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Social Phobia Disorder

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Also known as Social Anxiety Disorder.

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      16.08.2011 19:32
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      When it's not just a case of being shy

      Social anxiety disorder (also known as social phobia) is characterized by intense fear in social situations causing considerable distress and impaired ability to function in at least some parts of daily life. The diagnosis of social anxiety disorder can be of a specific disorder (when only some particular situations are feared) or a generalized disorder. Generalized social anxiety disorder typically involves a persistent, intense, chronic fear of being judged by others and of being embarrassed or humiliated by one's own actions. These fears can be triggered by perceived or actual scrutiny from others. While the fear of social interaction may be recognized by the person as excessive or unreasonable, overcoming it can be quite difficult.
      (Source Wikipedia)

      ==My Story==

      I can't remember a time when I wasn't shy and didn't find it hard to initiate any social interaction, I'd always thought it was just part of who I was. Coming from a large family with lots of cousins my problems didn't real show themselves until we moved away when I was about ten. After all I knew my cousins really well, we'd spent a lot of time together from birth and I was comfortable with them. My early years at school were relatively trouble free as well. My first school was very small with far fewer children per class than the national average and we'd all started at the same time.

      It was when we moved that my problems really started, moving from an environment where I knew everybody and had my family around me, suddenly there was just me and my younger sister and I was transplanted into an established class of over thirty children. I vividly remember that first day, how sick I felt and how I had to force myself through the door. Perhaps this would be normal for anyone, but this continued for term after term. Throughout my whole life I've found making friends difficult, I've always been jealous of those people that can walk into a room full of strangers and feel at ease, it takes all my effort just to walk through the door.

      As I grew older my problems continued, through the last years of primary and then into senior school. Only I began to somewhat "act out", with my frustrations with not being able to integrate turning into anger. This lead to my first encounter with mental health professionals, with regular appointments with the school psychologist. So at fourteen I was diagnosed with anger management issues and depression and offered counselling for the first time. Only trouble is this counselling was with a complete stranger and remember just the thought of being alone in a room with a stranger scared the hell out of me. So of course I found various excuses not to attend, which is a pattern I followed throughout my teenage and into my adult years.

      Becoming a parent forced me to face social situations, even when pregnant I had to have some contact with complete strangers. The fact that these appointments were necessary didn't make them any less stressful, but by forcing myself to attend I steadily got to know my midwives and doctors, becoming more comfortable with them. Of course there were times when I had to meet different professionals and then I would find myself panicking. Once my children were born, there were a whole new set of circumstances to deal with, mother and baby groups, pre-school and the dreaded school gates. For my children's sake I had to deal with these situations and try not to let them know how terrifying I found them. In fact I think having my children was possibly the best motivator to deal with my social problems and even though I would often be up the night before I did manage to cope with these.

      I even managed to go to a breast feeding support group, but one of my coping strategies is to always turn up early so that I would never have to walk into a room full of strangers, so I was always at the door at least 30 minutes before opening time. Luckily I had been diagnosed with Social Anxiety Disorder a couple of years before I fell pregnant with my youngest, which meant that I had a health visitor who actually understood how I felt, even offering to attend these groups with me. In fact since my diagnosis there seem to have been a multitude of people trying to help, some of which forget that I find it really hard to trust new people.

      I know it's silly to feel so scared of social situations and meeting new people, I know that people aren't really judging me all the time, but that doesn't stop the feelings of pure terror I get just at the thought of walking in a room full of people. I've tried various types of counselling over the years including art therapy and Cognitive Behavioural Therapy, but have struggled so much to cope with just meeting the therapists that I feel I'm wasting my time as I sit in silence. The worst time was when a therapist got me to fill in a form and then told me that my social problems were down to me being at the low end of the autistic spectrum. Now, several years later, I can see where she was coming from, because I'm so scared of and wherever possible avoid social situations, I am very socially naïve. To be perfectly honest I really don't understand people and why they would say one thing and do another. Personally I prefer computers, they are so much more predictable.

