DILEMMAS : How to escape from the prison of agoraphobia

Last week's problem: Ever since she was sacked from her job last year, Greg's wife has become increasingly housebound. She's now not only incapable of getting to the shops on her own, but is finding it difficult to make social visits, even to her parents. She doesn't like Greg going out, and he's overburdened with all the extra shopping and chores. What can he do?

Losing a job involves losing much more than money. You lose friends, status and a disciplined routine. It can lead to depression, and then to Greg's wife's problem, agoraphobia. If she's got a sympathetic doctor - who won't put her problem down to "her age" or palm her off with pills alone - then Greg's wife should consult him. Even so, Greg could play a huge role in helping restore confidence in herself.

They should get books on the subject, and both read them, too, to feel less alone. Contact a self-help group. Then make a trip to the local shop, together, on a quiet day. They need only buy one thing - and Greg should promise that they can turn back any time she wants. If she falters before getting there, not to worry. Greg should be reassuring her all the time. And however far she gets, he should respond with huge rounds of verbal applause. "Brilliant!" he should exclaim. "What courage! You're doing wonderfully!" It'd be true, too, because for anyone who faces the panic attacks that provoke agoraphobia such small ventures are brave indeed.

I've only had one major panic-attack, after the birth of my son, on a walk round normally familiar Hammersmith Broadway, and cripes, was that alarming. I became stranded on a crossing, overwhelmed with terror at the cars that thundered down the road. To me they appeared like wild, rampaging buffalo.

As his wife gains confidence, getting a little further each trip, Greg could then perhaps suggest standing outside a shop while she goes in to buy just one thing alone. And if she feels she might be able to face an evening out with friends, Greg could reassure her that he'd be quite happy to leave with her, without any guilt-inducing sighs, immediately after the meal if she wished.

He should initiate this as soon as possible, because agoraphobia rarely disappears, and the woman's world - it's usually a woman - can get smaller and smaller until she ends up feeling just as trapped in her home as an Iranian hostage in a tiny cell.

While Greg should go on doing the shopping and chores, he can only do it without resentment if his wife's prepared to try to beat her problems. Otherwise, he may continue to do everything, and become either increasingly angry or, as has happened to some men, dependent themselves on their roles as super-copers. Ironically, if and when their wives do make a recovery, these men can then often find themselves losing self-esteem and becoming gloomy and panicky when their powerful role is eroded.

First Steps to Freedom offers one-to-one telephone counselling and an information pack. Send a large sae to 22 Randall Road, Kenilworth, Warwickshire CV8 1JY. Helpline: 01926 851608 10am-10pm every day.

The ex-agoraphobe

A couple of years after returning to full-time work, the stresses of juggling the responsibilities of home and career threw me into a very deep depression. All I wanted was to be left alone, to stare into space and contemplate how to end it all.

My husband used to humour me at first, but he got so desperate in the end that he took the risk of having a huge row and insisted that we go out to the pub and talk, if I still cared for him at all. It brought me back to reality with a jolt. Once I began to talk and cry freely, things improved remarkably quickly, and our marriage has been the better for it since.

Anon, Dorset

The adviser from bitter experience

I found myself in a similar situation when I was cornered into resigning from the Foreign Office because of a bullying manager. I felt a failure in my own eyes, those of my husband and parents and worthless in the eyes of the working world.

My world shrank until the thought of going out to the shops, the pub, even to my old supportive friends, filled me with dread.

If I forced myself to go, my legs soon went to jelly, I had nausea and diarrhoea, cold sweats, shakes and an overwhelming fear that I was going to die. If my husband needed to go out I would feel angry and rejected and in fear of having to cope alone. Yet I had been the practical one, the organised one.

I tried to convince myself that I had some unknown physical ailment. It was by chance that I discovered I was suffering from anxiety attacks, more than another year to face up to my situation and another two to overcome the sometimes suicidal depression and feelings of inadequacy that had set in.

Do tackle her growing social phobia together. Unless you both do something soon the "illness" will become entrenched. It took me five years - years of wasted time for both of us.

Yours sincerely,

Freya Martin, London

The husband who helped

My wife showed the same symptoms as your wife and I was at a loss as to what I could do. First of all your wife has to admit, not only to herself, but also to you, that there is something wrong. She's not going mad, but the stress which she's under probably makes her think that she is. She doesn't want you to tell her to "pull herself together". All that will do is add more to her anxiety. She needs support and understanding.

Although you may feel tempted to say that it's getting too much for you, please don't say it. Try and work out ways in which you can help her to rebuild her life, even if it's going half way down the road with her and then back home again. Don't tell her that there's nothing to be afraid of because the feelings she's getting are so frightening to her.

It took time and patience but now things are fine. Helping her to face her fear in easy stages will enable both of you to begin to rebuild your lives together.

Anonymous, Oxford

N E X T W E E K ' S D I L E M M A

Dear Virginia,

I'm lucky enough to have a spare room in my flat. I used to think friends would often come to stay, but in fact it's only been used twice in the past year. I'm starting to feel very guilty about this extra space, particularly when I see homeless people. I don't want to make money out it, I just want to stop feeling guilty about having so much when many people have so little. I feel like ringing one of the homeless charities and offering my space to someone who needs it. But a friend has begged me to reconsider. She says it would be incredibly dangerous, they might be disturbed, what would I do if they drank - and so on. I am also extremely houseproud and she says my standards are too high for anyone else. Have any readers got any experiences that would help me make up my mind? What should I do?

Listen to my conscience or my friend?

Yours sincerely, Janet

All comments are welcome, and everyone who has a suggestion quoted will be sent a Dynagrip 50 ballpen from Paper:Mate. Please send your comments to me at the Features Department, The Independent, 40 City Road, London EC1Y 2DB; fax 071-293-2182, by Tuesday morning. And if you have any dilemmas of your own that you would like to share with readers, let me know.

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