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Housebound: Paralyzed with Anxiety

Within the last six months, I have treated two patients whose visits to my office were among the very few times they had left their homes — in years. They are just a few of the million or more Americans who suffer from anxiety conditions or weight problems or psychotic illnesses that lead them to dread leaving the house. Some are literally housebound and never venture outside, even confining themselves to a single room or barricading doors and windows.

The housebound population is a kind of secret in America, because these folks are often embarrassed about their situation and don’t know how to get help for it. House calls, after all, went out of vogue decades ago.

Conditions leading people to be housebound include agoraphobia (an intense fear of crowds and being publicly humiliated) and panic disorder (sudden bursts of anxiety often accompanied by a sense of impending doom, rapid heart beat and sweating).

6 Comments to
Housebound: Paralyzed with Anxiety

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  1. I struggled with panic attacks and anxiety for years but I was able to overcome most of it. It took a couple of really great therapists and finding a med that works for me, but it also takes facing your fears head on.

    One of the most powerful things I read was about how living with panic and fear is putting fear “on a pedestal”. You serve fear. That really hit home with me and I decided I was going to approach getting my life back by thinking of it as knocking fear off that damn pedestal.

  2. I have to keep an eye on myself with this, because I have a tendency to keep myself at home. Not because of any kind of anxiety about going out, but simply because I don’t want to or I feel too tired. The problem arises when it turns into a habit and I don’t go out even when I feel good. Definitely a slippery slope, and one some of us are more prone to than others.

    I think it may be just as important to keep an eye out for those who’ve started sliding as it is to help those who are already housebound, to keep even more people from getting to that point.

  3. good article. Thanks a lot. Could you imply more details about how to cure this housebound trouble?

  4. Dr Ablow s trying to exploit agoraphobics for his upcoming television show. That is what that phone number is for. He should be honest about what he is doing and not try to rope people into thinking that they are going to get help by calling that number–all they will get is the opportunity to be exploited on some kind of “freak show”.

    There is NO proof that agoraphobia stems from any kind of “uncontrolled psychological turmoil in their lives—whether in adulthood or during childhood—that led them to inappropriately seek safety in a kind of siege mentality”. That is hogwash and less than helpful. There are plenty of people walking around with “uncontrolled psychological turmoil in their lives” that never become agoraphobic. Agoraphobia stems from repeated panic attacks that morph into panic disorder. The fear of having attacks while away from home is the reason for the agoraphobia, not anything else. If panic is controlled, the person is able to go out, which is why medications are helpful. The only “turmoil” with agoraphobia is the repeated uncontrollable anxiety that has to be endured in order to de-sensitize the mind and body to the attack and allow the person to exert some control or endurance of it.

    Ablow could talk to someone about their “turmoil” until they are blue in the face, and it would never get them out of the house UNLESS they were willing to endure the panic that will inevitably occur. That endurance, otherwise known as CBT, is what gets people out, not anything else.

    As for people running errands and being co-dependent for the agoraphobic, that too is ridiculous. Has Dr. Ablow never heard of grocery delivery? The internet? Home shopping? Agoraphobics don’t NEED people to fetch things for them anymore. Dr. Ablow is reading from a 1960’s view of agoraphobia. Maybe he should update himself and get with the times. CBT therapy and/or medication is the only valid treatment of agoraphobia. Anything else is just wasting time and money.

  5. Agoraphobia does come from traumatic events, childhood, recent, etc… I know, I am sitting here suffering. Medication made matters worse. It is only time, psychotherapy, and faith that I am able to rebound. No pill is going to get you to forget a traumatic experience like rape, assault, etc…Mine comes from being sexually assaulted as a child. I am unable to move on because it involves a family member, and I keep it secret. I would love to move far away, but have not the means to do so. Some victims are more fortunate than others. A good support system is needed.
    Psychiatry in the 60’s worked better than the pharmacueticals of today. Cognitive Behavior Therapy (CBT) did come from the old schools of thought in psychiatry. Where is the psychiatrist couch now? They only have a prescription pad these days. I applaud those who still practice psychotherapy and get to the root of anxiety instead of masking it with drugs that create euphoria, build up tolerance, and cause horrible withdrawal.
    Trying to find a therapist who specializes in CBT is like finding a needle in a haystack, and then try to come up with the money when you are homebound is so easy. (detect sarcasm)

  6. As a practicing psychiatrist (25 years and counting) with additional training in psychopharmacology, I always am a bit leery about my colleagues soliciting for television shows. Recruiting patients for a well-designed research study is one thing — and I did a lot of that while pursuing my PhD in Pharmacology at St. John’s University (NY). I practice psychotherapy and I am proud to do so. We need to keep those skills well-honed and in practice. Of course, I write for Klonopin or Xanax where appropriate, but I have found ANY anti-depressant that truly can handle the kind of Panic Disorder anxiety that often accompanies agoraphobia. I have patients who take very few doses of benzodiazepines, but obtaining a new script for me every month and my reviewing how to take clonazepam or alprazolam for optimal effect can be, in itself, an antii-anxiety agent. Even when we write for anxiolytics doesn’t mean we should depend on the drugs to do our jobs for us. Omn a personal note, I sometimes am too overwhelmed to want to go shopping, etc. I ordered lots of clothes on sale from JC Penney’s and Macy*s. Those crowds could cause a Thorazine patient to experience significant anxiety. Every now and then, I order from Fresh Direct or Peapod. I’m not co-dependent on my neighbor, a grad school professor-cum-stay at home Mom for the next few years when she stops by and asks if I need anything, since she and her husband are going shopping. When dealing with severe trauma, I cannot in good conscience “snow” my patient with fur or five different drugs. I can and will prescribe multiple agents where indicated. This is a complex issue and Dr. Ablow treats it as if he were teaching Psychology 101 to undergraduates. I have a real problem with that. Education is needed, but why not let trained educators (that PhD comes in handy for more than research) who are mental health professionals handle that part. I’ve taught psychiatric residents for years and sometimes teach psychiatry courses at one of NYC’s Ivy League medical schools. I have years of experience educating medical students, resident (and Boarded) physicians and patients. Oversimplifying is NOT a valuable teaching skill, Doctor. You insult your readers, whose comments indicate to me they are capable of understanding more about these disorders without your condescending to them. Yes, it’s the end of a week and if I weren’t anxious and unwinding from that anxiety, I wouldn’t consider myself to have done a very good job a a psychiatrist, a psychopharmacologist and a teacher this week.

  7. I tend not to go out because i feel that i am not dressed right or i think i will say somthing stupid. I have grown up over the years so its now not so bad butis still a issue for i feel like i will be judged badly or something. Its like i have no self esteam I am a pretty girl and i get told all the time but its like the bad comments over the years have left me burted but this has always this since i was 12:( Help i am on anxity tablets they helped when i was working but i got made redunent and i never go out as i have not got many friends and find it hard to make new one’s.

  8. Weight problems, agoraphobia, sudden onset, hives! OMG these poor women are poster-girls for thyroid disorders &/or other endocrine problems effecting their anxiety levels. These women need complete physical exams w/ blood work to see if there are hormonal imbalances, pituitary gland disorders, metabolic diseases first and foremost before the always available parents get blamed, as there is always something to point out! This guy is using these poor womens’ symptoms to enrich himself. It was hard to watch. By the way, thyroid level normals have changed in some speciality circles! It’s not all in their heads!



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