Health

Experts Explain The Difference Between Reopening Anxiety & Agoraphobia

“In fact, wishing to avoid public places right now is a healthy adaptive response.”

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As much as you miss the cacio e pepe at your neighborhood pasta joint, you’re likely fairly adjusted to lockdown by now. But with coronavirus cases in the U.S. increasing as states reopen, you might find you’re feeling really, really anxious at the idea of going outside — where the people are, and all the germs.

It’s not possible to determine how many people will start feeling anxious about coronavirus and its spread, or how their anxiety will show up, but Child & Family Psychological Services notes that people who already have panic disorders may be particularly vulnerable. For many of us, though, going outside seems dangerous because, well, it is.

“Fearing to go out due to the COVID-19 pandemic is a normal response to an unusual and uncertain global crisis,” Antoinette Giedzinska, Ph.D., director of applied neuroscience at Sierra Tucson Treatment Center, tells Bustle. “In fact, wishing to avoid public places right now is a healthy adaptive response.”

There’s a difference between being worried about avoiding coronavirus, and anxiety so intense it signals a disorder. “Agoraphobia is the extreme fear and avoidance of open places or being in public situations, in which a person cannot escape,” Giedzinska says. “People will avoid public situations for fear they will become panicky with no safety route available to them.” Agoraphobia affects around 0.9% of U.S. adults, according to the National Institute Of Mental Health (NIMH). If the thought of supermarkets or crowded parks makes you experience symptoms of anxiety, like a racing heart, it could be a sign of agoraphobia that you'll want to bring to your therapist or GP.

Steve Joordens, a professor of psychology at the University of Toronto Scarborough, tells Bustle that coronavirus represents an ongoing source of fear that isn't going away, and that can make us panic.

"Part of our brain, called the amygdala, continually monitors inputs from our senses for any evidence of a threat. If it detects a threat, it activates our sympathetic nervous system, which essentially readies us to fight or flee," Joordens says. "The problem with COVID-19 is that the threat is not leaving, and it's not clear how to fight it or flee from it." This means our sympathetic nervous systems are activated all the time, but we have no way to control the thing that scares us.

"The biggest source of anxiety is getting COVID-19 and having to quarantine away from family, or not surviving it," Myisha Jackson, LPC, tells Bustle. "But I have clients that are nervous about coughing in public, due to fear of someone assuming they have COVID-19."

If you're feeling a lot of anxiety about leaving the house, Joordens says, there are techniques that can help. "Often the best way to banish anxiety is to learn how to summon feelings of relaxation," he says. He recommends looking for free anxiety-busting meditations online, to practice whenever you’re outdoors and feel nervous or panicky; having a breathing exercise or mantra on hand can be helpful if you feel stuck. He also suggests avoiding news and other things that raise your internal threat levels in favor of singing, dancing, exercising, or other relaxing activities. Giedzinska suggests talking about your fears and worries with other people, particularly professional support, or journaling about them to help you to work through their root causes.If you're anxious about going back to work, Joordens says you should consider pairing up with other employees in a buddy system, so you can check in on each other and share strategies for safety.

Ongoing agoraphobia needs to be treated with a therapist’s help. Cognitive behavioral therapy, support groups, and medication may all help people with agoraphobia to manage their disorder. Setting yourself weekly targets for situations you find challenging — for instance, going to a supermarket for at least 10 minutes — is one tool for tackling agoraphobia, and a trained therapist can help you build up your exposure over time.

It's reassuring to know that, when it comes to coronavirus, everybody in the same boat. "No one knows what’s going to happen next," Jackson says. "We are all taking it one day at a time."

Experts:

Antoinette Giedzinska, Ph.D.

Steve Joordens, professor of psychology

Myisha Jackson, LPC