a days I wonder why I ever had a problem but then I act like it was just a lucky day, that the norm is anxiety so I should expect to feel it. That has not been a helpful thought!
Ps - I know I'm doing it wrong otherwise it would be working. I know my fear of having a serous medical problem every time I leave my house isn't rational but i can't shift it. I do everything in a hurry as a result and like I said - massive panic happens when I can't do things quickly.
List the things you can do and not do that you do. That you do is important, you will probably notice that the things you do the easiest are things you want to do and are comfortable with. The next thing you notice is the things you can't do are things you have to do. And this one you need to look at carefully. Things you want to do because you feel you have to.** Things you have to do because you want to.
"Have to" is negative. It opens a path to Amygdala the fear centre. Amygdala has it's own memory it uses for decisions. In that memory is the thought that something terrible is going to happen if you leave the house. This memory is only in Amygdala's memory and only happens if you use Amygdala. Only negative thought uses Amygdala. In the last paragraph is one positive, two negatives and a positive with a negative rider** making it negative also. The deck is stacked against you if you feel you "have to" do anything, including getting better. Feeling that way opens Amygdala to give you the symptoms and thought you have been getting. Positive thought bypasses Amygdala if it is actually positive and has no negative riders. EG: wanting to do something because you have to. So the exercise is two fold. Changing thought patterns by using only the positive thought to do something and mild exposure you work up, to get that positive into memory for future reference and bury that unwanted thought Amygdala has. It helps that you know it isn't true. (core belief: do you know of anyone who left the house and dropped dead. The idea had to come from somewhere. Amygdala only uses it as an excuse to not leave the house. Given time it can use it to give you an excuse to not enter certain rooms. Don't worry we will fix this before that happens.)
First step. You do not have to do anything. This will take time to convince you of since right now your world consists of having to since it is the only way you can do things. Even if you "want to" there is still a "have to" rider. We are going to change that. You don't have to do anything, not even this. What, but I want to? You think you do and you do but there is still a rider saying you have to or you won't get better and there is probably another rider called doubt that it can work. Lets get rid of the riders. This does work and is going to work. Abandon doubt. And you are going to do this because you "want to", so there is no time line that would make it "have to". You do the exercise when you feel you "want to". The minute you feel or think you "have to" do this you stop and question that thought and go back to "want to". What is the easiest of the things you find hard to do? That is where you start. Maybe just going out the door. "I want to go out the door because I want to so I'm going too". First sign that you "have to" do this stop and challenge it. Tell it to get lost, you don't "have to" do this. First sign that something bad is going to happen challenge it. You are not going to do this without reward. First reward is always "I won, I did it" This is important because it is positive and you want it in memory. Second reward is something you like that you can only have if you do the first reward. (reinforcement for it) You will do a back and forth thing as old thoughts try to creep in. If at anytime you fail challenge it, remember you don't "have to" do anything, you are doing it because you want to. And you have time. And never feel bad if you fail at first. Remember me, I promised this works and it will. I have very good scientific and technical reasons why, that you don't need to know unless you really want to. Keep extending your safe area till you feel uncomfortable and stop and ask why you are uncomfortable. You aren't but Amygdala thinks you should be because you always have been. You can tell it quite verbally that it is wrong, because it is. A good place for strong words.
Before anyone gets a chance to say this is exposure therapy, it is not. In exposure therapy you push till you are uncomfortable and stay there till you get used to it. That Is coping. We are not going to cope, We are going to get rid of how we see the trigger. That is cognitive, Exposure therapy is behavioural. Cognitive is permanent, behavioural needs to be repeated for ever. There is a place for coping skills and you can use them to stay calm but only that. Do not let this drift into exposure therapy or it will fail.
Anyone can join in and let me know how they are doing, and you can ask any questions you want. You can PM me if you want to stay anonymous.
To get this Idea firmly in place does take about three weeks. The mind works only on appropriate. Repetition makes anything appropriate over time even negatives can become appropriate and have or you would not have anxiety.
Wow that's fascinating stuff about the amygdala. I do think "have to" - ie "I have to get better" and "I have to go out today." The pressure is already on me, to the point where I don't even know how people get up in the morning and go out. I have doubt and "have to" as a rider definitely - "I have to do this", "but can I do it?" And then "you want to do this." I want to drive to a big mall and go clothes shopping but that is not a quick activity and I already know at some point I will feel like I am not OK - strongly feel like I am not OK, then it's a long drive home.