      Over the years my SAD became much more defined and there were more things that cause me to have panic attacks. I find crowds of people very difficult to cope with, it just feels like everybody is looking at and judging me. This makes shopping quite difficult, I cannot manage to go shopping in the run up to Christmas without an escort. I also can't cope with the underground on my own, even the thought of it is bringing me out in a sweat. I find making friends difficult, actually making friends demands some sort of social interaction and I'm most likely to be found sitting in a corner at a social gathering. Even worse, when I'm stressed I start to rock, which makes me look like a nutter and means most people keep their distance. But if someone does see past these things and makes an effort to come and befriend me, they'll find that I'm a very loyal friend that would do almost anything for them.

      Of course there are then people that have abused that aspect, taking advantage of the fact that I wouldn't see them go without, which means that the next potential friend has an even harder time at breaking through the shell. Even worse are the abusive partners who honed in on my vulnerability and used my social problems as a way to worm their way into my life and then further distance me from the outside world. I'm not going to say any more on that subject because when all's said and done, that's a part of my life that is best forgotten.

      ===Me Today===

      I still have social anxiety, I guess I always will, but I've found ways of coping with most situations. Firstly I have a fantastic partner who understands that I have these problems and knows all the signs that show I'm becoming distressed. More importantly he knows how to react to those signs, whether I just need to know he's beside me or whether I need to get away. I also have medical professionals who understand that I need consistency of care and that it's not a good idea to suddenly have a new doctor thrust on me. I have a health visitor who has the best of intentions but is occasionally overenthusiastic in trying to help me access different groups. We've also moved to a small village, where I have relatively few neighbours. It took me a while to get to know them, but now I know they are looking out for me as much as I look out for them, and for the first time in my life I actually feel part of a neighbourhood.

      Whatever the future holds, I don't want to pass my fears on to my sixteen month old baby (and hopefully haven't passed them on to the older children). So I force myself to deal with the situations I find stressful, I've already touched on the fact that I turn up to groups early. Well I actually turn up to almost every appointment early, it really is my way of coping. It's all in my head but there's something about being the first in the room that helps me deal with strangers, even just knowing I'm early helps. To be honest there is absolutely no way I could force myself to go to anything knowing I was late, I even turn up at GP appointments half hour early. This also gives me time to calm myself if the panic starts to rise, maybe the only yourself thing I've got out of years of counselling is breathing exercises. A few long deep breathes and the panic moves a bit further down where it can't do any damage.

      One thing I don't do is take any sort of medication, prescribed, legal or otherwise. I did take antidepressants for a time, but these really didn't do much more than mask the problems I was having, the only way I've found of dealing with the fear is to actually face it. (Nothing is quite as bad as I build it up to in my head). At another point in my life I did use alcohol as a way of helping me deal with social situations as it helps to break down the inhibitions I've built up. But of course this only works while drunk and it soon became apparent that I was abusing alcohol and now I barely touch the stuff.

      ===Am I SAD?==

      Everybody experiences the feelings of dread, embarrassment and shyness involved with SAD at some point in their lives, maybe you were waiting to be called in for an important interview and had the sweaty palms, butterflies, nausea and need to pee. When it becomes Social Anxiety Disorder those feelings are pervasive and occur in situations where deep down you know that you shouldn't feel scared, but it happens anyway. If these feelings are preventing you from carrying out normal daily activities then it's a problem and you should speak to your GP about being assessed.

      The earlier you can get the condition recognised the more likely that you will be able to deal with the condition and maybe even beat it. So if you start to recognise the symptoms of anxiety in your child, find that they are excessively shy and wary of people, then please ask if there is anyone that can help either through school or your GP. I received totally inappropriate help growing up and through most of my adult life and now my fears are so deep seated that I don't think I'll ever completely conquer them.

