By Margarita Tartakovsky, M.S.
Agoraphobia narrows your world, literally and figuratively. People with agoraphobia avoid certain situations or places that may cause them to panic or feel trapped. This may include standing in line, driving on a bridge, being in open or enclosed spaces (like the movie theater), using public transportation or being outside the house alone.
There are gradients of agoraphobia. For some people the fear of being outside their home is so severe they become completely housebound. Others do venture outside but only to certain places they have to go, such as work. This still becomes a miserable experience, producing sweaty palms, racing heart rates, shallow breathing, chest pains and other symptoms of panic.
The good news is that this anxiety disorder is treatable. One of the best actions you can take is to contact a therapist who specializes in anxiety and panic disorder.
What also can help, according to Hal Mathew, in his book Unagoraphobic: Overcome Anxiety, Panic Attacks, And Agoraphobic for Good, is a structured daily routine. Mathew struggled with panic disorder and agoraphobia, and recovered 20 years ago. Since, he’s been leading support groups and recovery programs for individuals with agoraphobia.
Mathew provides a sample plan in his book, which breaks down a typical workday into hourly blocks. He suggests thinking of getting better as a job — the most important job you’ve ever had. Naturally, your plan will vary depending on how much time you have to devote to each activity. But this gives you a great example of what your daily routine can look like.
Hour One: Lots of Laughter
When you have agoraphobia, you may get up every day with a sense of dread, because your minutes are ruled by anxiety. That’s why Mathew suggests spending the first hour of your day laughing. He calls it comedy “endorphin therapy.”
According to Mathew, “You deserve and need a breakfast of laughs and merriment, and YouTube is your kitchen.” Check out videos of new and old comics, and watch TV shows you know will crack you up.
Hour Two: Sharing Joy
The second hour of your day is all about sharing joy with others. Mathew suggests compiling a list of people who’d benefit from a call or visit. You can contact your local senior citizen center, nursing home or church to see who might like to have someone to talk to. Also, start compiling inspirational quotes, jokes and stories to share.
“Doing these phone calls will help you get out of your own head and feel like you are contributing to someone’s well-being, which you will be.” When you’re ready, you can move on from calls to visits and other volunteer activities.
If you can’t do this just yet, focus on preparing for making your calls and gathering what you need.
Hour Three: Learning About Your Anxiety
The third hour focuses on learning more about agoraphobia and panic disorder. Think of it as going to school. Mathew calls it “AgoraGraduate School.” The goal is to become well informed about these disorders so you can get better.
Dedicate a notebook for writing clear notes about what you learn. Your research, he writes, can include reading journal articles or listening to lectures on brain science. Knowing just how your brain functions helps you better understand how the fear response works and how you can effectively navigate it.
Hour Four: Getting Physical
You might avoid exercise because it makes breathing more difficult, and you haven’t walked farther than your mailbox. Fortunately, there are so many options for moving your body and releasing feel-good endorphins.
For instance, you can try this progressive muscle relaxation while sitting in a chair. If you have stairs in your home, you can walk up and down. Again, you can check out videos on YouTube on stretching and practicing calming yoga.
Hour Five: Learning New Skills
Pick a skill you can practice in your home, which requires your total concentration and its complexity increases as your skill improves. According to Mathew, “This could be something novel to you, something you may never have even thought of doing or it could be something you’ve dreamed of doing for years.”
Mathew chose drawing, something he’d wanted to do for a long time. Drawing even became a kind of meditation for him. “Two hours passed unnoticed, and I discovered with delight that I could become a calm person again just by doing specific drawing exercises.”
Other options include: painting, playing a musical instrument, sculpting, making jewelry, writing and learning a new language.
Hour Six: Remodeling Your Brain
As Mathew says, during this hour, you’ll be focusing on remodeling your brain so you don’t have to search graveyards for a new one! Practice positive thinking exercises and visualizations, which, over time, help to change your patterns of negative thinking (because another great piece of news is that we can change our brain with repetitive processes).
Create mantras that are specific to what you’re working on. For instance, in one visualization, Mathew suggests taking an imaginary trip or visiting a fear-filled circumstance. Imagine that you don’t have agoraphobia. He writes:
Get into your daydream conveyance (make it a Corvette or Jaguar) and turn on the music, yawn, slowly pull onto the street, closely observe everything on your trip, whistle or sing on your way to wherever you are going, find a little open stretch of road where you can press down the accelerator, have pleasant exchanges with whomever, stop and get something, and go the slow way on your way home, and have a smile on your face when you return.
Then fill in the rest. Make it a comfortable, pleasant experience.
Hour Seven: Journaling and Recovery
Summarize the day in your journal by writing brief sentences on how things went and what you’ll work on tomorrow. Mathew shares this example on penning the first part:
“I learned some very helpful stuff I didn’t know about my one trigger on way to work and started work to defuse it. Still have terrible period of anxiety just before noon. Need to work on breathing and on-site muscle relaxation. Don’t know for sure if program’s working — still lots of anxiety. Doing this creates anxiety sometimes. Need to work harder on diversions in skill learning.”
He shares this example for tomorrow’s plan: “Return to brainsciencepodcast.com to finish neuron study; start day with adding to list of avoidances to work on; print out music for song to learn…”
The more you write, the more you’ll understand your anxiety and yourself. You can even start your journaling practice with this prompt from Mathews: “I’m a fifth-grade teacher, and I ask, ‘Will you explain to my students in class tomorrow exactly what you have and what they can do to avoid getting it?’” Go back to this entry, and revise it.
Living with agoraphobia can be agonizing. Thankfully, it is highly treatable. Please don’t hesitate to seek professional support and create a daily routine filled with key steps for helping you get better. Because you can get better.