So, today I "want to" go to the shop. My first thought is to check in with my body- what symptom is bothering me today? That symptom becomes evidence to my anxious brain that it's not safe to go out alone. I am making myself anxious thinking how I've gotta drive, park, cross the street, walk along the footpath, walk into the shop, where i will feel lightheaded and afraid and want to get out really quick, so i race around the shop and the anxiety subsides A LITTLE when I don't have to wait in a queue. But I'm not home yet so the anxiety builds as I walk back to my car and the "what if" begins - "what if I don't get home?" and i hurriedly start the car. I don't drive fast or unsafe, amazingly so that part of my brain still works. Driving home however I might start to feel a new symptom, like my eyes are pushing out of my head and I feel faint.
I'm not OK til I get home.
What am I doing wrong?
I will try your exercise Davit , as I have faith in your testimony. Perhaps the root fear for me is 1)distrust of others; will they care or notice if I need help?
2) I don't like drawing attention to myself; which something line passing out/panicking will do - although not panic itself because my closest friends sitting with me in a cafe can't even tell.
3) I fear independence? My mum always told me I couldn't do things for myself so she wouldn't lose her control on me. She doesn't care now, but she's already planted the seed that I am incapable. So I start panicking anywhere I go.
4) I have this irrational fear of undiagnosed illness - so when panic hits and feels so extreme and I feel so helpless (in the midst of bad panic i can't even pick up my phone) I feel like said illness is happening because I feel like the symptoms are manifesting. What I don't accept, I guess, is that it is symptoms of panic.
How is all this overcome? There certainly are things I want to do but all the above stops it happening. The worst part is psychologist have told me all they can tell me. If you have any insight and advice Davit, I'd really appreciate it as I can see you know your stuff.
Strawberry_3
22-06-15, 00:13
I really can relate to this. Leaving the house has been so difficult, I've even left my job.
Friends don't understand, but maybe because I'm too embarrassed to explain it to them. I've been making so many excuses about why I can't come out and meet up. The 'smallest' things, like meeting a friend for coffee, is such a big deal. I'm jealous of my past self, who would travel here, there and everywhere alone and not think anything of it.
When I'm out, I become so aware of everyone else, and suddenly feel vulnerable. I become terrified of fainting/suddenly becoming ill and not being able to sort myself out/get home and remain dignified!
What's helped me though is taking baby steps. I've been forcing myself to leave the house for short periods of time. It helps to know that you're in control of when you can leave and head home. For example, I began with getting in the car and going to the petrol garage, then coming straight home once I'd done.
The more we confine ourselves to the comfort zone of home, the more hopeless we feel longterm, and the more we reaffirm the belief that outside is terrifying. Every time you get home after being out, even if you've had a panic attack, reassure yourself with the fact that you survived it, nothing bad happened and it was just a panic, and that this proves that it's possible for you to go out with nothing bad happening.
Maybe some cognitive behavioural therapy would be helpful?
You can handle this :)
Wow, Yes you do have a few core beliefs affecting you. I think trust is a root core.
Second paragraph is all Agoraphobia. Fear of not having control. Other things dictate your actions that you would rather did not. At home, you make the rules, leave the house and you have rules to follow that are not yours. Have you ever had anything bad happen because you broke one of these rules. A near miss crossing the street because you didn't look. The car rolling away because you didn't park it right. The shop closed because you forgot the time. To a sensitive person with a perfectionist core these things are unacceptable and creators of strong anxiety. They open a path to associated "what ifs" in memory.
I want you to add another thought to I want to. "so what" This is a positive what if. So what if I can't find a place to park, I'll go around the block. So what if it isn't what I want to do because I do. I want to shop and if this is necessary then I will do it because it is my decision, I am the boss here. The rules are for my benefit only. So what if I have to sit for a minute, it will pass it always has.
The checkout is always the place with the most rules and the least control. Use the dog distraction. Or animals in general. The man with the jowls is a basset. The skinny woman a basset. The fat woman with the pug nose is a pot belly pig. Maybe her husband makes a pair. The lady yelling at her kids is a yappy sniff and pisser and her puppies. You might get some funny looks if you laugh out loud. All through this remember the rules are not important. You are doing this because you want to and you don't have to it would just be inconvenient not to.
Don't forget "I won". Versions of it. When you get parked. "well that wasn't so bad". That is a positive thought.
Back to the core beliefs. This is getting ahead of coping but in this case I think you would benefit from finding them.
