How do I find the motivation to leave the house?

July 31, 2009 8:39 PM

Long-term cabin fever, please help me get out of the house.

I have a long history of depression and social anxiety, both before and after the onset of bipolar II disorder. Over the past 18 months, through medication and therapy, I have made tremendous strides in nearly every area of my life: mentally, emotionally, socially, intellectually, and spiritually. I am also very much an introvert and that won't be changing, but I have been able to sustain friendships and I have grown significantly closer to the people in my life.

The one thing that really nags at me right now is the fact that I still spend the vast majority of my time in my home. I'm more willing and certainly more able to go out, but I have very little desire to do so. In fact, I think I might go out of the house less now than I did when I was depressed.

Through the keeping of mood journals and regular discussions with my therapist, I really don't think I'm depressed. In fact, within my home I am quite active. I spend hours composing music in fruity loops, studying for college and posting messages back and forth with other students (it's online), talking on the phone with friends, reading, researching, etc. I watch very little tv although if I'm feeling physically sick (which is sadly often, due to severe allergies, PCOS, and migraines) I do tend to watch marathons and movies. Yet mentally I feel active, and I feel involved in the lives of others. And I feel good emotionally, in ways I never have before. I've also fixed my sleep schedule so I sleep at night now, and I'm awake during the day (a major victory for me).

But there's a whole world out there. I think some of the problem is that I'm just not used to going out. I have been sick in a number of ways since I was in grade school, and had to have a teacher sent to my home when I was in high school because I couldn't go (eventually dropped out). Before the onset of bipolar I did work, but that was only about a year before I became sick. I have worked and struggled to get the health care I need in spite of my limitations, to earn my diploma and associate's degree, and to rebuild my relationships.

Eventually, I would like to return to work (or continue my education at a brick and mortar school, because I realize I really like school). My therapist and I agree that I'm not quite ready for work yet, not even part time, but surely there's another way to leave the house. I don't even know how to do it, really, like how to establish that kind of routine and I'd appreciate some advice.

posted by Danila to human relations (17 comments total)

Why has your therapist suggested you aren't ready for work? I think it would really help to have a simple customer service job, with part-time hours, to gradually re-introduce you to society.

The classic treatement for social anxiety is de-sensitization. If a job is out of the question, what about a regular volunteer activity such as reading at a senior citizen's home once a week?

As you spend more and more time cooped up inside your house, your world is going to become smaller and smaller. Don't ruin your life.

I would question your therapist as he/she seems to be encouraging this.
posted by Flying Squirrel at 8:53 PM on July 31 [1 favorite]

Volunteer work can be excellent solution - you can sign up for something manageable like 4 hours once a week. Knowing that people are counting on you to show up with give you an extra push to get out the door. You can pick something that suits your interests and skills. I'm thinking office work might fit, since there be a limited number of co-workers to get used to. try volunteermatch.org and see if you can find something.

Another option is either outdoor exercise or joining a gym or an exercise class. Exercise is great for depression, doesn't require much social interaction and if you sign up for a class you will have to little extra commitment to get there since you paid for it.
posted by metahawk at 9:01 PM on July 31

Are you able to get a dog (that is, if it's something you're interested in)? Taking a dog for a walk is a great way to get out of the house. You're doing something productive and necessary for a companion who gives you unconditional love, and you'll be out in the fresh air. Walking a dog also gives you the opportunity to encounter other people who are out and about, and you have the option of smiling and saying Hi, or even stopping for a short chat. It's a low-pressure way to ease into feeling sociable.
posted by amyms at 9:39 PM on July 31

I'm a little like you - I'm a homebody and that's ok. Some people are just like that. I'd rather be home. I stay busy and occupied and productive at home. I'm not just sitting around staring at the wall.

But, since you feel like there's a world out there you'd like to be a part of - why not start off at a coffee shop or library. Bring your 'puter, or a book, and just sit with a treat and hang out. Make a date with yourself once a week. Work up from there. And like previous comments, it helps when there are people counting on you to be at a certain place at a certain time. Find small tasks that require a commitment from you and follow through on them.

The biggest issue for me getting out of the house is the necessity of it all - and I think that's what you're talking about - if you don't HAVE to go out, how do you make yourself go?

And . . . I don't know the answer to that. I'm content doing the necessities, only going out when I have to - to get groceries, go to the doctor's, etc. But don't forget - those little outings count too! You are experiencing the world. Give yourself some credit.

But, I must say, that when I DO go out - for whatever reason, I feel like I accomplished something that day. It gives me a little spring in my step. It gives me something extra to talk about that day. And truthfully, I feel a bit more brave that I took on the world!

I'm sorry, I just wrote a lot of nothing - just wanted to say that you're not alone, that it's ok not to be a social butterfly or even to be one of these busy people that are running around all day long. Being a homebody is cool. It's also cool that you want to stretch yourself and get out more.
posted by Sassyfras at 10:19 PM on July 31 [2 favorites]

For awhile when I was having trouble leaving the house, the one thing that got me out for about twenty minutes a day, every day, was my morning coffee. Instead of making it at home, I'd fork over two bucks for an iced coffee at my local cafe. It puts a minor dent in the budget, but it's worth it just to get out for a little bit. (Another benefit is that you get to know your local baristas.)

