Describing social anxiety and panic attacks.

July 18, 2008 1:25 PM

What's an effective way to describe social anxiety and panic attacks to people who are unfamiliar with these concepts? Sometimes, there's little choice but to attempt an explanation, on the spot (let's assume you're not carrying around literature with you). How would you handle that? Metaphors? Anecdotes?
posted by zennie to health & fitness (26 comments total)

A feeling of disassociation, like you are outside of yourself. Sheer terror, as if something terrible will happen NOW and you must leave the situation.

BTW everyone knows what a panic attack is. Simply say " 'Scuse me, but I'm having a "moment" here, I must compose myself." (DEEEEEP Breath from the lower belly)

Had them for 40 years until I found Zoloft, changed my life forever now I don't ever have them.
posted by ~Sushma~ at 1:43 PM on July 18, 2008 [1 favorite]

Feeling like you're being suffocated.
posted by sweetkid at 1:46 PM on July 18, 2008

For social anxiety, perhaps relate it to a phobia of snakes, or maybe a fear of heights? People generally get an understanding of those phobias. That's how someone I know finally understood what his relative was going under with social anxiety--because he could relate it to his own irrational fear of heights.
posted by razdrez at 1:48 PM on July 18, 2008

This will obviously be easier if you know the person a little bit:

"You know how you freak out when you see a spider/dog/etc.? I get that way in certain social situations."
posted by theichibun at 1:50 PM on July 18, 2008

To me it feels like I am in a room with a bomb that I know will go off soon - absolute panic, a feeling of impending danger and the need to get out NOW!
posted by The Light Fantastic at 1:51 PM on July 18, 2008 [1 favorite]

My friend who had these described it to me as "it masquerades as whatever makes you feel afraid you're about to die." For her it was a pounding heartbeat. I had a small episode of anxiety attacks myself, and for me it was shallow breathing.
posted by Miko at 1:53 PM on July 18, 2008

Well, the chest pains feel like little knives which keeps you from breathing. It is impossible to escape the feeling of pure embarrassment that consumes the room. Maybe it's really a heart attack. Why is everyone staring? Escape escape escape!

Or just tell them it's like being forced to speak in public without any preparation.
In your underwear.
posted by idiotfactory at 2:30 PM on July 18, 2008

I think a good way to convey it is through analogy. Imagine say on the way to a neighbor's house party you accidentally run over and kill their cat. You feel extremely guilty and ashamed. You should've been paying better attention to the road etc. Yet you can't tell your neighbor at his party because you don't want him to be angry with you and you don't want to ruin his party etc. So the whole time at the party you are really focused entirely on that you just killed his cat, and you have to hyperanalyze everything you say before and after you say it to make sure your words don't reveal you just killed his cat. You can't relax and have fun and you just want to leave. Everything you say is from behind this calculated mask. Social anxiety is sort of like that except there is no explicit source for the shame and self-consciousness.
posted by norabarnacl3 at 2:46 PM on July 18, 2008 [13 favorites]

For me it feels like being crushed, suffocated, and drowned at the same time.
posted by divabat at 2:51 PM on July 18, 2008

The feeling that there's an elephant sitting on my chest.
posted by chez shoes at 2:59 PM on July 18, 2008

"Did you ever watch the Sopranos?"
posted by ook at 3:00 PM on July 18, 2008

you know that dream where you suddenly realise you're naked in public...?
posted by not sure this is a good idea at 3:22 PM on July 18, 2008

This may be the weirdest response you get, but to me it feels very much like my mind is playing chess against itself and has me checkmated - there are no possible escape routes and I'm utterly & completely trapped.
posted by mattholomew at 3:40 PM on July 18, 2008

It feels like drowning but without water. Like a panic of impending doom that is certain. Imagine the feeling of jumping out of an airplane and realizing you ACTUALLY DID FORGET THE PARACHUTE AND YOU ARE GOING TO DIE THERE IS NOTHING THAT CAN STOP IT.

YMMV.
posted by rooftop secrets at 4:09 PM on July 18, 2008

Since I've had the awesome fortune of having dealt with both I can tell you that social anxiety and panic attacks feel very little alike. The basic difference (in my experience) – social anxiety is just drowning in emotional content and panic attacks are mostly devoid of anything except flat-out fear.

Norabarnacl3 more or less covers social anxiety. Another way I think about that is, imagine everybody you meet is a leopard. They aren't necessarily out to eat you (that would be paranoia) but if they wanted to, it would be pretty easy.

With a panic attack you feel like you are going to die very soon. The vector of that death, you will invent. Chest pains, brain stroke, feelings that an artery is going to burst, shortness of breath, numbness, dizziness, feeling like you are about to float away and leave your body there, whatever. Quell one vector, you'll invent another. But it is a thoroughly physical fear, without particular emotional content, though it causes secondary emotional distress, mainly because panic attacks even if you disbelieve them are just unbelievably distracting and make it very hard to keep up with day to day tasks. I've since discovered a considerable contempt for the saying "live every day as if it was your last."

