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Dear Christine, Worried in Waterford

| April 14, 2018

Dear Christine, My partner of 18 years actually won’t come out of the house anymore. “Jim” worked hard, saved his money and retired about 3 years ago at age 59. We share a nice home and have amazing friends. Life is good for us but there’s one problem. “Jim” hates going anywhere! It started slowly. At first it seemed he just came out less and less always making excuses why he didn’t want to attend a party or go shopping. We had a pretty active social life that is becoming less and less active and more stay at home. If friends call to do something he often encourages me to just go ahead without him. He has a headache or wants to finish a book he is reading or any number of reasons. I have asked him if there is any problem. He says no. He doesn’t seem to be depressed and we often have friends over for dinner parties and game nights which he loves.
I am beginning to wonder if there is something going on and he is becoming one of those people who can’t leave the house. My question: Is there someway for me to be able to tell if this is something serious that needs to be treated or if he just really prefers to stay home most of the time. He has not been out of the house in 3 weeks now! Last time was a grocery store trip and he wound up staying in the car. I really love him and miss the old outgoing guy he used to be. Please respond and let me know what I should do. Worried in Waterford

Dear Worried, It’s hard to know exactly what is going on with “Jim”, as it sounds like he doesn’t seem bothered by the changes in his behavior that you note. It sounds like you are concerned that he may becoming agoraphobic (agora from Greek, for market place, and phobia, Greek for fear). Many people who have agoraphobia feel anxious or unable to face the stress and lack of control they feel when they are away from home, or at a mall, in a plane, or around lots of people. Usually they have a history of anxiety, and sometimes it worsens so they cannot leave the house. It is limiting and could be experienced as embarrassing. Sometimes it can come about from major life changes or medical problems, but usually it stems from other anxieties that grow in frequency and intensity. Unfortunately, to stay at home only will intensify the phobia, making it harder to leave.
For agoraphobia to be diagnosed, you must meet these criteria:
Anxiety about being in places or situations that it may be difficult or embarrassing to get out of, or in which you may not be able to get help if you develop panic-like symptoms
•Avoiding places or situations where you fear you may have a panic attack, or having great distress and anxiety in those situations
•Try not to avoid feared situations. It’s hard to go to places or be in situations that make you uncomfortable or that bring on symptoms of anxiety. But practicing going to more and more places does make them less frightening and anxiety-provoking. Family, friends and your therapist can help you work on this.
•Learn calming skills. People with agoraphobia are overwhelmed with worry about losing control or having a panic attack. Working with your health care professional, you can learn how to calm and soothe yourself. You can practice these skills on your own, especially at the first hint of anxiety.
•Practice relaxation techniques. Meditation, yoga and imagery are among the simple relaxation techniques that may help — and you can do them in the comfort of your own home. Practice these techniques when you aren’t anxious or worried, and then put them into action during stressful situations.
•Reach out. Consider joining a self-help or support group, where you can connect with others who understand what you’re going through.
•Avoid alcohol and illegal drugs. These can worsen your panic or anxiety symptoms.•
Take medications as directed. It may take a couple of weeks to start seeing benefits when you first start a medication, but stick it out. Also, don’t stop a medication without first consulting your health care professional, as some medications can cause withdrawal-like symptoms.
•Take care of yourself. Get enough rest, eat a balanced diet and try to exercise every day.•
Talk to Jim and see if he’s been feeling anxious. Maybe such feelings began when he retired and didn’t have to leave the house every day. See if there’s anything he feels he’s missing out on. Share with him your feelings of missing him being out and about with you. Ask him to talk to his medical doctor, or see if he will make an appointment with a psychologist. He could be evaluated and find out what exactly is going on and then, what, if any, treatment might help. There are a number of helpful websites on agoraphobia, and one I’d recommend is the Mayo Clinic: http://www.mayoclinic.com/health/agoraphobia/DS00894/DSECTION=symptoms
Before he agrees to go to a doctor or psychologist, have him do the following things to prepare for the evaluation:
• Write down any symptoms you’ve been experiencing, and for how long. • Write down your key personal information, especially any significant stress or life changes that you experienced around the time your symptoms first developed.
• Make a list of your medical information, including other physical or mental health conditions with which you’ve been diagnosed. Also write down the names of any medications you’re taking. • Ask a trusted family member or friend to be present for your appointment, if possible. Someone who accompanies you may remember something that you missed or forgot. Write down questions to ask your doctor in advance so that you can make the most of your appointment.•
http://www.mayoclinic.com/health/agoraphobia/DS00894/DSECTION=symptoms
On the other hand, perhaps Jim is not anxious at all, but just taking life at a slower pace, now that he is retired. He may be content to stay home and not join the rat race, even the parts you both used to enjoy together. Jim is the expert on his own feelings here, and all you can do is share your concerns, needs and feelings and ask him to explain how he’s changed from his perspective. Sometimes, gays and lesbians do tend to “cocoon” in a relationship, and limit or stop interaction with other friends or activities, keeping themselves focused on their relationship. This may be just fine with them, until the relationship ends due to death or a break up. Then, some of these cocooners realize that they’re out of the social loop and need to make friends at a difficult time in life.

Christine C. Cantrell, PhD
1026 W. 11 Mile Rd,
Suite C
Royal Oak, MI 48067
248-591-2888

Click here to email Christine.

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