Fear of public places in the age of Covid: is it agoraphobia or something else?

Few places are more worrying about an early pandemic than the grocery store.

In that first year before the vaccinations, when we had much less information about how the coronavirus was spreading, panic would press into my chest if someone approached me at Trader Joe’s. I walked hard down the aisles, narrowed my eyes, and threw oatmeal and bread into my chariot with the determination of a seasoned rider on”Supermarket sweep.

For those of us who have been vaccinated and have strong immune systems, indoor public places like the grocery store can feel a lot less insidious these days. But two and a half years into the pandemic, many people still experience mild to major anxiety when they leave their homes. This week, I’m answering a question about this from Carrie, 56, from Monrovia: “How can I distinguish between agoraphobia or an epidemic that keeps me at home and avoids grocery shopping?”

To really answer this question, we need to know more about what Carrie is going through. However, it is an opportunity to better understand the relationship between the pandemic and the ongoing anxiety surrounding life outside living rooms.

What is agoraphobia, actually?

In film and fiction, claustrophobia is Mostly photographed As a debilitating fear of leaving the house. Sandy Capaldi, associate director of the University of Pennsylvania Center for the Treatment and Study of Anxiety, said the diagnosis is actually given to people who are afraid of certain places or situations that might cause them to panic, feel trapped or embarrassed.

In general, these are places that are difficult to leave – like crowded concerts, planes and metro trains.

What distinguishes agoraphobia from other anxiety disorders is Wave Of fear. People with this disorder often worry that they may have a panic attack in public and embarrass themselves or be unable to escape. Capaldi said older people with agoraphobia are often afraid of falling and hurting themselves and no one will be able to help. A more specific example is a person who avoids driving on bridges because they fear they will panic and crash.

This is very different from avoiding groceries because you are afraid of contracting COVID-19, your social skills are not what they used to be or because depression has motivated you to leave your home.

Experts said it was unclear whether the pandemic had caused more agoraphobia. Research indicates that people often experience their first panic attacks during high-stress situations An increase in anxiety disorders During a pandemic – but not necessarily agoraphobia. “If there was a tendency toward agoraphobia tendencies, the past couple of years may have exacerbated them, but they didn’t necessarily create them out of absolutely nothing,” Capaldi said.

Some of us may experience social anxiety, rather than agoraphobia, after prolonged isolation, or adjustment disorder, which can occur when we struggle with a significant change to the point of severe anxiety or depression.

Kristina Charlotte, a clinical psychologist in Los Angeles who specializes in anxiety disorders, tells me she sees a slight increase in clients seeking support for a reluctance to show up in public when national crises are in the news, like mass shootings. Movie theaters, grocery stores, concert venues, and schools are now places to fear.

In 2020 and 2021, fear of catching COVID-19 in public was a “main theme” in Charlotte’s therapy sessions. “I hear the word COVID less now,” Charlotte said.

So what can we do?

If, for whatever reason, you feel anxious about being in public, you can take small steps to gradually reduce these situations.

“Let’s say you’re not ready to go to prom,” Charlotte said. “Can you go to a meeting with 20 people instead?” Choose to visit a convenience store at first rather than a shopping mall. Take someone you trust with you, and then go do it on your own. Identify what may seem difficult but not completely overwhelming; This will build your tolerance.

“It’s about proving to yourself that what anxiety tells us is wrong, that nothing bad will happen, and that we can deal with it,” Capaldi said.

Charlotte added that talking about your fears can build your tolerance as well, as well as thinking about it in an intentional way. “Train your mind: If a panic attack occurred, how would you deal with it? What would happen next? How would you pull yourself out of the situation and stand up for yourself?” Charlotte showed.

Self-compassion is crucial here. “I realize that it’s not something you ask to experience, that we all have different challenges that we have to overcome,” Charlotte said. “This in and of itself helps us build confidence in ourselves.”

How we relate to public spaces right now is very personal. If your immune system is compromised, for example, the threats to your well-being are very real. Each of us has to decide the level of risk with respect to COVID that we are able and willing to take to achieve the quality of life we ​​desire while still feeling safe.

There’s a good chance your COVID anxiety will subside on its own as the virus (hopefully) becomes less widespread. “People tend to be really resilient,” said Stephen Taylor, a clinical psychologist at the University of British Columbia in Vancouver who wrote the book.Epidemiology Psychology. “Many, but not all, will recover without help.”

If you feel like your anxiety is too much to handle on your own, or it’s all you think about, you may want to seek professional support. Experts recommend getting in touch with a therapist who specializes in anxiety disorders. “Don’t lose heart,” Taylor said. “There are very good treatments out there.”

In essence, whatever the origin of your fear, there are ways to overcome it. But you don’t have to do it alone.

see you next week,
Lura

If what I learned today from these experts speaks to you or you’d like to tell us your own experiences, please email us and let us know if it’s okay to share your thoughts with the larger group therapy community. GroupTherapy@latimes.com email reaches our team directly.
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Group therapy is for informational purposes only and is not a substitute for professional mental health advice, diagnosis or treatment. We encourage you to seek advice from a mental health professional or other qualified healthcare provider regarding any questions or concerns you may have about your mental health.

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