It sounds to me that you really are over analyzing things. In fact, you should be getting better now that you are off your smoking habits.

Of course, saying that your paranoia if you will is a mental issue. As for motivation you probably have lost interest in things that no longer interest you due to an older age. Try something new, get a new dream. See if that works.

However, after reading your thread in more depth I can see that you really need medical help. If it is hard for you to leave the house due to agoraphobia then you need to try your hardest to do so.

Coming here to the forums was a wise decision to make. Seeing how I have not experienced this condition myself I suggest to keep reading for more information.