Fear of Public Places in the Age of COVID: Is It Agoraphobia or Something Else?

Fear of Public Places in the Age of COVID: Is It Agoraphobia or Something Else?

Few places are more evocative of early pandemic anxiety than the grocery store.

In that first year before the vaccines, when we had far less information about the spread of the coronavirus, a jolt of panic squeezed my chest if anyone got too close to me at Trader Joe’s. I walked down the aisles, squinting, tossing oatmeal and bread into my cart with the determination of a permanent competitor on “Supermarket sweep.”

For those of us who are vaccinated and have strong immune systems, indoor public places like the grocery store might seem a lot less dangerous these days. But two and a half years into the pandemic, many people still experience mild to severe discomfort when they leave their homes. This week, I’m answering a question about it from Kari, 56, from Monrovia: “How do I tell if it’s agoraphobia or the pandemic that’s keeping me home and avoiding shopping?”

To really answer this question, we would need to know more about what Kari is going through. Still, this is an opportunity to better understand the relationship between the pandemic and the lingering anxiety surrounding life outside of our living rooms.

What is agoraphobia, actually?

In film and fiction, agoraphobia is mainly represented like a debilitating fear of leaving the house. In reality, the diagnosis is given to people who are afraid of specific places or situations that might cause them to panic or feel trapped or embarrassed, said Sandy Capaldi, associate director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania.

Typically, these are places that are hard to leave, like crowded concerts, airplanes, and subways.

What distinguishes agoraphobia from other anxiety disorders is the cause of fear. People with this disorder often worry about having a panic attack in public and being embarrassed or not being able to escape. Older people who live with agoraphobia often worry about falling and hurting themselves, and no one will be able to help them, Capaldi said. A more specific example is of a person who avoids driving on bridges because they fear panicking and crashing.

It’s very different from avoiding the grocery store because you’re afraid you’ll get COVID-19, your social skills aren’t what they used to be, or because depression has zapped your motivation to leave home.

It’s unclear whether the pandemic has triggered more agoraphobia, experts said. People often have their first panic attacks during high-stress situations, and research suggests an increase in anxiety disorders during the pandemic – but not necessarily agoraphobia. “If there was a propensity for agoraphobic tendencies, the last couple of years may have made it worse, but it didn’t necessarily create it out of thin air,” Capaldi said.

Some of us might experience social anxiety, rather than agoraphobia, after being isolated for so long, or adjustment disorder, which can occur when we struggle with a major shift to the point of anxiety. or major depression.

Christina Charlotin, a clinical psychologist in Los Angeles who specializes in anxiety disorders, told me she’s seen an increase in clients seeking support for their reluctance to be in public when national crises make the news, like shootings. massive. Cinemas, grocery stores, concert halls and schools are now places to be feared.

In 2020 and 2021, fear of contracting COVID-19 in public places was a “major theme” of Charlotin’s therapy sessions. “I hear the word ‘COVID’ less now,” Charlotin said.

So what can we do?

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

“Let’s say you’re not ready to go to a concert,” Charlotin said. “Can you go to a meeting with 20 people instead?” First choose to visit a small store instead of a mall. Bring someone you trust, then move on to doing it alone. Identify what would seem difficult but not completely overwhelming; this will build your tolerance.

“It’s about proving to ourselves that what anxiety is telling us is wrong, that nothing bad is going to happen, that we can deal with it,” Capaldi said.

Talking about your fear can also build your tolerance, Charlotin added, as can intentionally thinking about it. “Train in your mind: If a panic attack were to happen, how would you deal with it? What would happen next? How would you remove yourself from the situation and ground yourself?” Charlotin demonstrated .

Self-compassion is key here. “Recognize that this is not something you ask to experience and that we all have different challenges to overcome,” Charlotin said. “Just that helps us build confidence in ourselves.”

Our relationship 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 must decide what level of risk regarding COVID we are able and willing to take to achieve the quality of life we ​​desire while feeling safe.

Chances are your COVID anxiety will go away on its own as the virus (hopefully) becomes less prevalent. “People tend to be really resilient,” said Steven Taylor, a clinical psychologist at the University of British Columbia in Vancouver, who wrote the book “The Psychology of Pandemics.” “Many, but not all, will recover without help.”

If your anxiety seems too much to handle on your own, or if it’s all you can think of, you may want to seek professional help. Experts recommend contacting a therapist who specializes in anxiety disorders. “Don’t lose heart,” Taylor said. “There are very good treatments.”

In essence, no matter what is causing your fear, there are ways to overcome it. But you don’t have to do it alone.

See you next week,
Laura

If what you learned today from these experts resonated with you, or if you would like to share your own experiences with us, please email us and let us know if you can share your thoughts with the wider community of group therapy. The email GroupTherapy@latimes.com comes directly to our team.
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Group therapy is for informational purposes only and does not replace the advice, diagnosis, or treatment of a mental health professional. We encourage you to seek the advice of a mental health professional or other qualified medical professional with any questions or concerns you may have regarding your mental health.

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