      If you know someone with SAD then please be patient with them. You may think they are unsociable or don't like you, when in reality they are sitting in the corner of the room absolutely terrified that everyone else is judging them. I really wish there had been a few more people that had made that attempt to break through my walls to find the real me. As things stand, I have a small circle of very close friends, who all understand me and realise that I'm not being rude when I don't talk, it's just that I find it so hard to make the first move. They can also cope with how blunt I am, some people think I'm harsh, but the reality is that I say things as I see them, and don't have the social skills to tell the little white lies that everyone else seems to find so easy. And that's something you'll find with many people with SAD, because we find social interaction so difficult, we don't learn the "rules", which of course makes social interaction even more difficult.

      ===Final Words===

      SAD is something I wouldn't wish on anyone, but it's part of who I am, it's something learnt to live with and even in some strange way embrace. Ok, so most people wouldn't find talking to a new health visitor a challenge, but neither would they have the sense of pride at managing to cope with a visit to a baby clinic. All I ask is that people respect that I'm a bit different from them and they don't push me into social situations I can't cope with, even though I will often push myself into those situations. Oh and I'd like them to realise that I may be a bit strange but I'm certainly not mad.

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        31.01.2010 10:09
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        Hope this story helps.

        Im not 100% sure if what I have is a "social phobia disorder" as I have only ever had it explained to be as anxiety, but my story may be able to help those with the condition as it is very similar if not the same.

        I have suffered with panic attacks from the age of 5. The only way I could explain to teachers and my parents what it was I was experiencing, was that I was having a funny feeling. My teachers thought I was just playing up and I got labelled as a problem child. When I was 14 I was sent to see a psychiatrist and was diagnosed with sever anxiety and depression. At this time I would not go to school or even walk to the corner shop, I was petrified. I used to stay in my room looking out my window all day. The more I thought people were staring at me the more likely I was to have a panic attack.

        It took time but after having the medication for a while things started to improve, but at the age of 15 I realised that being on medication made me feel like an outcast, especially as a teenager and although my panic attacks were better my depression worsened. I stopped the medication and decided to overcome the condition on my own.

        My panic attacks felt almost like dejavu, a gut wrenching feeling that wizz's around my body, I got cold, clammy hands and feel very dizzy and if they were exceptionally bad I would blackout and sometimes have seizures. During my pregnancy I realised this was very dangerous as I had a few sever attacks where I had blacked out in the middle of the high street.

        I learned breathing techniques, which are quite basic where by you inhale deeply through the mouth and exhale out through the nose and kept telling myself that it was fine, its just a panic attack, it will go. Once I knew I could handle the attacks I started pushing myself to do things and each time I done them I knew I could do it again. It started off with small things such as going on the bus on my own and now I am at college and am on my way to university. I also found that pilates (yoga) has helped me too. Its been a tough journey and any sufferer of panic attacks have my full support, its not nice to feel terrified. I am living proof that the condition can be controlled, although I still get a little sweaty when I go out into town etc but I haven't had a sever attack for 3 years now.

        If you have actually read this.... Well done!! Sorry to give you my life story, hope it helps. = )

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          16.07.2009 19:22
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          It maps out my life

          Social phobia disorder is something most people haven't heard of but is quite common, I have suffered from it for 12 years.

          I did suffer slightly before that and suffered from depression from the age of 13, I was an over weight child who was also taller than most of the boys in our year and I got teased at school because of this, I also on a few occasions got abuse shouted at me in the street, as a young child who was starting to notice boys I found it very difficult and I believed I would never get a boyfriend.

          My social phobia really all started when I was 16, and I got a job where I had to get a bus to work, I use to panic that I was gonna be late for work and get a bus that got me there an hour early, stood at the bus stop I would count my bus fair over and over and I could constantly have what I had to say to the bus driver going around in my head, I would play out all the situations that may occur, what if there wasn't a seat and what if I had to sit next to someone and what if they had to get off the bus before me, I felt to go into panic mode when I saw the bus coming and would get detached from myself, it is like an out of body experience and the first few times can be quite scary.

