No I not mad and/or hysterical

October 17, 2009 5:12 PM

Professional with social phobia

I have social phobia with clinical depression. I have had this pretty much my whole life (panic attacks when I was 6, tending toward agoraphobia when I was a teenager, major depressions.) I pretty much have managed to take control of my life and I do pretty well. I do take medication (Zoloft). I have been in therapy. I am still depressed and have minor panic attacks (especially at night). I also have diagnosed ADD (diagnosed by three psychiatrists)

But I have some practical questions:

1. How do I stop blushing so much? I turn bright red, my chest, neck, face, and ears. It was kind of cute when I was young, but it not so cute now. I look out of control.

2. How do I stop getting teary eyed? I can be talking to someone and it appears to them like I am going to start crying, which I am not. The conversation can be about something serious or what I am eating for lunch.

3. I tend to want to avoid talking to people, but I force myself to do so. Is there a way to get over this dread of talking to some people? I still talk to them, but all the while a little voice is telling me to run away.

4. I try not to avoid social situations even though I really do want to avoid them, i.e., parties, weddings, funerals. My first inclination is to try and get out of going, but eventually I do go. How can i get over this initial fear?

5. When I was a teenager I had the beginnings of agoraphobia. I realized this and forced myself to go out (I am 51 now). I still have a fear of developing agoraphobia.

6. My work requires that I travel by plane once or twice a month. I fret about this for weeks on end. I find it very traumatizing. I am not afraid of flying, it is the going somewhere that I have to fly to that bugs me.

7. People tend to think I am outgoing and fun. I am fun, but the outgoing part is an act and it is very tiring. I would like to be more true to myself (reserved) but then people think I am angry.

Amazingly I do not live in dumpster. Which was my biggest fear. I am a professional with two masters degrees and I make $80,000 a year. Which is a major shock for me, since I was sure I was going to grow up to be a bag lady.

I know about therapy, but my HMO makes it very hard to get it and I cannot afford it on my own. I am hoping you all can share some practical behavior modification ideas that have worked for you.

posted by anonymous to health & fitness (12 comments total)

Wow, I could have written very much of this, and I'm really looking forward to the responses.

On the occasions I have gotten teary-eyed (like you, not crying but it looks like this), I have used the "Please forgive me, my allergies are acting up!" routine. Probably not the right way to handle it, but it's better than the feeling that people think I'm about to cry.

Can you wear your hair in such a way that you can quickly toss it in front of your ears when they feel like they're burning up? I do this, and I wear light makeup that in my mind hides when I am blushing (whether it does or not, I don't know and maybe don't want to know). Just thinking it's a little covered up helps calm me and stop the blushing from continuing. I think.

Regarding the travel, are you overplanning it? If you have everything packed, planned, ready to go too far ahead, you leave yourself more time to think and fret about the trip itself.
posted by dayintoday at 5:50 PM on October 17 [1 favorite]

6. My work requires that I travel by plane once or twice a month. I fret about this for weeks on end. I find it very traumatizing. I am not afraid of flying, it is the going somewhere that I have to fly to that bugs me.

For this issue in particular, it might help to spend some time figuring out why this causes you so much anxiety. I have issues with travel myself, especially when it involves flying, and those issues have nothing to do with the flying itself. (In fact, I think planes are very cool and I love the actual flying part.)

Just for example, I always worry that I'm going to forget something. I got a handle on this by making a written list of everything I need to take, and checking things off that list as I pack them. And for most things, I remind myself I'm not flying to the wilderness. If I forget to pack any socks, I can just buy some more when I get there.

I also worry that something is going to go wrong with the process of getting to the airport and getting on the plane. Will there be terrible traffic on the way to the airport? Will the check-in line be huge, or the security line, or the customs line (if you fly to the US from Toronto, you go through customs before getting on the plane). I tackle this one by showing up ridiculously early, in case of delays. Once I'm sitting in the boarding lounge, the administrative hurdles are all pretty much behind me, and I can relax.

