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Living with Social Anxiety Disorder
This page created Autumn 2003
By Sue Cleland B.A., B.Soc.Wk., M.A.A.S.W.
Social anxiety disorder is a common, yet extremely debilitating condition. I was diagnosed with social anxiety disorder at the age of 30, after living with it for twenty years. I would like to share with you some of my experiences of living with this condition; the distress, loneliness and isolation that engulfed my life on a daily basis, and then share with you how I overcame my fears to live the life I do today.
I remember being around thirteen years old when I was walking across a local park with a good friend, and there was a group of boys nearby who I had previously known. They called out to us, and I remember suddenly feeling overwhelmed with an intense need to escape, to run and hide. I could not turn around and even say "hello." I felt the heat in my face increase and a sensation that the group was all staring at me, whispering things between themselves about me; negative things. I just wanted to run away and disappear, to vanish into thin air. This was my first experience of being more than just shy. This was the onset of the development of a debilitating disorder that was to rule my life for the next twenty years, causing me much misery, distress, isolation, loneliness, lack of respect for myself and physical health problems.
During my childhood years, I was always a fairly quiet child, hanging around the edges, especially with people I did not know. School terrified me, especially when we had to get up in front of the class and give "show and tell." Although I had lots of close friends and enjoyed their company, as well as that of my brother and sister, I made sure I was never the center of attention in a group situation. I always tended to do what others wanted to do, letting everyone else make decisions for me.
Throughout my younger years, I slowly started to develop belief patterns that I was not capable of making decisions, and that in some way I was not good enough unless everything I did or said was perfect. As I entered my teenage years, these beliefs became very entrenched, to the point where I believed that I had to be liked and approved of by every person who came in contact with me. The expectations I had on myself at a very early age were so extreme and unrealistic that I had, in fact, set myself up for failure without even realizing it. As my beliefs were never going to be met, they slowly started to eat away at my sense of self worth, the essence of who I was. By the time I had reached the age of thirteen, my level of self-esteem was incredibly low, and I feared and mistrusted most people in my life, believing that they only wanted to hurt me.
Throughout my teenage years, the thoughts that preoccupied my mind were mainly concerned with how I appeared to others, how I looked, how I spoke, and what other people were thinking about me. These thoughts were all negative and very extreme, and were always accompanied by high levels of anxiety. I had no respect for my body or myself and, as a result, treated myself poorly and allowed others to treat me poorly. I did what anyone wanted me to (apart from my parents) and ended up engaging in some very "rebellious" behaviors throughout my early teens. I learned that when I drank alcohol, my anxiety decreased, and I didn't care so much about what other people thought of me.
As a result, alcohol became a major problem for me. I became very reliant on it, especially when I felt I was in situations in which I was being evaluated. I drank heavily throughout my teenage years and early adult years and tended to socialize with others who also drank large amounts of alcohol. Spring-boarding from alcohol, I started dabbling in drugs, particularly marijuana, also in an attempt to control my extreme levels of anxiety.
Throughout my teenage years, I also experienced extreme mood swings that affected my life greatly. My relationship with my parents deteriorated rapidly as I became more rebellious. When I think about it, my mom and dad were very lenient, considering some of the horror I put them through. When I was fifteen, my mom took me to a psychiatrist to try to find out what was going on. I was told that my problems were a result of how my parents treated me. This could not have been further from the truth. There was never any mention of anxiety or exploration of my belief system. I never went back, and I returned to live my life as only I knew how.
As I continued through life, my self-esteem remained incredibly low, and my false beliefs and thoughts became so entrenched that I could not imagine thinking any other way. As I had been having the same negative thoughts for so long, I now believed them 100%. I was on a train going backward at a very fast pace, and things would only continue to get worse. By the time I was twenty, I had dropped out of courses, as I could not bring myself to give a presentation in front of my peers. I was unable to attend a social event without having a few drinks of alcohol beforehand, I could not sign my name, or eat or drink in front of strangers, as my body would start trembling.
