Quote from MsDiagnosed
Agoraphobia and all phobias for that matter can be selective. It is very possible that this patient can be comfortable in a certain "safe area" be it a block or a few miles from her home, and be able to travel no further than that. It is also possible that the children are in fact serving as a "support" if she forces them to miss school just to accompany her to an appointment. The child does not have to be in close proximity to make them a "safe person", they can just be in the hall or in the building or even next door---again, this disorder can be selective in how it manifests itself.
In terms of disability, I would encourage the patient to see a psychiatrist who has some familiarity with anxiety disorders in order to determine if they are eligible for disability and to provide proper documentation. I doubt a GP or NP could reasonably make this call as there are so many variables with this disorder. For example, the patient might be able to attend court if they were prescribed a benzodiazapine and one would have to wonder why they were not able to get an Rx for klonopin before the court date. If a trial of klonopin was not sucessful at controlling the attacks then that would have to be noted in the report as it is also possible that someone can not face their fear even with klonopin in their system. It is not for anyone to judge this patient without the full scope of their symptoms and history. They need to be under the care of a mental health provider that can attend to this issue IMHO.
For those that wonder, here's the answer, lol. She IS taking a benzo, three times a day. Claims that doesn't help. She refuses to see a psych. She refuses to do anything other that exactly what she wants to do. We have referred her, to no avail. She cancels the appointments, or just no-shows. This has been documented. It's my suspicion that those notations in her chart, coupled with her refusal to attend the hearing, were what ultimately tipped the scale.
I should preface the rest by saying, while we do do pain management, Doc sees patients for primary care as well. Most, however, are pain patients.
Neither he nor I will even consider attesting to this person's complaint of agoraphobia. We have no way of knowing if she's having us on or legit. It's been YEARS since I did psych.
So, until something gives, I guess we're just where we are.