          At 18 I move out of my parents and moved 11 miles away, this is when my condition got worse, I got to the point I couldn't get on a bus and had to get a taxi the 11 miles to work costing most of my wage, I ended up getting transfered to a job location closer to home but still continued to get worse, on bad days I couldn't go into shops on my own and even when I did I would constantly check I had the right amount of money and practice what I would say to the cashier in my head. Every outside experience was accompanied with a panic attach.

          4 years ago I got robbed at work at knife point, this made my condition much worse and after a very, very bad experience with my ex husband my social phobia disorder is now at its worse, I have not left my house on my own for over 3 years, when I used to work I got a lift there and back but I have not worked now for over 2 years as I am raising a young family and this as made it worse, I only leave the house with my partner on a weekend or with my mum through the week, some days I can not even take my rubbish out to the bin that is about 10 steps away from my fount door. luckily I have a large enclosed back garden so I can still manage to get fresh air. I am worried as my oldest boy will be starting nursery next year and I will have to walk him there, this panics me already. I am not sure I will be able to do this but know I will have to.

          I went to see my doctor about it and he sent me to a cognitive therapist, unfortunately I found that it did not help me at all and the experience of going made me even worse and more anxious.

          As a result of suffering from this I find I have to plan everything, even when I go to the supermarket with my partner I have to have a shopping list written in isle order and my partner can't leave me to go get something as I panic and start shaking and nearly crying, once I have had the panic attack it takes over half an hour to feel ok again.

          The last time I went out for a drink, over 2 years ago, I needed the toilet and sat for over 2 hours not daring to walk past people on my own as the pub was very busy, in the end my partner had to walk me to and stand outside the ladies toilets otherwise I would have wet myself, I had tears in my eyes but I couldn't stand up and go on my own, I played it out in my head over and over and I just couldn't face going.

          It was hard when I used to work, I was a manager of a shop so if I had any money to take to the post office or I wanted a sandwich from the sandwich shop I would send one of my staff, all my regular staff new about my condition and knew what I needed in order to make it through the day without a panic attack, however if I had staff covering illness who I didn't normally work with I would have panic attacks all day worrying that I would have to go outside, I would avoid eating so I didn't have to ask the other person to get my lunch and so I didn't have to go out myself.

          I struggle when in large groups too, I am constantly going over things to say in my head and constantly rechecking everything I have said, this results in me saying very little and often not speaking at all and by large groups I mean more than 3.

          I find it has been a great barrier in my life, and it is increasingly getting worse, the more I avoid the world the more the world scares me, I am embarrassed about everything, I believe I sound stupid when I talk, I know I am vastly over weight and that I am not very attractive, My disorder does hinder me losing weight as my mum has an illness that means she cant walk any distance so I only get to go for long walks on weekends when my partner isn't working I also have to go for these walks at 8 in the morning so that no one sees me, as part of my anxiety I believe people will laugh at me thinking I am too fat to go walking, my friend and sister have tried to get me to join an aerobics class with them but I know people would laugh at the thought of me exercising.

          It is a horrible disorder but unfortunately I think it is one I am gonna be stuck with, I have gotten so good at avoiding the world I wouldn't know what to do if I had to start living a normal life again.

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            12.05.2009 22:55
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            A fear of dealing with people

            According to the NHS
            (http://www.nhs.uk/Conditions/Phobias/Pages/Introduction.aspx)

            "Social phobia is a fear of social or performance situations, such as a wedding or public speaking. Those with a social phobia have a fear of embarrassing themselves or of being humiliated in public.

            If you have a social phobia, the thought of being in public or appearing at social events will make you extremely anxious and frightened. It is because these types of situations make you feel vulnerable.

            Avoiding meeting people in social situations, including parties or eating in restaurants, is a typical sign of social phobia. In extreme cases, some people are too afraid to leave their home.