If that seems like it's too much, or even like it's too expensive, try going to the corner to pick up a copy of whatever cheap or free daily paper is distributed in your area. It's an errand, yes, but if you get up, get showered and dressed, and go out at about the same time every morning, you start to get into the habit of doing so. While you're out, you may find you're enjoying yourself more and more as the anxiety decreases.

You could also try going to the movies on occasional weekday afternoons. There aren't too many people, so it's not as anxiety-provoking as a full house usually is. And you get to watch a movie in peace.

Leave an hour early for your therapist's appointment -- you'll be going out on those days anyway, right -- and spend the time walking around the neighborhood. Maybe go to a bookstore and browse for awhile.

A lot of libraries look for volunteers for single-serving sorts of activities: reading to children, for instance. You could try the volunteering thing once and see how it goes. If you like it, sign up for more. Make a commitment once you feel it won't become a source of anxiety for you. But start out small.

When you're out, make a note of things that trigger you, so you can bring them up with your therapist and work through them.

Hugs to you, and congratulations on getting the sleep schedule in order. That's a tough one.
posted by brina at 10:30 PM on July 31

No Sassyfras, that was great, really. And I do some necessary things although not as often as I want to (groceries, errands, etc.).

brina, my therapist comes to my home actually (when I first started seeing her I'd go literally months without even showering, much less walking out the door).

In answer to why I can't yet work, there are a lot of issues involved there, but suffice to say that at this point, I am still disabled, even if I am a lot more functional.

I do have a dog although it makes me anxious to walk her so others in my family do it (had a previous dog and I was yelled at by a neighbor fed up with people who didn't pick up after their dogs, although my dog hadn't done anything; this was when I was still very anxious). There are so many things I long ago stopped even thinking about doing because I couldn't, and now that I might be able to I don't remember them. "Walking the dog" stopped being a part of my world years ago, dogs have died and new ones adopted and I hadn't even really considered it. That's definitely something I can try to do.

Lack of money is an issue for me: for example I used to go to libraries frequently (had a goal to visit every library in the city and I did visit most of them), but I rarely have money for transportation now and the nearest library is not within walking distance for me. As a Medicare recipient, I also qualify for a free gym membership, but don't have the money for transport and none in walking distance at all.

Volunteering is definitely a strong possibility. My mother volunteers nearly daily and really wants me to come with her. She too is bipolar, and when I was a teenager she spent months not just in the house (when not in the hospital), but in bed so much she fell into a coma and it was hard to tell, and now she is highly active, volunteering her time five days a week. I don't think I want to volunteer with her exactly, but she does demonstrate that it can be done.
posted by Danila at 10:44 PM on July 31

Seconding the suggestion to get a dog, if you can. There have been times where I feel too grim to get out of the house myself, but a couple of pooches jumping up and down doing the "please take me out to pee and to check out all the smells, oh wonderful human, please" dance not only gets me outside, but it always cheers me up, to boot.

Also seconding the suggestion re: exercise. Join a gym, make a pact with a friend to go hiking, take a yoga class -- it will help you start to associate getting out of the house with feeling good.

If you like writing, you can always set little creative assignments for yourself that involve being outside -- say, you'll write 2 pages in your journal in the park, or you'll write a poem incorporating 5 things you observe on a walk.

Good luck -- and good for you for pursuing therapy and meds. You can do this!
posted by scody at 10:46 PM on July 31

(sorry, didn't see your response re: already having a dog on preview)
posted by scody at 10:47 PM on July 31

Re your dog:

I do have a dog although it makes me anxious to walk her so others in my family do it (had a previous dog and I was yelled at by a neighbor fed up with people who didn't pick up after their dogs, although my dog hadn't done anything; this was when I was still very anxious). There are so many things I long ago stopped even thinking about doing because I couldn't, and now that I might be able to I don't remember them. "Walking the dog" stopped being a part of my world years ago, dogs have died and new ones adopted and I hadn't even really considered it. That's definitely something I can try to do.

It's wonderful that you already have a dog! Try going along on the walks with your family member, as a start. As you feel more comfortable, maybe the family member could walk on ahead at the halfway point and let you finish the walk by yourself (keeping the family member in sight so you can call to them if you start feeling anxious). Then gradually keep taking additional measures until you're able to be in control of the entire walk, and walking schedule, yourself.

Best of luck to you; it sounds like you've made a lot of progress so far.
posted by amyms at 11:32 PM on July 31

amyms has good advice re the dog; definitely try tagging along with others at first and then soloing.

You can also eventually try being the early morning walker of the dog - dog would probably be happy for some extra walk time, there are way less people about at that time of the day, and they tend to be more focused if they are about (on getting to work or exercise ...), rather than paying attention to what you would be doing. This is good exercise for you as well as the dog.

