Social Anxiety and Depression

In the therapy series, there are statements about social anxiety being accompanied by depression. After reading this a few times, I finally stopped and asked myself, "Am I really depressed and just didn't realize it?" I decided to do a little more reading about the association between social anxiety and depression.

Social anxiety is an intense fear of interacting with people due to fear of rejection, disapproval and judgement. I can say for sure that I am fearful of interacting with people in any type of social situation. On the surface, it's hard for me to tie it to the judgment, rejection and disapproval of others, but internally I know that's the basis of my fear. But the important question to ask, when trying to identify whether depression is also a factor, is whether or not desire still exists.

According to an article submitted to About.com by Arlin Cuncic, entitled Social Anxiety Disorder and Depression, I learned that having a desire to be around people, is what differentiates me from those with depression.

Let me put it this way. If I felt differently around people, would I still have the desire to be involved and around them? My answer is yes, I would. In fact, that is one of the hardest things for me about having social anxiety. I do enjoy friendships and interacting with people but I choose to stay away because of the seizing fears of being around them.

Let me quote from Mr. Cuncic's article, where he illustrates the differences between sadness and withdrawal associated with social anxiety versus depression:

Social Anxiety Disorder and Depression

By Arlin Cuncic, About.com Guide

Updated March 11, 2008

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Social Withdrawal Differs Between SAD and Depression

"Imagine a young college student who wants to make friends and go to parties but fears that she will embarrass herself in front of others. As a result, she stays in her dorm room night after night, wishing she could be a part of the group. Contrast this with the student who avoids social contact because it's just not any fun to her -- the thought of going to parties or getting together with a friend holds no promise of enjoyment.

Although both SAD and depression may involve social withdrawal, the cause of the withdrawal is different. People with SAD withdraw out of fear of negative evaluation by others, while people with depression withdraw due to a lack of enjoyment. People with SAD expect that they could enjoy themselves if they could somehow interact appropriately with others, whereas those with depression don't ever expect to enjoy themselves."

This article made a lot of sense to me and filled in some missing pieces. It actually made me feel slightly better about myself and grateful I'm not dealing with depression. For me, it's not the desire to be involved that is missing, it's the ability.

Do I still feel bad, sad, left-out, a longing to be included, shameful, inadequate and down? Yes, I do. I feel all of those things. I hate missing out on activities and relationships. I hate that I fear the most common every day situations and I hate that I feel like I can't act like a "normal" person. And unfortunately, living with these feelings of inadequacy just fuels the fire for further social anxiety. It's a vicious cycle. But that's where turning away from negative thinking comes in. If you keep the ANT's away (automatic negative thoughts), you also turn away from those feelings of inadequacy, shame and sadness.

And if that's not motivation enough, to heal, you also don't want what could come next if you don't continue fighting social anxiety. According to Mr. Cuncic's article, "if you have been diagnosed with SAD, you are up to six times more likely to develop depression, dysthymia or bipolar disorder. The risk of developing these secondary disorders also increases in relation to the number of social fears that you have."

If you don't want to stay in a place of fear and sadness and possibly develop depression or other complications due to social anxiety, remain focused on turning away from your negative thoughts, keep up with your therapy (whatever it may be) and continue moving forward. All of this, along with a hope for a brighter future and a day when I can look back and see this time in my life as just a distant part of my past, is reason enough for me, to keep fighting.

Controlling automatic negative thoughts

A major obstacle in overcoming social anxiety begins with the ability to turn away from automatic negative thinking. That's what I'm really working on right now.

Every time a thought pops into my mind about dreading something or anticipating anxiety over something I quickly try to put a stop to it. I try to distract myself by repeating a rational thought statement and concentrating on an activity, singing a song or doing something else.

I have caught myself several times this morning flashing with dread upon an upcoming staff meeting. In a few weeks I have a large staff meeting where I will have to introduce myself and will very likely be put on the spot during other team building activities. Since I already know this, I'm trying to rationally prepare for it, while not turning it into an event I dread, with anxiety-filled anticipation.

As soon as it flashes in my mind, within seconds the old me says "I'll make up an excuse and just won't go"...and then the new me says, "Yes, you will go and you will be fine." It's a bit of a tug-of-war.

And when one automatic negative thought tries to take over, another comes behind it. My mind almost immediately starts searching out any other potential threats. For example, someone is teaching my class at church for me for the next two weeks. I know I'll have to give her something to thank her for it. That means I'll have to go to her house and drop it off. That means I'll have to talk to her when I go to thank her. As I write, I know how ridiculous it sounds to dread something as small as talking with someone, but I know I have gotten anxious around her in the past and now it is what I anticipate happening again. But I can't let myself anticipate that or it will pull me down and I will end up making it true.

