My daughter (15) seems to have become agoraphobic

[lovelemoncurd]

This has been building for a while but has become worse since this last lockdown. I cannot get her out of the house without her going into an extreme panicky state and crying. I cannot get CAHMS help as they say there are too many higher priority cases. No counsellors seem to email me back. I'm worried about getting her back to school.

Clinical counselor here that works with teens. I'd get her set up with additional support but in the meantime keep getting her out of the house daily even if it's hard. Have her practice regulation and breathing techniques outside until the panic abates. Just keep going until each episode lessens. Does she like going anywhere at all?

She went out sledging when it snowed. She went to Superdrug with me because she got to look at makeup and her friends nattered her one day to go out and meet one friend for a dog walk. It seems to have become much worse over the last 2 weeks.

Poor girl, and poor you dealing with it. The anxiety around having a panic attack outside the home can be really overwhelming. I had a friend who had panic attacks and it really can put a huge limitation on you. My friend could not cope in crowds, even a slightly busy street or a bus was too much at one stage. Looking back I wasn't truly that sympathetic or understanding but I have had a few panic attacks in my time since so I know now how horrible they are.

If you can't get help from CAHMS yet then I guess you have to go DIY with a solution. Do you know if it's a fear of catching covid ("diseased air") or a less articulated general fear of being outside?

The problem likely isn't a fear of outdoors, it is the fear of having no control when the panic attacks happen away from home.

Step 1, personally, I would not tackle going out yet. I'd say, ok there's no pressure to go out, but as a compromise if we are staying in, then we have to stay fit somehow. I would ask her to start every morning with yoga on YouTube and ,join in if you can. I'd also insist on something else - maybe zumba or dance, or join online martial arts. Or good old fashioned aerobics and stretching.

If/when she is receptive and wants to get on top of the panic attacks she could try deep breathing and visualizing to help calm herself about being outside the house. If she gets in the habit of practicing those routines at home then she has a toolkit to keep herself outside safe in the knowledge that she can control her own anxiety. The key is for her to know that if she starts to feel panicky she can keep a lid on it.

Also every single day, she must have fresh air- this means opening upstairs windows to air all the bedrooms and opening the door downstairs to let the house freshen up. See if this causes any drama.

Once she starts to feel more in control suggest doing something outside but very close to home- eg wash the outside windows for a spring clean, plant some bulbs in pots, wash the car, sand and paint a new shelf for her room, beat out the rugs, hang out the washing on a line. Giving her an active chore forms a distraction and a time limit - once it's done she can go in. If that works, ask her to go and post a letter if there's a post box nearby, or drop a card into a neighbour's letterbox for you. I would aim to build up these little tasks so she is outside each day even if only for a few minutes. If it goes well add more outdoor activities - a bbq at the weekend on a fine day, even if cold, is fun. Or do something childish - blowing bubbles is extremely soothing (the action of breathing in and blowing out is helpful), failing that do a skipping rope challenge or see if you can spot certain stars on a dark night.

Although staying so close to home might not seem to answer the problem, it's about small steps and confidence that the anxiety is under control. Once attained then you can build up to bigger things.

School is still weeks away, and if she can't go back due to the problem then if nothing else it may force CAHMS involvement.

Thank you for taking the time to post.

I think you are right I will start small by trying to get her outside to feed the rabbits then a little more each day. I need to look up the breathing exercises.

I've had a look at my staff benefits and it looks like I get some (6) free counselling for dependents to I will contact them I think.

I developed agoraphobia in my early twenties so I sympathise. I was able to shake it off without help from MH pros but I was desperate to practice every day. I would go out "to practice" with one of my parents every day and I would try to go ahead on my own a bit longer on each practice. Initially, I could only do like a few feet (I had an irrational fear of falling down so had to have someone by my side all the time) but it got better over time with my going out totally on my own, and now I have been totally cured for many years. I would suggest starting out with a place where she is unlikely to bump into people as busy areas and shame of bumping into friends could be another trigger?

I have had some experience of this when I was in my early twenties although I wasn't agoraphobic, but I did have some panic attacks. I read up a lot about it and had a couple of CBT sessions. And I helped my teen DD when she got nervous and panicky before exams.

Totally agree with Rtmhwales with the only addition from my experience being that you go out for a "purpose" , even if it's fabricated, otherwise it will be on your dd's mind that she is going out for the sake of going out to cure her problem, and all thoughts become focused on her panic, whereas if you go out for a purpose (not easy atm I realise) then she will be hopefully distracted from it a bit (it's very very important that she learns to diminish her panic too - through calm breathing - and stay with it until it diminishes and not retreat from it) and ultimately she will have the added bonus that it is a pleasurable experience, if she does something she enjoys.

For example, if she likes baking, could you support her to go to a corner shop to buy ingredients? And then you bake cakes together = pleasurable reward.

Could you accompany her on a 10 minute run, or a bike ride or a skate boarding session in the park? Maybe challenge one another to run, cycle a short distance supposedly for fitness purposes?

You need to start very small and build up gradually.

Maybe go out for a drive first to pick up some take away food?

Then go with her to the shop to buy a magazine.

A couple of days later back to the takeaway and she gets out of the car to pay or to buy drinks or similar?

Next day, back to the corner shop to buy two more magazines and add a five minute walk to the chemist?

Then go to a bus or train station and get her to go one stop and you pick her up at the other end.

The next day she does two stops etc etc.

