Help me find a therapist in my area for agoraphobia.
June 14, 2022 3:19 PM Subscribe
I’m agoraphobic (female, 45yo). I live in Ottawa, Canada. I’ve hardly been out of the house in 3-4 years. I realize I can’t live like this forever, and don’t want to. So, I’d like to start seeing a good therapist who could help me figure out what to do now.
I’ve had a look online for therapists who might have an interest in working with a person like me. There seems to be at least a handful of people who specialize in agoraphobia in my region. It’s hard to know whom I should call. Also, most of them use a CBT approach, which I have found to be unhelpful in the past, for depression and anxiety. I currently take medications for these (Cymbalta, Wellbutrin and Abilify) — these meds seem to work well enough for the depression, but I have not had any luck with Ativan (lorazepam) alleviating the panic attacks which occur when I need to go out. It just has no effect on me, aside from making me feel really sleepy. The psychiatrist who had prescribed the Ativan has recently retired and I am relying on my family doctor for my antidepressant prescriptions at the moment. In any case, my doctor has refused to prescribe any benzodiazepines for me. Please keep in mind that family doctors who take new patients are few and far between in my area and that it would be almost impossible for me to switch to seeing someone else.
Complicating all this is the fact that in roughly the same time period as I have been housebound, I have also developed osteoarthritis in my knees which causes chronic pain. This keeps me from walking and standing for any time at all. I need to see my family doctor for this and other new ailments, but I just can’t seem to make myself leave the house.
So. My questions are the following:
Can anyone recommend a therapist in the Ottawa area, qualified and interested in treating agoraphobia (and maybe how to cope with chronic pain), who would also be willing to communicate with me by video call or phone, at least to start with?
And has anyone here been in this kind of situation? Were you able to eventually work past your agoraphobia? I need a bit of hope right now.
Thank-you! I look forward to reading your replies.
I’ve had a look online for therapists who might have an interest in working with a person like me. There seems to be at least a handful of people who specialize in agoraphobia in my region. It’s hard to know whom I should call. Also, most of them use a CBT approach, which I have found to be unhelpful in the past, for depression and anxiety. I currently take medications for these (Cymbalta, Wellbutrin and Abilify) — these meds seem to work well enough for the depression, but I have not had any luck with Ativan (lorazepam) alleviating the panic attacks which occur when I need to go out. It just has no effect on me, aside from making me feel really sleepy. The psychiatrist who had prescribed the Ativan has recently retired and I am relying on my family doctor for my antidepressant prescriptions at the moment. In any case, my doctor has refused to prescribe any benzodiazepines for me. Please keep in mind that family doctors who take new patients are few and far between in my area and that it would be almost impossible for me to switch to seeing someone else.
Complicating all this is the fact that in roughly the same time period as I have been housebound, I have also developed osteoarthritis in my knees which causes chronic pain. This keeps me from walking and standing for any time at all. I need to see my family doctor for this and other new ailments, but I just can’t seem to make myself leave the house.
So. My questions are the following:
Can anyone recommend a therapist in the Ottawa area, qualified and interested in treating agoraphobia (and maybe how to cope with chronic pain), who would also be willing to communicate with me by video call or phone, at least to start with?
And has anyone here been in this kind of situation? Were you able to eventually work past your agoraphobia? I need a bit of hope right now.
Thank-you! I look forward to reading your replies.
Best answer: I don't know anything about therapists in Ottawa, unfortunately, but I have plenty of hope about agoraphobia. Let me share some with you!
I'm male, 47, and agoraphobic since I was about 24. I've been in remission and also sober for over 7 years. Agoraphobia came first and is what I think of as my "proximate cause", addiction came later from my attempt to self medicate. The addiction brought me into the hospital many times and rehab twice. The side effect of ultimately accepting the treatment for addiction was that I was able to accept the treatment for agoraphobia as well. It's complicated, your mileage may vary by a lot. I actually feel lucky because the rock bottom crash that was brought about by my addiction gave me an opportunity to make a new decision about who I was. I'm glad I had that moment around which to pivot my life. There's no reason that I couldn't have made a decision to change on my own, but for some reason I needed an overwhelming push. Luckily no one is required to make my mistake.
It took work, and was not what I would call easy, but it wasn't nearly as bad as my phobia was telling me. It wasn't a matter of summoning all my courage and willpower, gritting my teeth, and doing the scariest thing I could think of. It was a matter of medication, group and individual therapy to get started, and working my way up to the scary thing. I had actually tried the 'hold your breath and go the the grocery store at 5pm' approach a few times and all it got me was painful setbacks.
