Fear and Loathing in New York and Los Angeles

By Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’m pretty much a by-the-book General Anxiety Disorder & Agoraphobic. I had my first panic attack during a high stressed time in my life about 4 years ago when I was just turning 21 (I was moving cross country for the first time, and was getting my wisdom teeth pulled out) . At first, I wasn’t really effected, but after a while, I just couldn’t get that fearful moment out of my head and began to have anxiety attacks every now and then until one day it took me to the emergency room and the dr. told me I had had an anxiety attack & was in perfect health. After that, I guess I ended up avoiding lots of things and taking some time off and working from home which felt better and safer. I didn’t really realize that this was actually making things worse. I was 21 and had quit my waitress job as I moved to a new city to be with my boyfriend, the love of my life, who I’m still with today.

By 22, I was still able to go out and was even going back to school and working and going out every now and then, but mainly I stayed home, as that’s where my friends were. Between 21 and 22 I had gotten burned by some very close friends (one screamed at me that they didn’t care about me at a time I was looking to chat when I was sad/weren’t getting along, two roomates stole about $2000 and disappeared with surprisingly hateful feelings towards me, an acquaintance stole my car and I was never able to get in touch with her again, boyfriend decided not to move cross country with me so I could finish school after promising he would, and other hateful things out of the blue from people). I ended up not going cross country at the moment. I used to trust people very easily, but after all those things, I’ve recently realized that I really don’t trust people anymore.

At 23, things were getting a little worse. I was going out less, quit my job & worked from home, and was becoming a very irritable person. I stopped everything and moved to NYC for a month on my own, subletting from people I didn’t know while interning & working. I actually did really really well in NY. Although I had a few anxiety attacks, I ended up for the most part, getting it together and enjoying myself and dealing with things. I was very happy but still had the GAD symptoms.

A few months later, my boyfriend and I moved cross country to California and am still here. But I feel like things have gotten worse. In the beginning, it wasn’t that bad, as exploring the new city was still interesting. However, I still haven’t even walked around downtown or been to an major sites as I would start to get anxious and panicky. I worked a little here and there and was okay, but still in agony. I tried going to school, but couldn’t deal with the anticipation. About a year ago, I just couldn’t handle the meetings and interviews anymore at work. So I quit my job and have continued working from home.

Lately I’ve been researching a ton but am terrified to go out and get help. I understand that the best things to do would be a combination of CBT, Acceptance, demanding more, Exercise, Eating Right, Meditating, rooting myself, hypnotherapy, and medication. And I have been doing most of those exercises and I feel in a good place as far as digesting information, but I want to start medication & therapy, but again, just cannot leave the house.

I had a bad panic attack the beginning of 2010 and have been locked in my house ever since not seeing many or any people. Although, I have been productive with the exercises, reading, research, have a creative outlet, and supportive boyfriend.

The only other important factor might be that my mom got married when I was 18 to a guy I just get a horrible feeling from. We just don’t like eachother at all and I don’t trust him. I’m an only child and I guess I was also a little peeved as my step dad had died only 2 years prior & I felt it was a little fast for my mom to get married to someone she admittedly said she didn’t love. I’m accepting it a little better now, but we still don’t talk, as I moved out as soon as he moved in. I am very close with my mom still though. I tried telling her my feelings at the time but it didn’t really get through. We just don’t talk about it.

Currently, even though barricaded, I can walk around the block at night, but can’t go to the store, restaurants, parties, friends house, etc. my heart just drops in social situations.

Okay, so my question is, is there somewhere I can talk to someone on the phone or online that specializes in anxiety disorders? And with agoraphobia, I can’t go out to a dr or to meet someone even though that’s the cure. It’s a bit of a catch-22. What would be the first steps to do before I’m at the stage of being able to go out? What else would you recommend besides the standard vague answers of talking to a gp? What medication have you found that works best? How can I get a prescription if I can’t go out? Can i do a video conference with a doctor? My research has pretty much been pointing to lexapro (ssri) with a combination of cbt to get me on my feet again. What do you think?
Thank you.

A: It sounds like you have been coping with a great many issues, and have been able to amass much good information and insight about your condition.

Two things stood out for me from your description. First, the move to NYC was a clear success, and secondly, that you are able to leave your place at night and walk around the block. You were successful in both instances, and in both instances you made a decision and followed through on your own. I think this is very hopeful. It implies that you are able to do quite nicely when the conditions are right.

Next are your insights. There were several relationship betrayals and the lack of trust left you feeling unsafe. The mistrust of others often multiplies and one way of coping is to avoid meeting anyone else who might betray you. It may be a way you have protected yourself. Instead of seeing the upside potential of meeting new people, your psyche may be viewing them as potential betrayers – so you steer clear.

Naturally we want to protect ourselves from further pain, but if the only strategy we use is avoidance we are likely to be missing valuable opportunities for connection. The famous psychologist, Abraham Maslow, had a saying: If the only tool you have is a hammer, every problem seems like a nail.

All your research looks like it is in the right direction. There are therapists who you can talk to directly, right now in fact, that specialize in treating anxiety. You can contact them here.

There are also newsletters on panic attacks with information about an online community.

And medical information along with some home remedies and information from fellow suffers about their experience with medicine.

You have certainly been doing your research, are engaged in a creative outlet, exercising, have a good support person, and are clearly motivated to change. You seemed to be preparing well to cope with this condition. My hope is that these additional resources will add to your readiness.

Wishing you patience and peace,
Dr. Dan

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Last reviewed: By John M. Grohol, Psy.D. on 6 Mar 2010

APA Reference
Tomasulo, D. (2010). Fear and Loathing in New York and Los Angeles. Psych Central. Retrieved on July 29, 2014, from http://psychcentral.com/ask-the-therapist/2010/03/06/fear-and-loathing-in-new-york-and-los-angeles/