Every time I walked down the street, I believed people were watching me from cars or buildings, waiting for me to trip over and make a fool of myself. Every time I entered a room full of people, I believed they were all staring at me, judging me, thinking, "What is she doing here?" Every time I spoke with someone, I believed they could see straight through my eyes and into my soul and they knew I was a quivering mess inside. As I got older, I developed more and more unhealthy coping mechanisms in an attempt to cope with the fear of what people were thinking of me and the high levels of anxiety I experienced as a result of this intense fear. Some of these coping mechanisms included avoiding all situations in which I thought I would be judged, isolating myself from my family and friends, continuing to depend on alcohol and other drugs to make me feel relaxed, binge eating patterns, and constantly moving house and interstate in an attempt to find a place free from fear. All these coping mechanisms were Band-Aid approaches. They only relieved my anxiety temporarily and made my life miserable, further impacting on my already shattered self-esteem.
Once again, at the age of 22, I visited another psychiatrist, who, at the first mention of some of my symptoms of anxiety, wrote me a script for Xanax (a short-term anti-anxiety medication) to take when I felt anxious. There was no exploration of how long I had been experiencing high levels of anxiety, or in what situations it occurred, or any type of therapy to assist me in learning to control it. Once again, I never went back. Xanax became just one more unhealthy coping mechanism that relieved my anxiety on a temporary basis only. I became dependent on Xanax very quickly, and found it very useful at tutorials and lectures at university. The more I took Xanax, the greater the dose I needed for the same calming effect. And, like all my coping mechanisms, when I wasn't engaging in them, my fear and anxiety remained.
To my friends and my family, I was just Sue-- sometimes moody, impulsive, always on the move, often quiet and a bit of a recluse, who enjoyed a drink. To myself, I was ready to give up on my life. Often, I contemplated suicide. After my earlier experiences with the psychiatrists, I shied away from seeking help from the medical profession, even though I desperately needed it. I believed that if I visited a doctor and told him or her what was really going on in my mind, then I would be labeled as weak, pathetic and a failure-- my worst fear come true. Or they would tell me there was nothing wrong with me, to wake up, "think positive," or "get over it"-- and I had tried-- maybe not in very healthy ways, but in the only ways I knew how. I needed someone to help me find an answer, someone to give me guidance and set me on the right path to understanding where my fear and anxiety was coming from, to inform me of correct treatments, to help me off the train I was on to destination "Self-Destruction."
In the first three months of 1999, I experienced panic attacks every day, barely able to function in my daily life. I was living on the Gold Coast on my own, 15,000 kilometers away from my family and friends. I had totally isolated myself. I was working as a social worker in a psychiatric unit, which just intensified my belief that there was something terribly wrong with me, as I could identify many of my patients' symptoms in myself-- I was withdrawn, preoccupied, and fearful. In the evenings, I would come home and drink alcohol and smoke marijuana, dreaming of another place, another life. any life but mine. I was at the depths of despair, unknown to anyone, as I continued to pretend to my family and friends that everything was fine. In fact, things had never been worse.
March 16, 1999, was the turning point of my life. I was hospitalized for three weeks when I was diagnosed for the first time with social anxiety disorder and other co-morbid conditions, including severe depression, avoidant personality disorder, and potential alcoholism-- all offshoots of living with such intense fear 24 hours a day for almost twenty years.
With a strong determination to beat the fear and anxiety I had lived with for so long, and with support from my family and friends, I overcame my social anxiety and related conditions. Treatment included many different therapies including anxiety education, cognitive-behavioral therapy, anti-depressant medication, self-esteem therapy, reality testing, relaxation techniques, perception/assertion training, interpersonal skills training, public speaking courses, focusing skills, the importance of a balanced lifestyle, and more. The main motivation behind my recovery was my determination to never again have to visit that lonely, miserable and fearful place in which I had spent so many years trapped. I wanted to live a more enjoyable life, free from fear, to develop a sense of self-worth, and to learn to take control and understand my emotions.
I am now 34. It has been four years since I was admitted to the hospital. It has been four years since I was diagnosed with social anxiety disorder. Nine months after my discharge from the hospital, I overcame all of my major fears and anxieties, and started living my life to its full capacity. I replaced unhealthy beliefs with healthy, rational beliefs and started trusting again. I replaced unhealthy coping mechanisms with realistic, evidence-based thinking patterns. And, for the first time in my life, I developed a sense of self-worth and appreciation for the person I am.
