Mental illness can make it difficult to leave the house. This can be hard for both us and our loved ones to understand. Particularly if we’re someone who’s always been fairly outgoing, independent, and sociable.
Anxiety When We Leave The House
Anxiety can be part of many mental illnesses; whether diagnosed as a distinct condition or not.
Sometimes it feels like we have an anxiety wall in our doorway. When on the ‘house’ side of that wall, our anxiety is just about at a manageable level. But as we start to pass through that wall, our anxiety builds and builds, until it reaches debilitating levels. Anxiety symptoms can include feeling sick, being sick, struggling to breathe, shaking, crying, and feeling dizzy. We can become so distressed that we breakdown in tears, feeling unable to move in that moment.
Though some of us can manage our anxiety to an extent, and consequently can leave the house occasionally (though it can be exhausting). Others have such high anxiety levels that we need to get back into the safety of our house to breathe and slow our heart rate down.
Fear Of Panic Attacks
For some of us the fear of having a panic attack when outside of the house can stop us from going anywhere.
When we have a panic attack inside our house, we’re likely to have ways of managing it. This could include using physical things such as blankets, apps, breathing techniques, having a particular drink, or playing a specific piece of music.
If we leave the house and have a panic attack then it can be harder to contain it. We can prepare to some extent; we can take our phone (and therefore our apps) with us, pop a drink in our bag, remember our breathing techniques and wear something blanket-like. But the reality is that however much we prepare, we can’t create a magical safe space in the middle of our local shop. As well as being hard to manage when in public, for some of us, panic attacks are more likely to happen when we’re out and about than they are at home.
The fear of having a panic attack and of others seeing us have a panic attack can create another barrier when we try to leave the house.
The Thought Of Social Interaction When We Leave The House
Unless we live in the middle of nowhere, leaving the house usually comes with potential social interaction.
Many of us struggle with social situations; some to the point of living with social anxiety. The thought of having to speak to others can leave us feeling nauseous, shaking, going clammy and stuttering. When living with particularly intense social anxiety; being around people, or thinking about being around people, can cause a spike in our overall anxiety levels.
On top of our worries about seeing other people, we might also worry about people seeing us. Although mental illness doesn’t have a particular ‘look’, it might be that we’ve struggled to dress, wash, put make-up on, or do anything with our hair. We might be embarrassed about our appearance and consequently don’t want anyone to see what we look like.
There are things we can do to decrease the likelihood of seeing or talking to others, such as by heading to more rural areas, wearing headphones, or putting our hood up. But even then, for some of us, the knowledge that people can see us can feel unmanageable.
Living with mental illness is exhausting. Some days, the thought of leaving the house simply feels too much. We’re too tired. Everything hurts. We can barely imagine shifting ourselves to the lounge never mind trundling down our local high street. Sometimes going out can feel like too much of a risk; what if we get so far and then don’t have the energy to get back? So we stay inside.
No Desire To Do Anything
On top of our lack of energy, we might also have a complete lack of interest or motivation in doing anything.
Mental illness can take the joy out of everything. We might not see the point in going outside. Feelings of listlessness can creep in. That coupled with an overriding sense of ‘can’t be bothered’, the exhaustion we feel, and the knowledge that going out might spike our anxiety levels, can make the thought of stepping outside entirely unappealing.
When Bad Experiences Make It Hard To Leave The House
Unfortunately, some of us haven’t always had the best experiences when leaving the house. We may have post-traumatic stress disorder as a result of past experiences. Trauma could have exacerbated or triggered our mental illness(es).
The sense that bad things happen in the world is acute, and for some of us, those bad things have happened directly to us when we’ve been outside of our house. Doing certain things or going to certain places can trigger a trauma reaction and until we’re well enough to cope with that we might have to exercise particular caution when going outside.
Experiencing Things That Others Don’t
Some people hear, feel, see, smell, or taste things that are very real to them but can’t be heard, felt, seen, smelt, or tasted by others. Paranoia can also form part of our illness(es).
If these things affect us, we might have tools to manage them, but sometimes these tools are harder to access when we’re not home.
Furthermore, the outside world could exacerbate some of our symptoms. For example, if we hear voices and we go to a busy place then we might struggle to differentiate ‘our’ voices from the voices of the crowd around us. ‘Our’ voices could become louder and more persistent or aggressive to rise above the noise of the crowd. They might scare us and we might begin to worry that we will be hurt or hurt someone.
Staying inside can feel safer and less distressing than coping with things like this.