I've got to figure out how not to dread things. Dreading only makes everything worse. Dread is the the hero of automatic negative thoughts because it not only listens to these thoughts, it celebrates them, builds them up and lets them dominate until the dread has left its thinker feeling completely hopeless and immobile.

I won't give into these lying automatic negative thoughts, but to do so takes a lot of work. It takes a lot of energy. It has to be a conscious choice. Every day I feel the work that is involved in turning my thoughts away from the negative anxious thoughts that come so easily into my mind. I can only hope that as I continue to turn away from these thoughts that it will become easier and I will begin to naturally turn away without as much energy or focus. That feels good. And so I continue on.

success!

Yesterday I had my annual performance review. All day I kept forgetting it was coming and then suddenly remembering. From peaceful to a punch in the stomach. I hate that feeling. The remembering part.

So all morning, every time I felt the grip of anxiety start to come over me, I would reassure myself that I would be fine. And amazingly enough, some of the positive statements from my therapy naturally popped into my head. It was relieving to realize the therapy is really seeping into my brain right where it's supposed to be!

One thing I have always known about myself, is that if I'm as prepared as I can be, it will help alleviate some of my anxiety. So I had prepared myself. I had written out a list of goals for the coming year. I had compiled a list of successes from this past year. I wrote out a list of things I love most about my job. You never know what they're going to ask you.

As I took the hot seat, I continued repeating calming, positive, rational statements in my head. As a mini wave of anxiety began, I replaced it with positive, rational statements. This continued all the way through the review. And to my surprise, I wasn't asked to share anything I had prepared. My boss did all the talking. I guess I'm used to my past higher level positions where it is expected to have those types of things prepared. Oh well, at least I walked out with a success under my belt!

Old habits are hard to break

The Relief Society President just left. I made myself go through with the visit, despite my anxiety. That alone is a huge accomplishment for me and I deserve a pat on the back.

Instead of really focusing on talking about my anxiety with her, however, I inadvertently lead the conversation in a different direction. I'm so good at that. And even when she directly asked if I've suffered from anxiety in the past, I found myself saying, "not really", and explained that even though I'm more introverted, it hasn't been a huge issue and that I really wasn't sure where it was coming from (um, if you're talking about 10 years ago!).

Anyway, I did try to explain that it's hard for me to have one-on-one meetings with people and sometimes in groups and that right now I just can't do visiting teaching. As she listened, she tilted her head and tried to understand what I was talking about...and maybe that was my cue. It was at that point that I proceeded to update her about my husband's and my inability to have children. Nice transition. What?

And although it was actually really nice to talk to someone about our infertility struggles, and she was very kind and offered some good suggestions on how to cope, I had skirted the issue I should have shared. And with her limited information, she concluded that my anxiety was related to the stress of infertility. And although on some layer there's probably some truth to that, I know my social anxiety stems from my past and I know I've struggled with it for years. But knowing all of this, I think in the back of my mind I also knew, that such a discussion might be better suited for a therapist, rather than a relief society president.

Near the end of our conversation, she asked about having our home teachers and visiting teachers over. I wanted to laugh out loud. I guess my small, distorted way of describing my anxiety in 5 words or less hadn't done the trick. She still didn't understand that's what I wanted to avoid. And how could she, unless she's really good at piecing together mysteries or reading minds? So I reminded her not to worry about that because it wasn't something I could do right now.

So in the end, as I closed the door, I wondered to myself if it was the right thing to have given her something more concrete like infertility, rather than asking her to try to wrap her head around all that is social anxiety. Because in the end, if she didn't understand, I'd be back where I started. And then I realized that's right where I am because I didn't give her a chance to understand. I'm way too good at that. It's an old habit to break, living with excuses and skirting around the truth for a lifetime. At least she knows there's some reason visiting teaching is hard for me, even if it's not the right reason. Hopefully it will buy me the time I need to work through the things I need to.

It's time for my therapy CD. There's still much more healing to be done.

The voice of truth

I love Christian music. It is uplifting and has reassuring, positive messages.

As I was listening to this song the other day, I realized the message is exactly what I needed to hear. It will be the song I play daily whether in my mind or over the radio waves, to bring me peace and reassurance and remind me that when negativity tries to creep in, that instead, "I will choose to listen and believe the voice of truth".