What I'm getting at is once you explore the reasons for your travel anxiety in a bit more detail, you might be able to spot some potential work-arounds for many of those reasons. The ones that are left are then easier to get through.
posted by FishBike at 6:10 PM on October 17 [2 favorites]

I'm confused when you say you make 80,000 a year but can't afford therapy. Also, how do you get your Zoloft - a GP or a shrink?
posted by bunny hugger at 6:31 PM on October 17

Yeah, I know about five people who pay for therapy out of pocket on lower incomes than that. People with high rents and lots of student loans. Dealing with this issue might be an investment with a major payoff in future happiness and increased earning potential.
posted by salvia at 6:40 PM on October 17

The benefit of the doubt would suggest she's, for example, paying for her parents' stay at a nursing home. The 80k demonstrates her competence, not spendable cash.
posted by gensubuser at 6:46 PM on October 17 [4 favorites]

If you're freaking out about plane rides for weeks on end, do you think your medication is really working completely?
posted by kathrineg at 7:42 PM on October 17

Two thoughts (from an introvert who is the daughter of a successful professional who is also an introvert):

1. Do you make time for yourself, alone? It's exhausting for an introvert to spend lots of time being social (even iif s/he enjoys socializing). You need to make sure you're taking the time to recharge your batteries, mentally and emotionally.

2. Have you exhausted all possible low-cost or sliding scale therapy options? In my area (Pittsburgh) I know of one place that charges $10 per session at a flat rate and another that does sliding scale with a maximum of something fairly low (I think it's like $30 max per session). Look into universities with clinical psychology programs--their students and recent grads need clinical hours, so their clinics tend to be very affordable. Your issues are serious and worthy of attention, but aren't so unusual or hard to resolve that a relatively new therapist can't be helpful.
posted by Meg_Murry at 7:52 PM on October 17

I swear by the methods in "The Feeling Good Handbook" by David Burns, MD.
posted by digsrus at 7:57 PM on October 17 [1 favorite]

I have mostly conquered my blushing problem by trying to get as red as I can, when I notice that I'm starting to blush. Somehow the effort to INCREASE the effect makes it go away, I suppose because it distracts me from the downward spiral of "Now I'm even more embarrassed because I'm so red!" After a couple years of doing this, I hardly ever get the uncontrollable blushes any more.
posted by vytae at 8:10 PM on October 17 [2 favorites]

I second digsrus recommendation of the Burns book. It's basically CBT - cognitive behavior training. Another fine book is "Mind Over Mood" by Greenberger and Padesky.

Once you feel a bit more confident, I would suggest Toastmasters as a fun and supportive way of leaving your fears behind you. I've been a member for more years than i can count. I joined because my first attempt at doing a presentation at work was a disaster. I had a rush of panic that left me speechless and someone else had to take over.

After less than a year attending their weekly meetings, I felt a big leap in confidence. Now I can give presentations, no problem. I can get up and speak on any topic off the cuff which I would never have believed i could do. I've been called on at parties to give impromptu thank you speeches or giving a toast. It's kinda neat! Even so, the nervousness never goes away permanently. I find that if i don't keep practicing, i relapse (although never back to the way it was that first time). I think i'll always be shy and quiet but it no longer gets in the way of doing things in the world.

The biggest thing i learned from Toastmasters is that social anxiety is a learned behavior and therefore it can be unlearned.

Finally on a tangential note i recommend exercise (real hearty aerobic stuff) three to five times a week as a powerful mood changer. I remember reading that it is more effective than pharmaceuticals. The effect takes a while to kick in but if you give it a month, it's pretty amazing.
posted by storybored at 9:04 PM on October 17 [2 favorites]

I just tell people. Especially when you get to feeling like you're going to have hysteria if you can't find some nice little corner to sit in while you silently scream it's amazing how just confessing it can elude both sympathy and conversation.

Have something to talk about can help. Back to the full-disclosure concept, I've found it helps to know your Myers-Briggs results. Mine comes out introvert off the scale despite my being a rather outgoing person on the surface. Lots of people know their Myers Briggs type, and if they don't you have an instant topic of conversation (plus, there's an app for that so everyone can pull out their smart phone and get instant results). The other thing I do is give myself a task-- at events for my own organization I have managed to become the photographer. This forces me to interact, which is important to my job, while taking the focus of the interaction away from having to do scary things like engage in conversation or look people in the eye.

But really, I've found full disclosure to be the best thing. One remark from you "god I hate these things I never know what to say or how to act" will get all the extroverts off and running, and will give the closet introverts and social phobes cover. You'll be a star.
posted by nax at 7:41 AM on October 18

Let go of changing the blushing and teary eyes. While our culture might expect us all to be like Arnold Schwarzenegger, we just aren't. Say and do what you need to do even when these things happen. Anyway, they're kind of endearing, IMHO.

For the rest, it sounds like you are soldiering through, which I think is the right thing. If you are really suffering more than in the past, definitely talk to your doc and look into therapy. IANAD, but there are other drug options for social phobia, outside of the SSRI class of drugs.
posted by DarkForest at 1:18 PM on October 18