Make the outings pleasurable, calm and upbeat. Put music of her choice on. Let some of them end with a treat - go to buy a new t-shirt?

Try and talk to her very gently about the detailed specifics of her fear. What is it exactly that is making her anxious? Is it that she might have a panic attacks, or she might cry or throw up or embarrass herself in public? Is it catching Covid or giving it to you? If so, then reassure her that loads of people go through the same thing, that she is totally normal, everyone is focused on their own business and won't be looking at her, that she can recover if she practices every day, and keep emphasising calmly that what she is experiencing is nothing to panic about in itself (as teens can become fearful of the fear itself) and these are worrying times but she will be fine. Keep very very calm yourself and don't show any distress at her panic. Be very reassuring.

Something that might help her to get out of the door in the first place is getting her to practice breathing exercises and learning how to calm herself down before she goes outside , maybe start in your hallway, or just in your garden, or outside your house. There are lots of You Tube videos about this. Have a look at Therapy in a Nutshell - there are free videos and also a reasonably priced course you can follow together. It's good because it's sympathetic yet backed up with science.

A friend of mine learned to diminish their own panic on aeroplanes by learning Tibetan breathing from You Tube (sounds strange but it worked well).

If your daughter likes animals, then I would highly recommend trying to book her a session at a hippotherapy or equine therapy centre, where she can learn to bring herself down from a high state of panic to a state of calm, by being around horses and learning about their reactions to anxiety (they react to anxiety in humans too so it's a great way to learn) and indeed the entire art of horse training is about going from a state of flight ( or very occasionally fight ) to a state of calm, so there are many parallels.

Your gp may be able to recommend some calming pills, natural remedies that you can buy over the counter at the chemist, there are quite a few on the market, even the placebo effect can help. When she is older, she may be able to take beta blockers to manage the symptoms but she's probably a bit young for those yet

One last thing - once your daughter gets more confident about going out and the weather gets better - think about doing a family on-line walking challenge such as The Conqueror Online Fitness Challenge www.theconqueror.events/ . I know that's way off what she can manage now but it's good to have an objective you can build up to, and mentioning it as something you can maybe do later on, shows you have complete faith in her that she can do it. That's for much later though; best to start very very small for now. I only mention it because what helped me immensely was my DH treating me totally normally as if I didn't have a problem with anxiety at all when we spoke about the future, even though he was sympathetic to when I had a panic attacks in the present if that makes sense. But we never started out anywhere with him assuming I was going to have one; we started each day afresh and that really really helped me.

Btw, do you have a dog, because they can sometimes help and reassure anxious DC? You could perhaps approach the Cinnamon Trust in your area and borrow one if not.

Sorry for long post! Good luck, these are really hard times for teens and I hope your lovely girl recovers her equilibrium soon.
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Just for interests sake: “ Agoraphobia is a fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong. Many people assume agoraphobia is simply a fear of open spaces, but it's actually a more complex condition. Someone with agoraphobia may be scared of: travelling on public transport.”

Great advice from Sillyoldmummy and Tunmahla which I seem to have replicated in parts - sorry - X post!

Thank you for all the advice. I've tried a few things to tempt her out but most of them get knocked back. I have learned quite a lot about agoraphobia now and it became clearer to me it fitted with this. My mother also suffered with this.

Her teacher seems not to be convinced. I think they feel it's histrionics sometimes. It's awful for her because she has a big group of friends female and male and sometimes she has to come home because of it. ( this was last summer). I feel lockdown has allowed it to take over further.

If you haven't already come across her Dr Claire Weekes books may help you..I know for me they were a lifesaver. her technique is very simple. .but very effective.

@toomanyspiderplants thank you. Now ordered that book. Amazing reviews.

The pandemic has so much to answer for for you op.

I found little shuttle runs with my dd worked well, and we gradually expanded the trips. Keep going out every day, garden centre for some pot plants, supermarket for flowers for her room, chemist for make up etc. Make a plan and keep going so that she will be ready to go back to school next month.

@speaksofty I just feel so guilty if I get her out to a shop. I feel people are judging and thinking why aren't you shopping alone. I've seen so many comments on Mumsnet about that. It's so hard at the moment.

I think in these circumstances your presence is justified op because you are in a caring role, it's important that your daughter gets out every day and no doubt you are both being sensible. Agoraphobia is a serious illness.

You say this started before Covid, and that lockdown has exacerbated it, do you know what caused it before? You obviously don't have to answer herev but it's really important to drill down to the specific things that are scaring her in order to confront them very slowly, bit by bit.

Also, apologies if I have misunderstood your previous post, but I assume you know that panic attacks and agoraphobia can be very much interwined?

From the Mayo Clinic website:
"Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again."

Also, can you get your gp to write to the school?

Thankyou yes. I think I need another conversation with the gp. Last time we went she was prescribed propanol but it doesn't get to the root of the problem as you say

I had agoraphobia in my 20s and more recently in my 50s still can't go on public transport.
My therapist tried to urge me to do things each week but when I was too down or exhausted I didn't get the homework done.
Thankfully in lockdown the streets are much quieter and walking in semi darkness helps.
Also when I've had a fun positive day baking and posted the results on Instagram and had positive feedback it lifts my spirits and I can find myself popping out with renewed positivity.
What I'm saying is perhaps some distraction and positive affirmation helps as thinking I can't go out becomes a cycle and I remember looking out of the window with fear of the outside world and feeling quite trapped.
It is a hard one I hope this helps.