The voice of negativity and anxiety is the voice of lies and defeat. It tells me to be afraid. It tells me I'll never be able to change and I'll never overcome this. That all is lost. It is the giant in this song. It taunts me and reminds me of all the times I've tried and failed and that I'll never beat this. "But the voice of truth tells me a different story...the voice of truth says, "Do not be afraid!" The voice of truth says, "This is for My glory" Out of all the voices calling out to me, I will choose to listen and believe the voice of truth."

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(click on the title to take you to the song; hit back button to return to this page)

Voice Of Truth

by Casting Crowns

Oh what I would do to have

The kind of faith it takes

To climb out of this boat I'm in

Onto the crashing waves

To step out of my comfort zone

Into the realm of the unknown where Jesus is

And He's holding out His hand

But the waves are calling out my name

And they laugh at me

Reminding me of all the times

I've tried before and failed

The waves they keep on telling me

Time and time again. "Boy, you'll never win!"

"You'll never win!"

Chorus:

But the voice of truth tells me a different story

The voice of truth says, "Do not be afraid!"

The voice of truth says, "This is for My glory"

Out of all the voices calling out to me

I will choose to listen and believe the voice of truth

Oh what I would do to have

The kind of strength it takes to stand before a giant

With just a sling and a stone

Surrounded by the sound of a thousand warriors

Shaking in their armor

Wishing they'd have had the strength to stand

But the giant's calling out my name

And he laughs at me

Reminding me of all the times

I've tried before and failed

The giant keeps on telling me

Time and time again. "Boy you'll never win!"

"You'll never win!"

But the stone was just the right size

To put the giant on the ground

And the waves they don't seem so high

From on top of them lookin' down

I will soar with the wings of eagles

When I stop and listen to the sound of Jesus

Singing over me

I will choose to listen and believe the voice of truth

How social anxiety effects your job

To put it plainly, social anxiety has had a major impact on my ability to work. In the worst cases, people are unable to work at all, in other cases people force their way through each painful day, and for others, anxiety might be limited to specific situations like staff meetings, performance reviews, presentations, etc.

For me, what started out as a bright career path progressing upwards, has plummeted and flat-lined to a level way below my ability and earning potential. I remember the days when I first entered the job force after college. I was full of potential. I was driven and eager to learn. I worked hard and received praise. I was promoted. I was admired and respected. I was recognized as bright and able.

Slowly, as my social anxiety increased, my ability to get through every painful day decreased until finally I quit full-time work and haven't gone back since. It's been four shameful years since I've been able to hold a full-time job. The group staff meetings, one-on-one meetings, presentations, impromptu questions, the overbearing boss, were all too much for me to handle.

Six months after quitting my last full-time job, I tried to hold a part-time job. After about 6 months I quit. It was a small family owned business with way too much interaction for me. Lots of lunches together and invitations for parties and activities outside of work. They wanted us all to be very involved with each other and this brought on a lot of anxiety for me. After many creative excuses for why I couldn't go to things, and people always asking why I couldn't be there, it was time to walk away. It was too much for me.

These days, my part-time, low-level job is all I can do and even now I sometimes feel like I'm hanging on by a thread. In a way I feel like I'm holding my breath - that at any given moment it might be too much for me and one day I'll have no choice but to leave and never go back. But I won't give in and let my negative thinking completely enslave me, so each day I keep going. And somehow I get through the uncomfortable parts of my job. And while I am truly grateful to have the job I do, and the strength to do it, it's hard to feel the judgement and disappointment from my family.

My husband understands it is all I can do at the moment and even with him I feel a sense of shame and guilt that I'm not contributing more (because I know what I should be able to do). And then there's the rest of my family. It's both fortunate and unfortunate that we know our families well enough to know what they're thinking. And deep down in the truest part of me, I know what my family thinks (and who can blame them, with their limited perception?). They think I'm lazy. They think I'm unmotivated. They think I'm okay with barely getting by. And I don't know what is worse - knowing they think things that aren't true or knowing the truth about my social anxiety? I guess I've already answered that question because they have no idea that I'm suffering. And in some weird way I think my mind qualifies what I'm doing in their eyes because growing up I was often told that I didn't try very hard and only did enough to get by. I began to believe the lies; and as I believed them I owned them; and as I owned them it is what I became. So they shouldn't expect much more from me, should they?