            Paruresis, also known as bashful bladder syndrome, is another type of social phobia. This anxiety disorder means that you are unable to use public toilets or urinate when others are nearby. It can make it hard to perform normal activities, such as going to work, attending social events or taking holidays. Paruresis can start at any age and seems to affect men more than women.

            It is thought that 1-2% of men and women have a social phobia, and it is usually linked to low self-esteem and fear of criticism."

            --------------------------
            MY OWN EXPERIENCE
            --------------------------
            Growing up, I always felt that I was 'different' from other people - I was always described as 'shy' and 'quiet' in school, and when I had to give a talk in high school, I was actually in tears. I always really disliked school, and had very few friends.

            When I started uni, I was forced to be more independent (I did force my mum to come with me for registration though!) but there were a few 'strange' things I would do like

            I would wait for a bus, but not get on it if it looked a bit full - I would sometimes wait more than an hour so that I could get on an empty-sh bus, though loads would go past.

            I would find it hard to talk to the bus driver to pay the bus fare, or shop assistants for my size, so I would try and avoid these situations

            If I was lost, I would wander around trying to find my own way (I'm VERY bad at directions!) rather than ask someone.

            I would mess up lab experiments, because I didn't want to ask for help.

            If I did end up at a social function, people would often ask people who were with me 'what's wrong with her?' - not in a mean way - they genuinely thought there was something wrong because I was so quiet and withdrawn.

            --------------------------------------------
            FINDING OUT I HAD SOCIAL ANXIETY
            --------------------------------------------
            Eventually, when I went to the doctor once to get something else checked, the doctor must have noticed something, because she said that I looked upset, and asked me to talk to her about it. She said that I seemed very depressed and wanted to prescribe antidepressants. As I hadn't thought about it, I wanted to know if there were any alternatives; the doctor then decided to refer me to a psychologist.

            After a few weeks, I had an preliminary appointment - I had to talk to someone, who would assess what the next step would be. I don't remember too much about this, but I spoke to a very nice lady about what my problems were and what would help me (I think we discussed depression groups and one to one appointments with a psychologist).

            After about a year, I had my first appointment with a psychologist. After a couple of appointments, she worked out that I had social anxiety, and asked me if I would be interested in a CBT (cognitive behavioural therapy) social phobia group, which was run at the hospital by the psychologist I was seeing plus one of her colleagues. I was very wary but decided to give it a go.

            -----
            CBT
            -----
            The group was run over 10 weeks with one 2 hour session every week (I think).
            The areas covered included; what is social anxiety? Safety behaviours (the patterns of what you do when you feel socially anxious), changing thinking patterns, reducing self- consciousness and building confidence, amongst others. I'll have to dig out my old worksheets to detail everything!

            The first couple of times I went, I was so nervous and shy, I barely looked up. After that, I started to get to know and feel comfortable with the group (there were about 6 of us), and just started opening up a lot more. During the time I was at the group, I started a jewellery making class - something I wouldn't have contemplated doing on my own before, and I used a lot of the techniques I learned in the group to feel more comfortable. I had thought that there would be really strange people at the group, but everyone was perfectly normal, and not all 'shy' - there was one guy who came across as very confident and outspoken but he couldn't give presentations at work, for example. The group really helped me, and the psychologists that ran it were fantastic, especially as one of them specialised in social anxiety, and had previously suffered from it. For a while, I kept in touch with one of the people from the group, but I lost her number.

            -------------------------------------
            WHAT ELSE HAS HELPED ME?
            -------------------------------------
            After the group had finished, and I was advised that I didn't need the psychologist appointments anymore, I found it hard not to go back to my old ways, but a couple of things helped me not to do that. One was the book 'Overcoming social anxiety and shyness' by Gillian Butler, and another was a couple of social anxiety forums, where there are lots of discussions of different issues those with social anxiety face.:

            http://www.sascotland.co.uk/forum/ (you don't have to be Scottish! - it's just a smaller community of mostly those from Scotland) and

            http://www.social-anxiety-community.org/db/

            I've also found it helpful to put my problems in perspective - I do have my physical health, a lovely family, and many other things to be grateful for.