Why is it not safe to go out alone, where did this core belief come from. This is a secondary core to the root one of trust and somewhere in here is control so it could actually be a third spinoff. So the actual cause might only be mildly related to to the symptom. This makes finding cores frustrating. On top of the core belief that this is how life is supposed to be because it is how it always is. No changing these is not impossible, just hard and time consuming. Remember this is going to take weeks.
You have already taken a bite out of your core beliefs by trusting me. Every success will reinforce this core. You know the cores you listed are false. You can trust yourself to be right. Another bite. You didn't give up when nothing else worked, a bite out of number three. You can be independent.
Too much for you to work on at once. Push to hard and it become exposure therapy. We don't want that. Don't forget any distraction you use needs at least six parts to it.
---------- Post added at 16:32 ---------- Previous post was at 16:26 ----------
Strawberry.
Being outside isn't terrifying, having no control of being outside is. Control is the actual trigger. Fear of outside is the symptom. Panic is the reaction.
Very insightful! Far better than even my psychologist who just says "so what?" when I tell her i am afraid of outside, trusting others, being out of control. She means "so what?" not in a nasty way but just as a way of telling me I can't control everything, and "so what" is a letting go. Apparently thinking nobody will help is a common fear with anxiety, but logic tells me it's not true. Most people would be quick to get medical help or be of assistance. I ask myself if somebody near me was in danger, OF COURSE I would call for help. Fainting in a shop or being noticeably sick is not the norm like I think it is in my head, so when other people see it, it's a big deal and they draw attention to it.
The fear definitely is lack of control, although I've relied on others my whole life to take care of me and make my decisions and control-freaks are attracted to me because they see me as someone who needs looking after. I guess that's where my "I don't feel safe on my own" feeling comes from. At first it was just leaving the house, but now I fear being home alone, too.
I knew I had agoraphobia. Thank you for confirming that. My psychologist said it wasn't a bad case yet as I still go out (with a great deal of anxiety and all I can think about is getting home again) but I know it could get bad if i let it.
The check out line game with the people and animals made me laugh out loud, that's a great idea! It almost made me want to go out just to try it.
This "want to" and "have to" stuff makes so much sense. Sometimes I don't even want to go somewhere but I mistake that feeling for anxiety. You're spot on about everything. It's a huge relief and very encouraging that I can tell someone here what I am feeling and they can explain it, that I am not just crazy. My family think my fear is of being attacked or robbed or something out there, they don't realize I am afraid of myself.
Thank you so much for taking the time to help me. I am determined to do as you say with this exercise. I understand commending myself and thinking positively. What happens if I start to panic and lose more confidence? I hear of people panicking in a shop and just leaving for a few minutes and going back in. My psychologist says I am struggling so much because I keep running away without testing the panic - and I'm reinforcing that leaving is the only reason I escaped/stopped something bad from happening. going back into the situation a few minutes later sounds like hell to me but is it the only way to recovery?
Ditapage
I have been through all that so had to find out why and how to fix it. Your psychologist is right, you can't fix every situation. But then that is not what you are trying to do. That is coping only, like the dogs. What you are taking back control of is how you see the triggers. You are taking control of your part in this only. That is the nice part. Once you have control of how you see the triggers and your part then new triggers mean nothing, they become only facts. With exposure you learn to cope with a situation but every situation is different so you are always coping. With cognitive restructuring (want to) you are coping with only one thing, how you see every situation. The situation doesn't change, it can't. You can shop when there are fewer people, You can hide till no one is at the till and rush through. Then you can cry all the way home because it really cured nothing. Or you can change how you see the triggers so they mean nothing. People shop every day. Don't look at their faces, you will see panic in at least ten percent. For most it is just routine, but for some it is actually fun. For me the only thought about the store is if it is open. If I need something I just go get it. Often there is a core belief that was built around the thing you can't do. Some trauma. Mine I think was embarrassment from my arthritis. I got over that. I even joke about it. (excuse me hunch back hobbling through) I've changed a lot of core beliefs. I've learned to accept things I can't change too. Those are all part of cognitive restructuring. They are changing thought patterns the psychologists talk about. So is "Want to" yet some don't know how to do it. They just tell you to think positive but nothing about challenging negatives so you can. Or why thinking positive works. You know this won't change overnight but it will change and it won't change back.