So what keeps me going every day? The children I work with. Yes I still feel anxious at our daily staff meetings and yes, I shutter at the thoughts of performance reviews (speaking of which I have one this coming week, gulp), but for me, the children are the reason I can make it.

I love children. Children are healing for me. With children, you get what's real. If they tell you your lipstick is too bright, it probably is. If they tell you you're shouting, you probably are. And because they tell you like it is, you know you'll always get what's real from them. Not the quiet, layered judgement from adults. Children are the most real people on the planet. They are young and pure and haven't bridged the gap between sincerity and judgment.

My prescription for anyone feeling alone, down or unable: spend the day with a child.

And a quick update: the Relief Society President is coming tomorrow morning to talk with me. Of course I've thought of cancelling it about a million times, but each time I remind myself that I can't shut myself off entirely from my ward. Because #1 I really don't want to and #2 because I know I can't - because if I think I can - I will. And then I will be alone, backed into the corner where I entrapped myself; not because it's what I wanted, but because I thought it was necessary.

As for church today? Church is always a test of my strength because it's filled with wild cards. People who could talk to me at any moment. I am always glad I attended, but I'm always exhausted and relieved when it's time to go. I'm hoping that as I go through this therapy that I'll change my negative thoughts about church so I can fully enjoy it and everyone there. Our ward is full of kind, interesting people and I'm on the outside looking in. Hopefully one of these days I'll be inside too.

Social Anxiety Isn't Your Fault

A major lesson learned, as I thoughtfully listened to Dr. Richards' voice guiding me along my path to recovery, is that social anxiety isn't my fault. And it isn't yours either.

Now before you jump to conclusions and think this is about playing the blame game, read on. It is actually not about placing blame, as much as it is taking the blame off of ourselves, and putting it outside ourselves where it belongs.

Think of it this way: none of us were born thinking the worst of ourselves. We weren't born with low self-esteem. We weren't born thinking we weren't good enough. We weren't born thinking we were less than perfect beings. We heard it and learned it from other people. And as we learned it, we began to believe it. And as we came to believe it, we owned it. And through our ownership of it, it is what we became.

To realize social anxiety really isn't my fault gave me a sense of relief, self-acceptance and hope. I had never thought of it in that way, but it rang true with me and finally began making sense.

And although we may recognize one or more major figures in our lives that contributed to our having social anxiety and the depression that comes with it (the two go hand in hand you know; but that is for another post) it doesn't mean we need to focus on blame, which just fuels anger and resentment.

We are on a quest to heal. If we stay in a place of blame, we will only stay in a place of blame and why focus on something we can't change?

I didn't ask for social anxiety.

I didn't choose to have social anxiety.

But what I can ask for is help to overcome it.

And what I choose, is to be whole again.

Pushing forward

Since I last posted, I have done a couple of things.

First, as much as I tried to avoid it, I knew it was something I needed to do. I contacted the visiting teaching coordinator and Relief Society president to let them know I needed a break from visiting teaching for a while, both as a teacher and as a teachee.

I told them in an honest email, that I was experiencing anxiety in certain social situations and needed to take a break from visiting teaching and hope they understood. I didn't want to do it. I put it off for two weeks. I was humiliated having to divulge my secret shame to people in my ward. I have lived it before and didn't want to bring this baggage with me to my new ward. I knew, however, like I did in the past, that if I didn't acknowledge my need to take a break, I would only end up making it more uncomfortable and awkward each time I tried to dodge my visiting teachers or make up excuses with my current visiting teaching companion and teachees.

The Relief Society President emailed back and said she'd been through some things herself and wondered if I was up for a visit. Funny how a visit is what I've been trying to avoid. My instinct has always been to hide out and isolate myself, but I knew deep inside that if I did, I might never come out. So instead of isolating myself and turning away from a hand of friendship reaching out to me, I reached back. She's coming Monday to visit with me. I'm so very guarded about myself and especially about my feelings surrounding social anxiety. I'm hoping it will be a comfort to share my burdens with her and although it will be somewhat difficult to know how to express myself about these things, I do appreciate her gesture of friendship and caring.

I refuse to sit down and accept social anxiety as my permanent condition so I continue daily with the lessons and exercises in the therapy series. I'm still only a few sessions in, but I can feel the truth of what I'm learning. And more than that, I feel a connection with these truths to the gospel somehow and it rings true to my spirit. It is bringing to my mind truths I already know, about my worth. Truths that have been smothered by years of life, criticism and painful experiences. Truths that are peeling back the layers of remorse, pain, defeat, and regret; reminding me who I really am.