How can I deal with intense social anxiety so I can get on with living?
January 31, 2010 8:50 AM   Subscribe

For the past few weeks, I've been struggling with especially severe social anxiety with people at work and even some of my close friends. How can I reign this in?

I've been struggling with generalized social anxiety for some time now, but it's always been manageable.

A few weeks ago at work, I had a near panic-attack when asked to present something in front of my boss. I sort've laughed it off and blamed it on coffee - but ever since I've been extremely tense and anxious around him. I've been taking klonopin lately when I know we'll be working together during the day - but it only helps a bit. I'm still having difficulty doing basic things like talking about whatever I'm researching at the moment or even what I did over the weekend. This is really unusual, as before that episode of panic I was usually fairly relaxed around the guy. I usually experience the anxiety as extreme tightness in my chest, to the point where I have chest pains and difficulty breathing.

Now I'm experiencing the same debilitating anxiety around some of my friends - having trouble just conversing without seeming like I'm totally losing it.

I keep going to work, and meeting up with friends, realizing that avoidance will just make the anxiety worse. But how is exposure supposed to help when I continue to experience severe anxiety and reinforce my fears?

Have you ever gone through a particularly difficult period of social anxiety? How did you move past that point?

For the record - I'm currently not in therapy because I don't have the money and it's not covered under my insurance. I'm on a waiting list for a university study which will essentially give me 12 free therapy sessions, but that's a few months away. I'm also not on any meds besides occasional klonopin - SSRI's have not been effective in the past.

Any tips, book recommendations, anecdotes to help me cope would be appreciated. Thanks!
posted by anonymous to Health & Fitness (6 answers total) 17 users marked this as a favorite
Check out the Anxiety and Phobia Workbook. It'll give you some background information on anxiety, and give you a start on cognitive-behavioral therapy. (I've found CBT to be ridiculously effective in deaing with anxiety, and one of its great advantages is that it's very easy to do on your own.)

Good luck!
posted by asterix at 9:04 AM on January 31, 2010 [1 favorite]

Oh, and a psychologist I know recommends this site for dealing with panic attacks. (I don't have any personal experience with it.)
posted by asterix at 9:06 AM on January 31, 2010 [2 favorites]

Two tips from one who's mostly put his social anxiety behind him:

1) Quit caffeine; it probably doesn't cause your anxiety, but it almost certainly magnifies it.
2) Exercise. I know it's boring, but if you get good and exhausted three or four times a week, you'll be flooded with all kinds of happy neurotransmitters. Your mood and your confidence will rise accordingly.

Ultimately, books and tapes didn't do much to help me, perhaps because -- like I've noticed lots of smart folks with anxiety/depression doing -- I wallowed under the idea that my anxiety was the result of my perspicacity about how existentially terrifying the world really is. And, though meds did help, they also sapped me of my curiosity and energy, which isn't tolerable for long. I think the trial-and-error process of finding out what works for you will bolster your confidence and ensure that you come out the other side a stronger, more courageous person. Best of luck to you.
posted by CutaneousRabbit at 11:15 AM on January 31, 2010

I find my social anxiety ramps up if I'm separately anxious about something else. So if I'm justifiably anxious about something, I'll end up not able to even go to playgroup or have coffee with friends. My best friend is outgoing and wonderful and extroverted, but if she's worried or scared about anything she rarely leaves the house.

In other words, is there something else bugging you? I was having massive issues until I worked out what the real problem was - then I could work on that, which freed up a bit of the anxiety. I still have it, but my usual methods for dealing will work now.
posted by geek anachronism at 2:34 PM on January 31, 2010

I understand that you are taking meds and have had panic attacks- both of which I have no experience with. That said, here are my two cents.

I have read the following books which deal with anxiety of some sort-

1. Feeling good
2. Under Pressure and Overwhelmed
3. CBT of IBS
4. Systematic Desensitization

I think it really doesn't matter why or what kind of anxiety you have- there is bound to be something in these books that you can work with. For instance, I like the CALM technique mentioned in 3, it can be applied to non-IBS situations just as well. Its all about thinking of things in a certain way, and becoming aware of your self-talk- conscious or not. I haven't seriously tried 4. And I still have bouts of anxiety but I am still working on it. Some of the things I have picked up from here or there have helped, all of which I have mentioned here. Other things that help-

1. Quit caffeine- in any form. Absolutely, no caffeine after lunch.
2. Watch what you eat. Think caveman- try to minimize processed foods, esp if you have allergies or sensitive GI.
3. Exercise, exercise and exercise. Pick something you really enjoy and start slow if you haven't been doing this. Even if you start once a week, you will feel better.
4. Deep, abdominal breathing. I do this at bedtime. Lie on the back with hands on the belly- feel your belly go up as you inhale and down as you exhale. You can also count while you breathe. The number of counts on inhalation are less than that for exhalation when you first start. (they are supposed to even out as you practice more and breathe properly on a more regular basis). I aim to count till 20 esp when I can't sleep. So far the technique hasn't failed to knock me out- so it does work for relaxation. According to Book #2, you can also think of your breath as a rail- sometimes when you slip on the stairs, you just manage to get hold of the rails and don't fall. Your breath is your rail and you always have it with you. Hold on to it when you need to, and hang in there.

For me, realising that majority of people have issues/anxieties of some sort never fails to make me feel better. Talking helps but if there is no one to talk to, it helps to listen to other people's problems and realise that they are going through the same things you may have in the past. No one thing has worked to completely rid my anxiety but I use things from different sources and try to figure out what works best for me. And that usually helps. Also, practicing the techniques you learn, from where ever, is just as important.

Hang in there!
posted by xm at 8:52 PM on February 14, 2010

One more point-

I keep going to work, and meeting up with friends, realizing that avoidance will just make the anxiety worse. But how is exposure supposed to help when I continue to experience severe anxiety and reinforce my fears?

While avoidance isn't a solution, you have to learn a coping strategy while you keep exposing yourself, so that you can practice it when you face the anxiety on subsequent exposures. See #4 above.
posted by xm at 8:55 PM on February 14, 2010

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