Me and Social Anxiety

I’ve wanted to share my experience of social anxiety for a while, but who wants to write on a public blog that you’ve got mental issues? There is still plenty of stigma attached to mental illness, and frankly I feel more comfortable talking about being physically disabled than there being anything wrong with my mind.

Sometimes I’ve told myself that I need to beat it first before I have anything worth saying — so I can write that victorious “how I beat anxiety in 5 simple steps” article. But I don’t know if the internet will still exist by the time I manage that.

I’ll start with a disclaimer (and unsubstantiated opinion) that mental health diagnoses are clumsy groupings at best — different people have very different experiences of the same illness. The brain is a biological network comprising of about 20 billion neurons, and capable of malfunctioning in a near infinite number of ways. My experiences may be very different to fellow anxiety sufferers.

What is anxiety?

Just as depression is not the same thing as being sad, or even being really sad — having an anxiety disorder is not the same thing as being nervous or stressed. When something tragic happens to us, it’s healthy and normal to be sad. When we do something risky or out of our comfort zones, it’s normal to be nervous or anxious. When we work too hard and take on too much responsibility, it’s normal to be stressed. It is a disorder when those things become irrational and debilitating.

Imagine for a moment how you feel when you find yourself in a dangerous situation. The blood drains from your face, your heart starts to race, you have a feeling of dread in your gut. Now imagine waking up every morning for weeks on end feeling like that — or feeling like that whilst trying to do everyday things like have a conversation with someone. That’s anxiety.

Where does it come from?

A lot of people are of the opinion that mental health problems are a biological imbalance that you’re born with, and there’s not much to be done about it besides medicating to restore some balance. My experience of talking to GPs about mental health issues is that they usually won’t do much more than prescribe medication, tell you eat healthily, stay hydrated and do some exercise.

That might work for other people, but for me it’s an incomplete view of my own anxiety, and not a view I’ve found particularly helpful in trying to deal with it. My specific flavour of anxiety is social (or performance) anxiety, and for me it’s not difficult to see a link between that and the challenges I faced growing up with a physical disability. The fear I felt as a child that people would realise I was not physically “normal” — unable to do something because of my hemiplegia — closely resembles the fear I sometimes feel now that people will see I’m not mentally “normal”.

Having said that, there are times when I’m aware of what situation is triggering my anxiety and sort of understand why — and there are times when I feel terrible and haven’t a clue why. Sometimes I can recognise a trigger event, but even after it has long passed and my rational mind is adamant I have nothing to be anxious about, I still feel awful.

Living with it

Social anxiety is tricky one to live with because the fear isn’t necessarily irrational. If I’m afraid of spiders, I may be able to convince myself that handling some (safe) spiders will be good for me — do it, and realise that no harm has come to me. If I’m afraid of certain social situations, I can put myself in those social situations but it is entirely possible those situations will go badly and I’ll come away feeling like my fears were justified.

That can produce a feedback loop — I worry about appearing anxious which makes me more anxious which makes me more worried about appearing anxious which makes me more anxious… and eventually I’ve convinced myself that I’ll have a panic attack in front of whole world — everyone will think I’m a basket case and my life and career will be over, and I’ll have to go live in a cave somewhere, where God forbid I won’t be able to make anyone feel uncomfortable.

For example, on one occasion a few years ago I remember finding out that in about three months time I’d be travelling to a conference. I didn’t think much of it at the time, but over the next few weeks my mind started to fixate on the idea that I was going to be anxious when presenting and meeting colleagues. As hard as a tried not to think about it, soon I was waking up in the middle of the night feeling like my world was going to end at that conference. Not sleeping properly exacerbates the problem and soon I didn’t feel capable of leaving my bedroom, and had to take a few days off work.

That’s my rock bottom and once I’ve hit there I’m surprisingly good at turning things around. I go see a professional, take medication, talk to friends, go for a motorbike ride, and am usually back on my feet in a few weeks. I did all of those things in this particular case, and by the time the conference came around I felt relatively sane — I went, presented a paper, socialised, and even met my wife to be.

