COVID-19 is a brief and mild disease for many people, but for some the disease is leaving a lasting impact - “temporary agoraphobia,” experts said.
While a condition known as “long COVID” – characterized by lasting fatigue, persistent pain and breathlessness for months - has already been recognized as an aftermath of the condition, doctors say agoraphobia - the fear of leaving the home - is a less reported post-symptom of the global pandemic.
Home confinement and remote working experienced by many during the pandemic are one cause of the condition, as well as a lingering fear over the threat of the virus, according to UAE-based experts.
Dr. Laila Mohamadien, a specialist psychiatrist at Medcare Hospital in Sharjah, told Al Arabiya English that agoraphobia stems from the new adaptation of staying at home for most of the past year, the fear of social contact, and the avoidance of closed or crowded spaces.
“One of the unfortunate outcomes of the pandemic led to people now being scared to leave their homes - a form of temporary agoraphobia,” Mohamedien said.
“People have been adapting for the last six months to stay home, and now that the vaccine is still on trial, no definite cure or prevention except for the PPE and physical distancing, the gradual back to normal life’s, open of malls, back to school, back to work will raise a lot of anxiety and agoraphobia that - in some cases - precipitate panic attacks,” she added.
Agoraphobia is an anxiety disorder that is caused mainly due to neurotransmitter imbalance mainly low serotonin which should be treated by medications in the form of serotonin replacements as a first-line of treatment.
Psychotherapy may also be needed, according to Mohamadien.
“Everything in life is perception and adaptation, after long months of perceiving the outside is a threat to my and my family’s safety by staying home staying safe, and keeping the social distancing. The brain and the subconscious become adapted to avoid the threat, avoid going out to avoid a source of danger, and going out will be a source of anxiety and to get rid of the anxiety simply avoid going out,” she said.
Anxiety on the rise
Dr. Biji Bob Thomas, an internal medicine specialist at UAE’s Aster Clinic, agreed.
“Anyone can develop agoraphobia, especially in response to a pandemic,” Thomas said.
Some people are at higher risk, according to Thomas, such as those with another anxiety disorder including a panic disorder or generalized anxiety disorder.
“People continue to face uncertainty and fear about the virus and what happens next, the long-term effects and consequences of the virus, an even more deadly mutant version of the virus, and more.”
“Add to that work-place based changes, personal relationship changes during the pandemic and an overall fear of the unknown - as none of us know what the post-pandemic era will look like.”
Dr Padmaraju Varrey, a specialist psychiatry at NMC Specialty Hospital in Abu Dhabi, said agoraphobia usually develops after a person experiences one or several panic attacks.
“The person will typically start to feel ill, nervous, embarrassed or fearful in public places, experiencing psychological, physical and social symptoms when they are faced with situations which they can’t escape from, like leaving the home, traveling on public transport or standing in a long queue.
“During treatment for agoraphobia, a person will be encouraged to expose themselves to things that they’re trying to avoid. For example, they may be being encouraged to go out and to meet people.
“Yet, we find ourselves in a time of social distancing, where we are advised only to go out for health problems, to attend to a vulnerable person, for one hour of exercise per day or to buy essential items.
“For someone with agoraphobia, it is important to remember that while it may be difficult to go outside, there are still opportunities to do so. The worst thing you could do is to stay at home and avoid going out and doing things which usually bring you anxiety as it could set back your treatment. So take the opportunities where possible to still engage in day-to-day life while also keeping in line with government guidelines.”
Dr. Reena Thomas, a clinical psychologist at Medeor Hospital, Dubai, said the major impact of COVID-19 is that it confined people to their homes.
“The confinement did actually topple the lives of many. It’s been almost a year since the disease has been first reported. So, people, particularly high-risk group, in various parts of the world have been confined to their homes or safe places to avoid getting infected.
“Now, since people have gotten used to be within their safe place, some may find it a bit difficult to stroll in the public. This is natural as each person reacts to situations differently. This is not be seen frantically. It is quite natural that for some people it might take more time to get back to the normal.
“We should give them more time to cope with the reality.”
Thomas said people can seek help by joining an online support group, breathing slowly through the nose when a panic attack is starting, and engaging in activities and hobbies that reduce anxiety.
But he believes that with the roll out of the vaccine in the UAE people’s fears will begin to fade.
“By and large, most people will be happy with the prospect of an oncoming vaccination rollout, to be outdoors, to be mask free, to socialize and to enjoy their ‘newfound freedom’ away from restrictions,” he said.
Mohamadien also issued advice.
“Always acknowledge to yourself that anxiety is an unwanted unnecessary feeling, which adds nothing or solves the problem, it is only going to trap my thinking to tunnel vision, be more overwhelmed, overthinking, and have a trapped mind.
“Try to adapt yourself to calmness, meditation will add a lot. And remember, life is a mix of bad and good things, the good things for the reinforcement and motivations to keep going but the bad things are more important, as they are life experiences and life lessons.”