Dear Rachel,

Over the last few years, I’ve become more and more reluctant to leave the house, except for work. I avoid social events, nature hikes or vacations that require lots of travel. At first, I thought this was just because I am getting older, or because I don’t like to be away from a place where I can have my needs met, but lately, I’ve begun to think that I might be agoraphobic. It seems to be getting worse. I don’t want to turn into a hermit. What should I do?

Scared

Dear Brave,

Millions of people suffer from agoraphobia and related panic attacks. So, first of all, know that you’re not alone, however small a comfort that may be. Although many phobias can be managed by avoiding the situations that trigger them, avoidance tends to feed the fear, making the phobia worse. And while avoidance can work for some phobias, such as coulrophobia (the fear ofYou’re not alone clowns), agoraphobia is more pertinent to daily life and requires more assertive management.

There are, of course, support groups and therapies for these kinds of conditions, and I don’t mean for my words to take their place. I will, however, give you a few tips that might help.

Observe

First, try to distinguish between the times when you just don’t feel like going somewhere or participating in something, and when you feel anxiety about doing it. Just because you turn down an invitation does not necessarily mean that you have agoraphobia. I would advise keeping a log or a journal recording the times when you choose not to do something and when you’re actually afraid, and what it is that triggers the fear. That will give you a clearer idea of how much you’re being manipulated by your fears.

Take Care of Your Needs

When we’re young, we’re often reckless and carefree. Our bodies are strong and we feel invincible. As we age, we become more realistic and more dependent on our creature comforts, like food, sleep, temperature regulation and bathroom facilities. Before embarking on any outing, make sure that you have access to the facilities that you need. The same way a mother leaves the house equipped with a large bag for her baby’s needs, you can travel with whatever things you feel you’ll need when you’re away from home. Also try to choose methods of transportation that make you feel most comfortable: walking instead of taking a bus, driving instead of walking, etc.

Nowadays, we tend to overextend and overschedule ourselves. Your fears may be your body’s way of telling you to take it easy. Trim down your social calendar a bit and see if that helps reduce your anxiety regarding other commitments.

Connect to G‑d

The Hebrew phrase Ein od milvado means, “There is nothing else but G‑d.” G‑d is everywhere, and He is always protecting you. Repeating this phrase as a mantra when you feel an anxiety attack coming on can act as a deterrent. Sit or stand wherever you are, close your eyes, and repeat the phrase to yourself as you take deep breaths. Panic attacks start to lessen after about 10 minutes, and if you can ride it out, you can continue with whatever activity you were doing or planning to do.

Reciting Tehillim (Psalms) has been a way that Jews throughout the centuries have remained calm and focused. You can buy a small book to keep in your purse (in English or Hebrew). Saying a few chapters will help you feel both more grounded and more connected above. Reciting Tehillim is a great antidote for feeling vulnerable.

Many Chassidic groups, chief amongRepeating this phrase can act as a deterrent them Breslov Chassidim, have a practice of going out into nature to commune with G‑d. Seeing the beauty of G‑d’s work has a calming effect. When you’re out in nature, try to focus on G‑d’s artistry and greatness instead of on danger and uncertainty.

Make a Plan

Extend the amount of time you spend outside your house slowly. If you feel uncomfortable about taking an hour-long walk, start with five minutes, slowly extending the amount of time you walk. If you’re afraid to go to the supermarket, start with the corner grocery store, etc.

As we age, we are more easily annoyed by loud noises, crowds and long trips. You may feel more comfortable getting together with a few friends than at a large rowdy party. If so, you can limit the time you spend in places you feel less comfortable. You can go to a wedding for one hour instead of five, for example. Or go shopping at a neighborhood mall instead of downtown.

When women are in labor, they time the length of their contractions and the spaces between them. Knowing there’s a time limit to their pain helps them to deal with it. If you approximate the time of your outing and say to yourself, I’ll be safe at home in three hours, it will make it easier to deal with. Check the time frequently and give yourself positive reinforcement for the time you’ve spent away from home. Having a time limit should help you feel safe.

Use Your Imagination

If you’re already imagining a host of negative possibilities, ask yourself: What’s the worst thing that can happen? So what? What if that does happen? Usually, the things we fear are not as frightening as we think they are.

Imagination can be a wonderful thing. It also can create scary monsters under your bed when you’re a child or scenes of impending disaster when you’re an adult. Telling yourself that everything is OK and nothing bad is happening will help reign in your imagination. Looking around and noticing your non-threatening environment is good way to keep grounded.

There is another possibility that has occurred to me. If you’ve made a change in your life—gained weight, lost weight, started dressing more modestly or altered your appearance in any drastic way, you may have an unconscious fear of being seen in public. Our friends love us for who we are. Strangers don’t give us much thought, and being embarrassed once in awhile is part of life. It’s how we interpret the event that makes it feel dangerous or not. Having an “Oh well, it can happen to anyone” mindset will make the potentially embarrassing moments more tolerable.

Get Practical

There are natural remedies that can be helpful with reducing anxiety. Also, reducing caffeine and sugar intake goes a long way to making you feel more calm.

Many people develop agoraphobia because of a threatening event: being mugged or in a terrorist attack, getting lost, needing to use the restroom and being unable to find one, forgetting a speech, being sick in public or being shouted at, hit or embarrassed in someOur friends love us for who we are way. In an attempt to remain safe from having that happen again, people will avoid public situations. While avoidance might feel better in the short-term, it will not help in the long run. Finding a therapist who deals with trauma, and who will help you work through the event, is highly recommended.

This may sound counterintuitive, but when you’re helping someone else with their fears, you don’t have time for your own. Take an outing with someone who also fears going out, perhaps an older person who needs help getting around. Reassuring her, and being the one she leans on for support, will help keep you feeling calm and secure. You can’t help but alleviate your own fears when you try to alleviate someone else’s.

Reward yourself every time you conquer your fear of going somewhere. If you go shopping, treat yourself to a new accessory or a special coffee. If you go to a wedding, have some cake. Every attempt is a success in itself. Reinforce your successes and don’t beat yourself up for your failures. Keep a success journal so that you don’t miss any opportunity to reward yourself.

Many people prefer home and hearth to gallivanting, especially as they get older, and you shouldn’t feel guilty about that. But if your fears are keeping you from doing things you would enjoy doing, then follow the above exercises. If they don’t help, then I recommend seeing a professional.

The world is a beautiful place! Enjoy it!

Rachel