            ---------------
            NOWADAYS
            ---------------
            I find that I'll push myself to deal with situations that may make me feel anxious - and it does help. I can now make a phonecall without building it up for days (though I do still hate answering the phone), and am fine with travelling (I had a job in Edinburgh for a few months, which was a nightmare for travelling - 5 hours per day!, but I got used to it, and I think it made me stronger). I think that being shy is partly my personality, but I do still think I have 'social phobia', though it is probably much milder than before. I think I still need to work on assertiveness a lot, and dealing with people (I had a horrendous time being bullied by a colleague at my old work, and generally found it hard to be scrutinised when carrying out my work) but I believe things will, hopefully keep getting better, as long as I keep making the effort to improve.

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              10.05.2009 23:58
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              Life may be harder, but not impossible.

              Social Phobia or Social Anxiety Disorder as it is sometimes called is the third most common psychological problem in the developed world today. That statistic may surprise many because it virtually unheard of by most. Even the run of the mill GP will have a hard time identifying or diagnosing it for the serious and debilitating affliction that it is.

              What is it you ask? Imagine that tomorrow at work you have to give a presentation to your company's biggest client. If you don't make a good impression the client could very well pull out of the deal and redundancies will need to be made with your job being the first to go. What makes it worse is that you've just started at this company and is the first time you've made a presentation there. Not only are you under the scrutiny of the client but also your co-workers. Do you feel that feeling in the pit of your stomach? Increased perspiration? Difficulty swallowing? When you try to speak does your voice still work? Does you voice still sound like your own or like it belongs to another source?

              So do you have Social Anxiety Disorder? If you don't have it you would surely still have some of those symptoms after all it is normal to be nervous in such circumstances mentioned above. That is a taste of social anxiety. For those with Social Anxiety Disorder (Or SAD'ers) sufferer it is far worse than that and can become the central consideration for all of life's decisions. It won't just rear its head before a major presentation either. In extreme cases it can make the simplest daily task seem like a major battle.

              Social Anxiety Disorder is an irrational anxiety to what is in reality a harmless situation. Even equipped with the knowledge that it is indeed irrational to react this way, the situation doesn't change. In fact it becomes almost a self fulfilling prophesy as the fear about worrying about the situation, and the symptoms it brings, becomes as much a part of the condition as the social situations that brought it on in the first place.

              I suppose the best way to illustrate this point is to tell my story. That's not something I am at all keen on doing because believe it or not, my social anxiety stretches as far as having what I write read by others, especially if it is personal. Writing reviews seems like a strange hobby for me then doesn't it? Well compared with dealing with life face to face it is very much the lesser of two evils.

              OK so here we go. I was always a shy child but some kids are so it is probably not something the average parent will be that concerned about. Also, Social Anxiety was only recognised in 1980 and I was born in 1973 so I guess medically speaking my disorder predated its medical recognition.

              Probably my first memory of not wanting to speak out in front of a group of people was when I was in nursery. As the teacher ran through the names on the register each child replied "Yes Miss," on cue. For the first few days I did it, and then one day I had the realisation that I was speaking in front of a group of people. My name was called, and I couldn't answer. The teacher looked at me and knew I was there so me there was no need to force me to answer but she insisted I did. After that, each day as the register was being called there was an eerie silence when it came to my name. This made me the centre of attention, the last thing I wanted to be, but somehow simply answering my name caused an inner struggle and I just couldn't do it. Eventually I solved this little problem by sitting at the front of the class close to the teacher so that when I answered only she would hear me. I used this method throughout the rest of my school career. Silly right?