"For me the only thought about the shop is if it's open"
Congratulations on your recovery, that is an awesome thought and I would do anything to get it back. I have done the whole go early thing..a 27 yr old girl at the supermarket at 6:30am- my friends couldn't understand it. I got what I needed, but I knew I was letting panic win. If I needed something during the day, I go to the nearest shop which is way more expensive - all because if I drive towards the supermarket I even start feeling anxious on the way, let alone parking the car to go in. One day I parked the car, walked in, felt immediately woozy, and walked out.
Today I left the house to go to a small shopping complex a 5 minute drive away. I "want to" go to the bakery. I was able to go to both the bakery and a chemist when I just planned bakery. But as usual I am
Doing it all in a hurry. Fortunately I was served straight away at both places. I didn't have an attack but I felt anxious and way too tuned in to my physical sensations. I get very upset about this strange numb sensation I get around one side of my mouth and face. I am linking it to seizures, tumors, etc. I feel like if the symptom went away I would be able to do anything, but I know it's not entirely true because my symptoms are always Changing and I'm using anything to justify not going out. maybe the symptom IS caused by the worrying about the symptom. I don't know.
But I'm determined to do your exercise Davit. So I've commended myself for leaving the house and now I have yummy cakes as a reward :) it helped a ton already just to say "I'm going out because I want cakes" instead of I'm going out because I have to fight this anxiety. its those damn riders going "don't go out alone, what if your numbing feeling is something bad and you faint and you will be stuck in public needing help" etc. did you experience this kind of anticipatory anxiety? I hate always expecting the worst.
Today I thought:
"What if I pass out?"
And counteracted it with "what if you get what you need and go home and end up sitting in the room again where you were wondering half an hour ago how you were going to leave it, then you did?" which is exactly what happened. Yet my anxious brain is going "but maybe next time you won't be so lucky" so I am still thinking outside is a place to fear and "escape" in the nick of time. This is not really a success, right?
It is a success because you know the thoughts are false. It was hard for me because I have a disability. I could fall down and not be able to getup. If I hurried I could hyperventilate and get dizzy. My riders were not as strong as yours. I burnt a lot of gas going to one shop at a time. I live 20km away from town. After a week I did seven stops in one trip including seeing the doctor and getting blood work done.
Possibly because I actually have a disease I know what is real and what is imagined. Put a positive rider on your riders. Are you not happy you did two stops? I said this would take time. Trying too hard encourages the negative thoughts you got. It is an accomplishment. It would have been with one stop. About a month ago I was going home after doing my hardware shopping and pharmacy. As I went by a store I don't use I though I should get some canned cherries. My rider went oh oh, parking lot is full, go home. I went get lost, I want the cherries and I'm here, Did a turn in a parking lot and went back. I has to get help to get the cherries off the top shelf, but I got them. Went home happy thinking "I won" anxiety can't touch me. That was a rare occurrence, normally I would have just gone straight to the store and not thought about it. One occurrence like that a year doesn't count. Even normal people have bad days.
You could have gone outside looked around and thought nothing to fear here. Remember what I said, don't push too hard right away, don't let it turn into exposure. Yes I had set backs. I had no one to tell me it works I had to believe and I had to tell the riders to get lost. They went pretty fast. I actually started to enjoy the trip to town. A couple of times when pharmacy needed a half hour I went for a hot chocolate by myself. Even talked to strangers. What can you use to prove your riders are wrong. I see them as the only problem.
Great thread with some excellent responses.
I find that waiting for absolutely anything in any situation increases my anxiety levels unless I can be distracted.
Thanks so much Davit! your help is wonderful and your story is so encouraging. I totally relate to your cherries story and how the mind can kick in and say "no screw it, I am here, I'm getting the cherries!" And you feel on top of the world for it. Once I panicked big time in a shop and started driving home upset that I didn't get my groceries . I pulled into a car park on the side of the street, turned my car around and went back and went to three different shops and kicked panic's arse. It was freeing! Your post reinforced that panic is just empty threats. Panic is also isolating so when you said you were able to have a hot chocolate and talk to others, that is the act of stepping outside your mind and interacting with the world around you. I feel a thousand times better when I can do that. You truly are a success story and I've loved hearing of your experience and how you conquered it. Excellent! I'm continuing your exercise and will keep you posted how it goes. So far the riders have been brutal, bombarding me with horror thoughts and making me think I need to find the nearest hospital.
Now that you know what riders are they have more power but at least you have something obvious to work on. They can't hide anymore. No more pot shots from the dark, it is just you and them out in the open. I'm counting on you to shoot them down. I don't want to be the only recovered.
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