Q: I am a student in high school or college, how can I recover?

A: Many libraries have Steve Soifer’s book on AP. See your nurse or school clinic about on-campus options for cognitive/behavioral therapy and other anxiety treatment options or support groups. Talk to your parents about your paruresis. Show them information from this web site (see the question above on information for parents of children with paruresis) and try to get them to help find a doctor to get you started on a recovery program. If you don’t get support from your parents, find another trusted person to help out such as a grandparent, aunt, uncle, older trusted sibling, special teacher, school nurse, and even your clergy person if they have had counseling training. Don’t give up if your parents aren’t supportive or are unable to support you due to financial or other concerns. Try to find help through other means. Your life is important, and paruresis does not have to get in the way.

It is common for younger people to feel very concerned about sharing something like paruresis with an adult because of the desire to fit in with the crowd. It is not a sign of weakness or craziness to ask for help. The earlier you get help, the quicker recovery tends to be, so get started now. Most of us who are older have grown to realize that in the scheme of things paruresis is a minor problem compared to the things many “normal” people are hiding. The less you worry about how others will view you when asking for help, the less power you give the paruresis and that will start the process of weakening it and giving you the upper hand in getting better.

Q: I have limited income, what can I do to get treatment?

A: Many doctors and psychologists have a sliding scale fee for patients on a limited income. Talk to your doctor, or use a referral service such as Anxiety Referral Online (http://www.anxietyreferralonline.com) to find therapists that offer this option. If you currently have a physician, he or she may be able to prescribe some of the medications used to treat paruresis so you don’t need to see another doctor for this purpose. It is still preferable to work with a therapist specializing in cognitive-behavioral therapy (CBT) if you can afford one.

Support groups can be a valuable option for those on limited income since they are free. You can set up your own support group if one is not available in your area. Participation in a support group without any other medical or psychological assistance is not something IPA recommends, but it may be the only option for some people of limited means.

The cost of CBT therapy can run around $125 per session, but most therapists will only need to treat you for six to ten sessions. That means it may be possible for you to find the money for these sessions by saving for them, taking on another job if you can find it, or working on other creative ideas.  If a sliding scale is applied, these costs will be lower. Consider volunteering for a mental health services agency in your community. Some of these agencies may have ways of offering treatment for free or at reduced rates in exchange for volunteer work.

Check with your state’s health services agency to find out if they offer options for treatment for people of limited economic means. Many states offer assistance of this type, but the amount of assistance, forms of treatment covered, and requirements for qualifying for benefits vary from state to state.