Therapy

Over the years I’ve talked to a few different therapists and counsellors, and generally had very positive experiences. Sometimes that therapy has focused on talking about my past, feelings, and all the things I hate talking about — and sometimes it’s been more structured and pro-active like Cognitive Behavioural Therapy (CBT). Sometimes they keep asking me to do breathing exercises and I get bored.

There was a time when I believed that if I just talked about every terrible thing that’s ever happened to me then I’d be fixed, but I find myself increasingly doubtful of that. It seems like there are plenty of traumatic childhood memories deep in my mind, and I can revisit them from time to time, get upset, feel a bit better. But a year later I can be back talking about the same things, feeling the same way.

I’ve found CBT more helpful — its basic idea is that thoughts drive your emotions, and you feel anxious because of how you are thinking about certain things. We all have a certain degree of control over our thoughts and I’ve found this idea quite empowering. I’d like to think it’s helped me avoid starting the anxiety-feedback-loop-spiral many times.

However I’m not sure CBT’s advocates appreciate its limitations. Sometimes, it’s literally impossible to think about a situation differently when past experiences are screaming otherwise, e.g. this impending social situation will go well even tho it never does! Sometimes you need medicinal assistance.

Medication

I think to date I’ve been prescribed about 6 different anti-depressant medications but I can only remember one of them ever helping me. Some didn’t seem to make any difference whatsoever. One only seemed to make me fall asleep, and one made me feel indescribably bad.

The specific medication that I have found to work is far from being a miracle cure. What it appears to do is dull all my emotions, even the good ones — and that puts a limit on how physically anxious I can feel. That gives me the confidence to go about my normal day knowing that although I might feel awful, I’m not likely to descend into anything like a full panic attack.

In weird way I also sometimes like that it makes me feel a bit sick when I start taking it. When I’m having anxiety problems, part of what distresses me is that I feel I have no reason to feel bad — I’m constantly berating myself for not feeling great. Then when medication makes me feel sick, I feel an odd relief at finally having a valid reason to feel like crap.

A bit of nausea also re-assures me that I’m taking real medication and that my doctor hasn’t secretly signed me up for scientific trial and given me sugar pills.

Learning about the mind

Something else that’s helped me (perhaps because I’m a nerd) is reading about how the human mind works — or at least contemporary science’s best guesses. One day when I was reading a book about the evolution of humans, the idea of thoughts driving feelings really clicked. The author was talking about the evolution of imagination and ability it gave our ancestors to simulate the world around them.

If you’re plodding across the prehistoric savannah and you come across a lion — it’s very useful to be able to run simulations in your mind to figure out what’s likely to happen if you fight, if you flee etc. A creature that can’t do such a thing has to learn by trial and error, and if error means becoming something’s lunch, you won’t be doing anymore passing on of genes.

Now if a simulation concludes with DANGER! — the result isn’t handed back to your conscious mind so that you can stand there pondering what to do about it. It goes straight to the bits of your brain that can get you ready to fight or run. Your adrenaline levels shoot up and your heart rate increases. At this point things are out of your control, because there’s no time for control.

Millions of years later I don’t have to worry about bumping into lions, but we live in world where how you perform socially is immensely important. It determines where you sit on the social ladder, whether you can have a good job, whether you have a partner, whether you have friends, etc. To the socially anxious mind, appearing crazy in front of other people (especially any sort of authority figure) can feel as “life-threatening” as meeting a lion.

Talking about it

So for me, the fear driving my anxiety is that people will realise I’m something other than “normal”. The problem is compounded by the ridiculous standard of normality that I try to hold myself to — I must exhibit no problems at all, physical or mental. Sometimes the scariest question a person can ask me is “are you ok?”

But if that is one’s ultimate fear, there is something one can do to loosen its grip — admit the problems! Shout and blog about them if needs be. I’ve been forced to accept over the years that passing myself as a 100% physically and mentally “normal” guy isn’t actually an option. Trying to do that, trying to hide every problem so I can pass myself off as a human ideal, doesn’t work and makes me miserable.

And I’d rather people know I’ve got problems than be miserable.

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