You say that there is no library within walking distance, but is there anything within biking distance? I assume you or someone in the family has a bike you might be able to use, and it would be exercise as well as getting you out and about. You might even consider volunteering at the library, shelving books or something along those lines.
posted by gudrun at 1:30 AM on August 1

I did walk the dog this morning and I did enjoy it, thanks very much for that suggestion. I don't think I'd left the house in a week so that was good.

I am still worried at how easy it is to fall back into familiar patterns. Throughout this journey it has been hard to know when I've really made lasting progress, when I'm just hypomanic (not the case this time), or when I'm just caught up in a motivated fit that won't last. However, it has been a very long time since I had an actual commitment (as in someone else counting on me) to leave the house on a regular basis.
posted by Danila at 4:51 AM on August 1

To the person who suggested a simple customer service job-uh, no, those are a lot more stressful than you think. To someone just trying to get a toe back into the outside world, that's not a first step!

To the OP-how does your mother get around? Would she give you a lift to the library on the way to her volunteer job, maybe?
posted by St. Alia of the Bunnies at 7:00 AM on August 1 [1 favorite]

Get a bicycle. It's great exercise, it's free transportation, and you can't use it in the house. Used basic rideable bikes can often be had for very little money and they cost almost nothing to maintain if you learn how to fix them yourself.
posted by Caviar at 7:03 AM on August 1

Danila, is there any way you could go to your therapist's office for appointments? I know it can be difficult, but if you have any transportation to get to her, it's a good first step. You know your therapist's office is a safe place, and you'll have minimal contact with others when you're on your way to and from appointments. And you will know you're getting out of the house on certain days and times each week. (You'll also have that actual commitment of which you spoke, and it's a good motivator.)

Not to pry, but do you receive SSA/SSI checks? If you do, you might try to dedicate some of that income toward a form of transportation.

Also, I didn't know Medicare qualified folks for free gym memberships. I just may have to take advantage of that one.

I have one final suggestion for you, which I call therapy school. It's generally referred to as either "intensive outpatient" or "partial hospitalization," depending on where you are. You would go anywhere from three to five days a week, for a good part of each day. Hospitals that have this service generally teach coping skills, focus on distress tolerance, and try to help people re-enter the world. These programs can be incredibly helpful. The time is structured, the people you interact with are good supports and can become good real-life friends, and your social worker or case manager would help you set goals for what you'd like to be able to accomplish (a) during the program and (b) after you left. Medicare covers these sorts of programs, and you should be able to apply for transportation funding of some sort as well. It's sort an immersion-type thing in that, on the first day you don't think you'll be able to get through it. It's intense. You meet a lot of people, many of whom you'll find have problems even bigger than yours. (Didn't think it was possible, did you? It so is.) Anyway, by the time you've finished (it takes anywhere from two weeks to a month), you'll be able to go to lunch with friends and even consider that part-time job. I don't know if you're in an area with a major hospital, but if you can get yourself to one of these programs they are quite literally life-saving. If you want more info, feel free to send me MeFiMail.

Congrats again on the progress you've made so far, and good luck on your next leg of the journey. (((hugs)))
posted by brina at 12:08 PM on August 1 [1 favorite]

I didn't know what partial hospitalization was (and flinched at the thought of any kind of "hospitalization"), but after looking it up I think it could be what I need. I was in a program like that when I was a teenager, and while it didn't help all that much, it was a welcome escape. As an adult, I think I am far more capable of taking advantage of what the program has to offer. There are a lot of major hospital systems in my area.

To answer some loose ends: Looking to my family for any kind of help is going to be difficult and asking for any help from the people in my life is still a major source of distress to me. Any resistance and I give up and try on my own (and my mother has already consistently resisted changing her plans to take me places). As for transportation, Septa's transpass costs would eat up too much of my budget at this point. About Medicare gym memberships, I misspoke. I think it may just be my insurance (Blue Cross- Keystone 65). It's something called "Silver Sneakers" and I don't know if other insurances do it. And my therapist only does home visits; as soon as I am truly capable of regularly attending therapy appointments on my own, I will have to get a new therapist. That's the goal of both of us, but I just want to kickstart things a bit.
posted by Danila at 2:23 PM on August 1

Also, if anyone has more general suggestions and tips for getting out of the house that would really be appreciated.
posted by Danila at 2:24 PM on August 1

it's really easy for me to get sucked into my house - some strange form of inertia.

but i feel so. much. better. if i get up and GO to do something. it's hard to leave the house, and it takes me so long, but it's worth it just for not sitting around and hating being at home.

so i usually try to make myself go do things with other people because i very rarely regret it.

totally get a bicycle! a good used bicycle will set you back maybe $100, and it means exercise and FREE to get almost anywhere in a city.

bike folk are usually super friendly too, i have made a few friends just by them talking to me at red lights!

your google coordinates put you in philly - here's the website for the bicycle club of philadelphia , which is a non-profit and maybe has some volunteer work to be done, and here's the bicycle coalition of greater philadelphia.

good luck!
posted by chickadee at 3:03 PM on August 1