The entry below describes the struggle a person like you or I, but suffering from agoraphobia, goes through when trying to get medical help. It was written by a close friend of the person with agoraphobia and they have let us publish their work here on Virtually Free, in an attempt to spread awareness on how much agoraphobia can truly affect someone’s life. We thank the person and writer for being brave enough to write about their experience with agoraphobia and share it with the rest of the world. If you also have agoraphobia, we hope you will too. We are building an app specific for agoraphobia and if you have any thoughts or comments (or advice!), please email us at firstname.lastname@example.org.
Do All Agoraphobics Have Rotten Teeth?
Imagine having excruciating toothache and not being able to go to the dentists, a lump in your breast and not being able to have it scanned, an ankle injury and not being able to go to A and E. For the majority of us such scenarios are barely tangible, but for many agoraphobics they represent some of the problems they face on a daily basis.
Agoraphobia is not merely a fear of open spaces as many people believe. It is a fear of being in a place or situation where you cannot escape easily to a place of safety, which is most likely to be your home. The fear frequently culminates in anxiety/panic attacks leading the sufferer to associate the panic with going out. Sometimes agoraphobics can go to familiar places where they feel comfortable/safe, but frequently this list will diminish as panic attacks are suffered, rendering the sufferer housebound and in the worst case room bound.
Agoraphobia can be so severe that sufferers cannot attend medical appointments even for life threatening ailments. To anyone who doesn’t suffer from agoraphobia this seems incredulous. Why can’t agoraphobics just “pull themselves together” and think of the detrimental effects of not attending that appointment? Why can’t they put their family and friends before their fears and just go to the hospital or clinic? Why don’t they just put a blanket over their head and pretend they are going to somewhere familiar? The answer to this is quite simple. The fear and subsequent anxiety/panic attacks overrule logical thought and come first. The fear of the panic becomes so consuming that it is paramount in decision making. The trauma of a panic/anxiety attack can be so severe that the sufferer can take days to “come down” from it and the memory of how frightened and alone in their fear they felt stays with them for a much longer period of time. It becomes “easier” to stay home. The knowledge that the sufferer must fight and conquer their fears and panic is tiring in itself without the actual act of the battle. It remains “easier” to
stay home. Then it becomes too hard to go out, too exhausting and too frightening. The thought of going to one of your old faithful, friendly and safe havens is too daunting and the circle closes in further.
Your support network of family and friends has little relevance other than to intensify feelings of guilt. You don’t want to let them down, you know how important it is to them that you go and have that scan, but if you try and fail you will not only be letting yourself down but those nearest and dearest to you as well. The anxiety that this pressure generates virtually guarantees failure and more self- reproach. Whilst supportive company when venturing out can be of some benefit, the chronic agoraphobic will feel totally alone in their panic and could be accompanied on their journey by one or one hundred loved ones, the only voice they will take notice of will be their inner voice telling them that they will only be safe if they stay home. This inner voice will control the way their body reacts and the likely outcome will be a full blown panic attack.
Not everyone suffers so severely. Many “mild” agoraphobics will get to their appointments. They will struggle and suffer but they will getthere. For those who can’t- what assistance is available to them to ensurethey receive the same care and service as non sufferers? An assortment of Primary Care Trusts (PCTs) were asked what policies they had in place for agoraphobics in respect of general healthcare, particularly access to medical services such as breast screening, dentistry, X-rays etc rather than mental health services.
Mid Essex Primary Care Trust confirmed that they are able to provide some low technology interventions for people in their own homes, such as blood tests, however it is not practicable to provide services requiring larger pieces of equipment, as these are not portable. They have local primary care services that provide support and treatment for agoraphobia to which patients can choose to self –refer or be referred by their GP. Mid Essex PCT’s focus is more on offering interventions that give people strategies for tackling their agoraphobia so they can access services and to offer support in other practical ways, e.g. patient transport.
This approach is comprehensible. It is more practical and cost effective to tackle the problem of agoraphobia and help the sufferer to attend their medical appointment but for severe sufferers these interventions may not work rendering them impotent in obtaining urgent medical attention. There is no obvious answer but it seems desperately unfair that someone should be denied the opportunity to receive healthcare because of a mental health problem. Many GP’s are reticent to make regular home visits and some are unsympathetic to the problems agoraphobics have, quite frequently telling them to come into the surgery to discuss their concerns. If they could get to the surgery they wouldn’t have concerns. So they sit at home, venturing out only to their “safe” destinations, battling every day to keep afloat in the sea of anxiety that rules their life. Hopefully that battle will be won and subsequently the war and agoraphobia will be just another brick in the construction that makes a person unique, but if the battle is lost and the war continues then there is every possibility the agoraphobic may need diagnosis of, or treatment for, a medical matter that is not mental health related. They may just need a filling to rid them of excruciating toothache or an x-ray on that sore wrist.
None of the other Primary Care Trusts contacted had any policies in place to support agoraphobics to access general healthcare although they did have mental health support.
If you are imprisoned by the British Justice System you are entitled to, and receive, excellent general medical care. If you are imprisoned in your own home by your Mental Health you are not so fortunate.