Anxiety comes as part and parcel of many mental illnesses. It can also be diagnosed as an illness of itself. Anxiety symptoms often include feeling or being physically sick, struggling to breathe, trembling, sweating, dizziness, crying, and sometimes a feeling of being physically ‘stuck’ and unable to move. This list is not exhaustive, they are just some of the most common symptoms.
Mental illness, and in particular anxiety, can make it very difficult to leave the house. What if we’ve always been someone who’s outgoing, independent, sociable and seen to be an extrovert, always expected to be at every party? People don’t understand why you never come out anymore. And if you are someone who has always been fairly introverted, used to your own company, happy to stay in, people may not realise that your alone-ness has changed - it no longer feels like a choice. Being happy on your own might have transformed into loneliness and a desperation to get out. Our friends’ well-intentioned texts, calls, voice notes, facebook invites and everything else that comes at us through our phones or laptops can feel like constant bombardment; overwhelming and attacking.
People who have anxiety can learn to manage their symptoms. This means that some of us can leave the house sometimes, and others can leave the house occasionally but find it exhausting. Some people have such high levels of anxiety that we need to get back inside almost immediately, so that we can get our heart rate under control and feel able to breathe again.
Why does leaving the house feel impossible?
There are so many possible answers to this. Here, I’ve listed some. There will be many more for other people. Everyone’s anxiety and everyone’s illness(es) feels different to each person, and we cannot completely generalise the experience.
Fear Of Panic Attacks
For some of us, it’s the fear of having a panic attack that can stop us from going outside. Having panic attacks inside the house may be more easily managed - we’re likely to have found ways that they can be quelled quicker - some people have herbal teas they drink, others listen to specific music, or we have a ‘safe spot’ in the house where we can go and recover.
Having a panic attack outside can be harder to curb. For some, panic attacks can be more likely to happen outside of the house purely because we are feeling more vulnerable and the fear that is induced at the (sometimes obsessive) idea that we might have a panic attack, is the very thing that will cause it to happen.
The Thought/Fear Of Social Interaction
Social anxiety causes many of us to struggle with social situations - the thought of interactions can make our symptoms flare up and our anxiety levels to spike - leaving us feeling shaky, clammy and unable to speak.
Social anxiety can spark a worry that we will see and have to interact with people (for some, strangers are the worst - others fear seeing people they know). However, we might also be concerned about other people seeing us. Mental illness can cause us to struggle to keep on top of basic hygiene. We might have struggled or actually not been able to shower, get changed/dress or have done anything with our hair. Either way, this makes knowing that people can see us, or we might have to see them, intolerable.
Mental illness is exhausting to live with. We’re tired just from experiencing it all the time. Some days it feels hard or even impossible to psychically get out of bed. So, there’s very little chance we’ll actually go outside. The fear of tiredness can factor into this too - if we have to walk ten minutes to the high street, what if we can’t face the ten minute walk home afterwards? Much safer to stay in.
A complete lack of motivation or interest
Let’s not forget, we also may be experiencing a total wipeout of interest or motivation in anything - even things we used to love. We might not see the point of doing anything, let alone going outside.
Previous experiences have proved us right
Post-traumatic stress disorder may also make it feel terrifying to leave the house as a result of past experiences. For some people who have anxiety, the sense of impending doom is constant and acute. For some, those bad things have happened to us when we’ve been outside of the safety of our homes. Certain actions or places can trigger a trauma reaction and until we are well enough to cope with that, we may have to exercise due caution when going outside.
Our reality can be different from others’
Some people see, feel, hear or smell things that can’t be seen, felt, heard or smelt by other people. Any kind of hallucination can be very distressing, and paranoia can also form part of our illness(es).
The outside world might amplify some of these symptoms. For example, if we hear voices and we go to a busy place, we might struggle to differentiate ‘our’ voice(s) from the voices of the crowd around us. ‘Our’ voice(s) could become louder and more persistent or aggressive to rise above the noise of the crowd. They can be really scary, and we might worry that we will get hurt, or hurt someone else. For some, trying to/feeling unable to filter out all of the sounds and voices of a busy place is enough to make us feel very scared (and exhausted!), and want to retreat into our homes. Staying inside can feel safer and less distressing than trying to cope with this.
For many of us, public transport is what nightmares are made of - lots of people in a confined space where we can only get off at specific stops or times. That makes it difficult to feel like we control our escape (which is an important part of some peoples’ anxieties). Mental illness can also affect our memory, concentration and information-processing capacity - this means that routes which involve more than one bus or train can feel incredibly stressful and just planning these journeys feel very overwhelming.
Ways To Manage Leaving The House
There are things we can do to make the outside world feel more accessible to us. For many of us, driving can be much less stressful than using public transport. We feel safe in the bubble of our car - it also reduces the chances of social interaction. SatNavs and Google Maps can ease our worries about route planning, and we also have control over when we leave/arrive - so the worry of missing trains/buses at certain times is also handled. It does have to be acknowledged though, that this is a luxury that lots of people do not have access to.
Wearing noise-cancelling headphones can help with noise-busyness and may help with auditory hallucinations. Even if we have nothing playing, the white noise can help to drown out other external and distracting sounds. Music can comfort us and help us feel a little bit less exposed. A little bit like being in our car, it can provide us with a safe bubble.
Keeping something in our pocket that feels nice; a smooth stone, a fiddle toy or a stress ball can help us to focus and release some of our anxiety.
Breathing sounds like a very obvious one - but different breathing techniques can reset our nervous system and physiologically reduce anxiety levels. Anxiety makes us breathe quickly, and with shallow breaths (into our chests, not our stomachs). This can make us dizzy and disorientated - which may cause further panic. Long, deep breaths into our stomachs can help - and there are lots of apps such as Headspace and Zen which are full of great breathing exercises we can try out on the go.
Try to prevent the build up of anticipation about leaving the house - the longer it’s been since we left the house, the more overwhelming that idea becomes.
While we’re at home, keeping connected as much as we can to the outside world might prevent such a build up of anxiety. As much fresh air as possible is always good - opening windows or being on balconies and in gardens helps us to feel familiar to the sounds and smells of outside. The internet is also a great place to help stay connected to friends and people in general - try podcasts, the radio, YouTube. Only use social media and the news if it is good for you - try to monitor how they make you feel.
When we do start leaving the house again - start small. A whole day out after a week indoors might feel overwhelming and may end up a backwards step. Instead, try a short walk to the end of the road, then maybe to the local shop. Build it up slowly.
Be your own best friend
It’s really easy to be mean to ourselves when we know that we’re finding things difficult that others seem to find effortless.
We have no idea what’s going on for other people. Just like people may not be able to see yours, other peoples’ triggers or struggles are not always visible to us. The likelihood is that we walk past several people every time we’re out who are struggling in their own way. What’s easy for you, might seem impossible on some days, to them.
Importantly, we have an illness. This is not our choice. We have a whole added barrier to break through before we do things. It might be more difficult for us, but it’s more impressive when we do manage them.
Recovery is never linear. There will be good and bad days. A walk that we’ve done countless times might one day send us spinning. This can make our anxiety feel crippling and unmanageable, but bad days happen. Let them happen, write it off as a bad day. Good days will follow.
Getting out of our house can be very difficult. That’s alright - we can build ourselves up as slowly as we like. There is no rush - talk to yourself the way you would your best friend. You’ll be much more likely to feel able to tackle things that way.