For many of us, public transport can be difficult. It often involves lots of people in a small, contained space, and we can only get off at specific stops, rather than having complete control over our ‘escape’, and that can be incredibly anxiety-provoking. Public transport can also involve a lot of thought and planning, especially if we need to take more than one bus or train to get to our destination. Mental illness can affect our concentration, memory, and ability to process information, which can make planning public transport incredibly stressful.
Ways To Manage Leaving The House
There are things we can do to make the outside world feel more accessible.
Firstly, we can control the auditory input we have coming in. We could choose to wear noise-cancelling headphones with nothing playing, listen to the radio or some music, pop a podcast on. The things we’re listening to can both comfort us, help us feel a little less exposed, and reduce our awareness of the world around us. An additional bonus to wearing headphones is that we often find that people don’t approach us or talk to us as much which can help if we have social anxiety.
Although driving can require concentration, for some of us, it can be less stressful than using public transport. Our car can provide a barrier between ourselves and the rest of the world. When planning a journey, we have the option to safely use tools such as a sat nav or Google Maps, to ease the worry we might feel about directions, and such. If we do begin to struggle when out and about, then our car can provide us with some space to be alone.
We could try things like mohdoh, holding something that feels nice in our pocket such as a smooth stone, fiddling with a small toy, using a stress ball, or playing with something that gives us a repetitive motion such as a spinner ring. All of these things can help us to focus and release some of our anxiety.
Managing our breathing can physiologically reduce our anxiety levels. When we get anxious, we often breathe more quickly. This can make us dizzy and disorientated, which can further exacerbate our anxiety. Ensuring that we keep our breathing nice and slow can help to keep our anxiety at a manageable level. We could try using Headspace or Calm as we’re walking, or try an app such as Fear Tools to help us manage our breathing.
Build It Up Slowly
When we start to leave the house again, it’s all too easy to expect ourselves to immediately return to the point we were at before we became unwell.
The problem is, going straight to a full day in the centre of a busy town, is likely to be all too much. We might struggle to cope, and send ourselves spiralling backward as our confidence takes a huge knock.
We need to start small. Leaving the house for the first time is a big step.
We could start, by opening a window, then going outside but remaining within the boundaries of our property, if we have some outside space. Whether it’s spending some time in our garden, or stepping outside of our front door for a few minutes. Repeating these little trips outside not only gives us some fresh air, but can help us to begin to feel comfortable with the outside world again.
From there, we could start to walk up and down our street or around the block. We might choose to do this alone or with someone we trust. After that, we could begin to try places that we know well, or venture to a street 5 minutes from our house.
Visiting a place once is fantastic, but it’s important to repeat that journey and to keep repeating it until we feel comfortable before taking the next step.
We might choose to go out once a week to start with, and slowly build it up until we go out every day.
Recovery isn’t linear. We have good and bad days. There might be a trip that we’ve managed loads of times which one day sends us into a spiral of anxiety. This can knock our confidence, but bad days happen.
We can take our build up as slowly as we like. There’s no rush.
Stopping “The Fear” From Building
When we don’t do something for a while, the fear we have surrounding it builds. The longer we go without leaving the house, the scarier the idea becomes.
For some of us, leaving the house just isn’t an option at the moment. Our illness is such that we need to prioritise other things for the time being.
There are some things that we can do to keep us connected with the outside world. For example, we could spend time in our garden or, if we’re not up to that, then we could open some windows. This provides some fresh air and helps us get used to the noises and smells of the outside world. There might be friends we’re comfortable with who we could invite over. Perhaps we could listen to the radio, use social media if it’s helpful for us, watch YouTube videos, or if we’re up to it, keep an eye on the news.
All of these things can help us to stay connected with the world around us, and to stop us from becoming so isolated and shut off.
Cut Yourself Some Slack
It’s all too easy to start beating ourselves up when we find things difficult that everyone else seems to be able to do without a second thought.
Firstly, we have no idea what’s going on in other people’s lives. People struggling often look just like people who aren’t struggling. There are likely to be other people on the streets we walk down who also find leaving the house to be a challenge.
Secondly, we have an illness. Parts of this illness can make it hard to leave the house. Others, who aren’t unwell, don’t have that layer of ‘stuff’ to contend with when going outside. It’s not our fault that we’re ill. We didn’t choose it.
Leaving the house can be incredibly difficult – and that’s okay! We can only ever do our best and being kind to ourselves is will make tackling these things much easier than being mean to ourselves.
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