Treatments involving medication, exposure therapy and connection to other people who share the experience are incredibly effective. They can seem overwhelming and scary, and they kind of are, no lie. There is a certain amount of pain and effort involved, but I spent so much time avoiding that pain and effort that I created for myself an equal if not greater amount of pain. Agoraphobia is resistant to treatment because, frequently, the treatment involves literally the thing you're phobic about (irony!). But the hurdles are lower than you think, and it is well worth it.
Phobia does not exactly present with improved clarity of thought. All my beliefs about not being up to the challenge, or being somehow the most incurable case on record, turned out in the end to be symptoms of my phobia itself. But that doesn't mean I jumped off a cliff! What I did was I reached out my hand, and found another hand there waiting for me.
I'm actually about to ask to go back on Celexa when I see my doctor later this week. I've been dealing with some stressors over the last year or so (who hasn't, amiright?) and I've had a couple of intermittent symptoms. I have a rule about my agoraphobia (actually I have a couple of rules that might actually constitute a discipline) which is that I'm allowed to have whatever feelings I want, but if those feelings stop me from doing something I want or intend to do then I have to go to the doctor and take care of it. So I am. One of the best things about being literally twice as old as I was when I first started having agoraphobic symptoms is that I can just go to the doctor about it without the baggage and denial that I went through the first time.
My life in the past few years has been richer than any other time in my life. The miserable trap that I was in has vanished into the past. I can remember it well enough to take immediate action about it, but it no longer looms over every decision that I make and tells me what I can and cannot do. I feel incredibly free.
You may memail me if you wish.
posted by Horkus at 8:11 PM on June 14, 2022 [10 favorites]
I'm male, 47, and agoraphobic since I was about 24. I've been in remission and also sober for over 7 years. Agoraphobia came first and is what I think of as my "proximate cause", addiction came later from my attempt to self medicate. The addiction brought me into the hospital many times and rehab twice. The side effect of ultimately accepting the treatment for addiction was that I was able to accept the treatment for agoraphobia as well. It's complicated, your mileage may vary by a lot. I actually feel lucky because the rock bottom crash that was brought about by my addiction gave me an opportunity to make a new decision about who I was. I'm glad I had that moment around which to pivot my life. There's no reason that I couldn't have made a decision to change on my own, but for some reason I needed an overwhelming push. Luckily no one is required to make my mistake.
It took work, and was not what I would call easy, but it wasn't nearly as bad as my phobia was telling me. It wasn't a matter of summoning all my courage and willpower, gritting my teeth, and doing the scariest thing I could think of. It was a matter of medication, group and individual therapy to get started, and working my way up to the scary thing. I had actually tried the 'hold your breath and go the the grocery store at 5pm' approach a few times and all it got me was painful setbacks.
Treatments involving medication, exposure therapy and connection to other people who share the experience are incredibly effective. They can seem overwhelming and scary, and they kind of are, no lie. There is a certain amount of pain and effort involved, but I spent so much time avoiding that pain and effort that I created for myself an equal if not greater amount of pain. Agoraphobia is resistant to treatment because, frequently, the treatment involves literally the thing you're phobic about (irony!). But the hurdles are lower than you think, and it is well worth it.
Phobia does not exactly present with improved clarity of thought. All my beliefs about not being up to the challenge, or being somehow the most incurable case on record, turned out in the end to be symptoms of my phobia itself. But that doesn't mean I jumped off a cliff! What I did was I reached out my hand, and found another hand there waiting for me.
I'm actually about to ask to go back on Celexa when I see my doctor later this week. I've been dealing with some stressors over the last year or so (who hasn't, amiright?) and I've had a couple of intermittent symptoms. I have a rule about my agoraphobia (actually I have a couple of rules that might actually constitute a discipline) which is that I'm allowed to have whatever feelings I want, but if those feelings stop me from doing something I want or intend to do then I have to go to the doctor and take care of it. So I am. One of the best things about being literally twice as old as I was when I first started having agoraphobic symptoms is that I can just go to the doctor about it without the baggage and denial that I went through the first time.
My life in the past few years has been richer than any other time in my life. The miserable trap that I was in has vanished into the past. I can remember it well enough to take immediate action about it, but it no longer looms over every decision that I make and tells me what I can and cannot do. I feel incredibly free.
You may memail me if you wish.
posted by Horkus at 8:11 PM on June 14, 2022 [10 favorites]
Best answer: Hi! I cannot be of help with Ottawa/Canada suggestions, but I can tell you about my experience with agoraphobia. Like many agoraphobics, I started out with generalized anxiety, social anxiety, and panic attacks. The panic attacks happened almost exclusively outside of being home, so I decided that being home all the time was my best option for not feeling the dreaded panic attacks.
For the better part of 2.5 years, I only really left the house when my family begged me or dragged me out. I tried and failed to attend big events, like graduations and parties. I couldn't even go to the grocery store reliably. I played World of Warcraft... a lot. I can't tell you that anything specific spurred it, but one day in the middle of the afternoon I was sitting on the couch while playing, and I got really sad that that was my life. I had struggled with treatment before, but hadn't given it my best shot, and I decided that I wanted to try really hard to get to a place that felt better.