Never actually did the Tony Soprano passing out thing.
posted by furiousthought at 4:28 PM on July 18, 2008 [1 favorite]

I think that suffocation/drowing is probably the most accurate parallel and will produce the closest visceral association.

Someone unfamiliar with panic attacks is not likely to be familiar with true phobias or have thought out how they'd feel in a major catastrophe, and the last thing you need is to get into an argument over the relative scariness of spiders or what they'd do if there was a bomb strapped to their chest.
posted by desuetude at 5:22 PM on July 18, 2008

A close friend described it to me as "drowning in the air", and I got her meaning right away.
posted by ersatzkat at 6:37 PM on July 18, 2008 [1 favorite]

As a 48 year old who's always had social anxiety (really lessened by Paxil though), I like furiousthought's analogy of meeting a leopard but I've never had a panic attack.

A close friend, however, who I've never seen show an ounce of anxiety has panic attacks. He had one after he boarded a plane recently and had to get off and go home.
posted by qsysopr at 7:01 PM on July 18, 2008

Norabarnacl3's description of social anxiety is brilliant. I'm planning to commit it to memory so I can repeat it like a mantra next time I'm faced with this.

As far as explaining this to people who don't experience it, good luck. I've tried. I very nearly got fired one day when my boss made me shmooze a roomful of strangers (many of whom already knew each other- the socially anxious' worst nightmare). I ended up crying in a bathroom stall (very quietly because I was so humiliated). She would not let me leave, and eventually just introduced me to someone to basically "babysit" me. god. Two days later she called me into her office, where I tried to explain the phenomenon, reminded her that I had told her before she hired me that I had this problem and that she could not put me in those situations because I would not be effective even if I managed not to panic. She absolutely did not understand (although I think she's learned her lesson). I'll try norab's wonderful analogy, but I'm not hopeful.
posted by nax at 6:09 AM on July 19, 2008 [1 favorite]

I am just so totally overwhelmed at that point that it's like my body is this big machine that I operate ala the Iron Man suit and there's some sort of malfunction. I'm still there - I just can't get any of the damn controls to work.
posted by damnjezebel at 6:28 AM on July 19, 2008

I can tell you that social anxiety and panic attacks feel very little alike.

Just to clarify, I included both terms because social anxiety is often accompanied by panic or anxiety attacks, which are events that often precipitate the need to explain.

"Did you ever watch the Sopranos?"

Uh, haven't, actually? :/
posted by zennie at 9:50 AM on July 19, 2008

One of the most revered figures in the history of psychology is William James, and your question brings to mind one of his most famous papers: "What is an emotion?"

James used the example of a hiker who happens across a bear in the woods. On observing the hiker, the conventional explanation of the chain of causation is that the hiker sees the bear, feels intense fear, and expresses this fear by elevating heart rate, and breaking out in a cold sweat. Generally speaking, that the order of events is percept, then emotion, then physiological response to the emotion.

James argued against this explanation, and instead suggested that the order of events was that the hiker saw the bear, prepared to run (by increasing adrenaline, heart rate, etc.), and that these physiological changes are what generate the emotion--- in other words, fear comes from the body listening to its own internally generated physiological signals.

It seems that this new order of causation provides for an explanation of a panic attack. If a physiological signal can generate fear, and the fear can lead to a change in thinking (such as imagining a worse outcome), and this new, more worrisome percept boosts the physiological response back at the beginning, you have a positive feedback cycle where what might have originally been a small trigger quickly builds into an overwhelming, spiraling-out-of-control breakdown.
posted by Maxwell_Smart at 4:17 PM on July 19, 2008

When I am not having an attack I describe them as having a gallon of adrenaline dumped into my blood stream all at once and since there isn't anything to fight all I can do is run away. Kinda of metaphorical there. When I am having an attack in public I explain it by saying, "I feel like if I don't leave right now I KNOW I am going to die" That's basically what an attack is like for me. Chest pain, cold sweat, pounding heart, and shortness of breath, and thoughts that I can't control, that I'm dieing.
posted by Kioki-Silver at 8:03 AM on July 20, 2008

Uh, haven't, actually? :/

Then I should clarify, because now I'm worried it sounds like I was just being snarky: the main character has panic attacks (albeit not from social anxiety). It's a recurring plot point on a well-known TV show, which will be familiar to a lot of people -- so referring to it could be a way to shortcut the explanation if you don't want to get into a lot of details.
posted by ook at 1:22 PM on July 21, 2008

Came up with another way of describing this: it's like everyone in the room knows something you don't know and they expect you to know it. The awful part is that it is true-- they all know how to function in a roomful of strangers.
posted by nax at 6:05 AM on July 22, 2008 [1 favorite]

Thanks for explaining, ook. I didn't think you were being a wiseass, I just didn't know what you were talking about.

Thanks everyone for your answers. I highlighted the ones that seem most helpful to me, but hopefully all these answers will be helpful to someone. And maybe there will be a few more before the thread closes.
posted by zennie at 2:16 PM on July 22, 2008