I now run the Anxiety & Stress Management Service of Queensland, based in Brisbane, Australia, where I provide both individual and group recovery programs to people whose lives are affected by social anxiety disorder and other anxiety disorders. In addition to this service, I have founded Social Anxiety Australia, an Australia wide community service providing information, education, and support to people around Australia who live with social anxiety disorder, as well as their caretakers, relatives, and other health practitioners. Some of the services of Social Anxiety Australia include an extensive website full of information and resources around Australia, telephone support, advocacy, workshops and seminars, and a fortnightly support group offering hope, support, and encouragement. In addition to the services of Social Anxiety Australia I have also established another Australia wide service Anxiety Network Australia that provides information and assistance to people who live with any of the major anxiety disorders throughout Australia, including Panic Disorder, Agoraphobia, Generalised Anxiety Disorder, Post Traumatic Stress Disorder, Obsessive Compulsive Disorder and Specific Phobias. Both these services fill a much needed gap in our health system for easily accessible information on all aspects of anxiety, where to find local support and assistance.
Social anxiety disorder is very common in our society. It is related to very low self-esteem, and negative, unhealthy beliefs and entrenched thought patterns in which you believe other people are judging you, criticizing you, and scrutinizing your every move. These belief patterns generally develop due to a combination of a genetic sensitivity to "worry," the way you were raised, and/or certain environment experiences. It is also related to placing extremely high expectations on yourself-- that unless you are perfect in everything you do, say, and the way you behave, then those around you will not approve of the person you are. Social anxiety disorder usually develops in childhood or early teenage years, impacting the essence of who you are and your sense of self-worth. As a result, it has an extremely debilitating impact on all areas of your life, including your interpersonal relationships, your social life, your career, and your physical health. Social anxiety disorder is suggested to be the world's third largest metal health problem, behind depression and alcoholism.
It is an illness that has a significant economic impact on our community resources, not to mention the impact on the individual's personal life. Due to the early onset of social anxiety disorder and its chronic nature, it is essential that we dedicate more time, energy and resources to recognizing and understanding this illness in its early stages to prevent a life of suffering and isolation.
Social anxiety disorder is a treatable condition. If you believe you may have social anxiety disorder, tell someone how you are feeling. There is support and treatment available to you to overcome your fears and anxiety and start living your life as you choose. With the right information, guidance, and support, fear can be replaced by healthy anticipation. Lack of self-worth can be replaced by acceptance of one's self and confidence. Isolation can be replaced by a sense of belonging. Lack of control can be replaced by choice. And your dreams and goals can become a reality.
For more information on social anxiety disorder support and treatment, contact Sue Cleland at Social Anxiety Australia or the Anxiety & Stress Management Service of Queensland at 07 33 696 090, e-mail sue@socialanxiety.com.au, or visit the websites of Social Anxiety Australia at www.socialanxiety.com.au and Anxiety Network Australia at www.anxietynetwork.com.au.
Note:
Sue has had her work in the area of anxiety featured in the 'Courier Mail', 'Sydney Morning Herald', 'Good Medicine Magazine', many other community organisation papers and magazines, as well as appearing on television, partaking in a documentary on anxiety, and appearing as a guest speaker at many mental health forums.
Sue's story of recovery from Social Anxiety along with 30 other people from around the world, can also be read in a new book published in America called ' Conquering Panic & Anxiety Disorders' by Jenna Glazter.
Each story has a commentary by Paul Foxman - Director of the Center for Anxiety Disorders in Burlington, Vermont, US. Here is an excerpt from what he said about Sue in his commentary.
"Sue's story about social anxiety explains the condition more vividly and comprehensively than any textbook on the subject. She emphasises a number of key features of social anxiety, and her website provides more helpful suggestions than many therapists have in their repertoire."
'Overcoming Panic and Anxiety Disorders', Glazter, J., 2002 p. 148 Hunter House Publishers, Alameda CA (USA)
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