It took 2 therapists, trying at least 6 different medications, and a very patient support system to get me to a place of stability - where I was back in university, still really nervous about having a panic attack in class and not being super social, but I was functioning and leaving the house consistently.
It is 15 years later now and I barely recognize who I was back then. I empathize with my younger self and I remember how awful it felt, but my life is ten worlds different now. I don't think twice about leaving the house. I schedule and attend social events, frequently. I travel on public transit and take plane trips. There are very minor coping mechanisms I retain and allow myself to retain, like not wanting to sit in the middle of a theatre row so I can leave easily if I feel anxious. But they don't stop me from enjoying my life.
I really, really feel for you because I remember how trapped I felt, but also how home felt like the only safe place. Treatment is rarely an upward, consistent progress, but more like 1 step forward, a quarter-step back, and 1 baby-step forward again. But if you keep going, I hope you can get to a place that feels freer than you feel right now. Feel free to message me anytime.
posted by rachaelfaith at 8:22 PM on June 14, 2022 [9 favorites]
For the better part of 2.5 years, I only really left the house when my family begged me or dragged me out. I tried and failed to attend big events, like graduations and parties. I couldn't even go to the grocery store reliably. I played World of Warcraft... a lot. I can't tell you that anything specific spurred it, but one day in the middle of the afternoon I was sitting on the couch while playing, and I got really sad that that was my life. I had struggled with treatment before, but hadn't given it my best shot, and I decided that I wanted to try really hard to get to a place that felt better.
It took 2 therapists, trying at least 6 different medications, and a very patient support system to get me to a place of stability - where I was back in university, still really nervous about having a panic attack in class and not being super social, but I was functioning and leaving the house consistently.
It is 15 years later now and I barely recognize who I was back then. I empathize with my younger self and I remember how awful it felt, but my life is ten worlds different now. I don't think twice about leaving the house. I schedule and attend social events, frequently. I travel on public transit and take plane trips. There are very minor coping mechanisms I retain and allow myself to retain, like not wanting to sit in the middle of a theatre row so I can leave easily if I feel anxious. But they don't stop me from enjoying my life.
I really, really feel for you because I remember how trapped I felt, but also how home felt like the only safe place. Treatment is rarely an upward, consistent progress, but more like 1 step forward, a quarter-step back, and 1 baby-step forward again. But if you keep going, I hope you can get to a place that feels freer than you feel right now. Feel free to message me anytime.
posted by rachaelfaith at 8:22 PM on June 14, 2022 [9 favorites]
I am in Ontario. I can't help with therapists, but I recently saw Dr Jeanette Janzen, a mental health physician, online through Maple. I paid out of pocket to see her because I wanted an appointment much more quickly than I could have gotten through a family doctor referral/OHIP. It was the most thorough, nuanced, compassionate, intelligent, comprehensive care I have ever received. She was intimately familiar with all of my medications. I was seeing her for a new antidepressant and the background knowledge that she had on what I was currently taking and what would be best was just exceptional. I felt SO well-informed and cared for. The appointment was $299 and follow-ups will be $200, so it's not cheap, but it's some of the best money I have spent this year.
She issues her prescriptions right in the online portal and you can them filled and delivered right from Maple (delivery is free, and your prescription costs would be determined by the insurance coverage you have).
I really, really emphasize with the idea that new family docs are hard to come by and I know your current prescriptions seem to be working well enough, but if you can afford the one-off fee I would high suggest booking with Dr Janzen specifically. It was really exceptionally good care and a thousand times better than my family doc just prescribing something, and her care brought me up from "this seems to be working well enough" to "WOW I can't remember the last time I felt so good". (For reference, I have major depressive disorder and have been medicated for it for the last twenty years.)
Good luck. I will be thinking of you.
posted by kate blank at 1:57 PM on June 15, 2022 [1 favorite]
She issues her prescriptions right in the online portal and you can them filled and delivered right from Maple (delivery is free, and your prescription costs would be determined by the insurance coverage you have).
I really, really emphasize with the idea that new family docs are hard to come by and I know your current prescriptions seem to be working well enough, but if you can afford the one-off fee I would high suggest booking with Dr Janzen specifically. It was really exceptionally good care and a thousand times better than my family doc just prescribing something, and her care brought me up from "this seems to be working well enough" to "WOW I can't remember the last time I felt so good". (For reference, I have major depressive disorder and have been medicated for it for the last twenty years.)
Good luck. I will be thinking of you.
posted by kate blank at 1:57 PM on June 15, 2022 [1 favorite]
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posted by jeszac at 6:05 PM on June 14, 2022