              I guess I must have come to terms with my Social Anxiety a little more as time went by because I can't remember too many more moments like that. I did used to go missing my uncles and aunts visited, I cannot remember saying a word to my Grandparents or hardly any other adults until I was 17 and there were plenty of classmates I doubt knew what my voice sounded like. I did have a small group of friends that I could be funny and talkative to. All in all I was ok until adolescence.

              At 14 years old, returning to school after the summer holiday meeting my friends in the playground my Social Anxiety came back with a vengeance. Those who were once my friends suddenly felt like strangers to me and I couldn't speak openly, tell jokes or be myself around them anymore. One on one I was often fine but in a group, I remained silent. I became quiet and withdrawn at school. I stayed on for the 6th form and things became worse. Almost all of my friends left school at the first opportunity and I was now amongst a group of strangers for the first time in my life. I coped with this by saying as little as possible through the whole school year. That paid dividends on my exam results though so it wasn't all bad.

              I left school at 17 and started work. I didn't want to go to work right then but in my mind I knew that if I stayed on at school for much longer I'd never want to start work. I also believed that being shy at the age I was would be easier for my colleagues to accept than if I was 20 or older.

              It would be fair to say that on just about every day of the two years I worked in my first job stay awake half the night worrying and vomited before I left for work in the morning, sometimes on the way to work. I left that job when my YTS came to an end but every job I have had since the pattern was very much the same.

              I became self employed age 29 and that was a breath of fresh air into my life. I stayed out the way and left the shop staff to serve customers while I made the products. This was a very happy phase in my life but trade wasn't so good and property prices were rising so I sold the business before it became worthless.

              As I was now unemployed and had no idea what to do with my life.. Aged 34 I was terrified to start a new job but I had no choice. Being away from people for a few years I had become worse at dealing with social situations without realising it. I hadn't had to go on a bus for a few years, or meet new people, or be in public much at all. With the pressure of having to find a job I withdrew more. I had never got on a bus on my own until I was 17 and that fear came back to haunt me at this time. I had a fear that the bus driver wouldn't be able to hear what I said and I'd be humiliated to have to repeat it. The supermarket presented new problems too. I was worried my hands would shake nervously as I handed over cash, and I worried I would drop the change as the cashier gave me change. In this frame of mind, interviews were going to be a struggle so I looked online to see if there was any help that could help me cope with all of this.

              I searched the internet for days and then by accident I found out about Social Anxiety. I had no idea it existed or anybody else in the world and this same condition. You can't imagine my relief to find out I wasn't alone, I had a real condition. In the past, everybody, and I mean everybody, had told me I was making a mountain out of a molehill. Now I had a name to call it I felt as though I could find a way to fight it. I read everything I could found out ways to relax and thought I was doing quite well.

              I was making progress until I got my first job interview. I was a nervous wreck for the whole 5 days preceding it. I couldn't eat, I couldn't sleep, I was nauseous all the time. If at any point I told myself that I could miss the interview I would have felt instantly better but I couldn't allow myself to do that. The morning of the interview came, I made myself look presentable in my suit and set out to walk the three miles to the interview. I didn't want to have to face both a bus ride and an interview in one day. Unfortunately the nausea overcame me and I vomited in the street halfway between home and the interview. I gave up on the interview. I walked back the way I am came and went straight to the doctor's surgery. I had to wait three days to see my GP (for the first time ever as it happens) and that was a weight on my mind and made me anxious and stressed for a further 3 days. I didn't like speaking about myself and I really did not want to share this with anybody but had my back against the wall and nowhere else to turn.

              Despite being obviously very nervous with my body shaking probably looking rather sick because I had barely had a bite of food for a week my GP offered none of the medication I had read about online, no advice and just booked me in for counselling which took s 13 weeks to begin.

              I did go to the counselling with high hope but I was sorely disappointed. The counselling was of no help to me. Being told to try not to be nervous and do little steps and try to help myself bit by bit was no help at all. In the end I just submitted to saying at counselling in order to just be able to finish the 12 week course then walk away and be on my own.

              I will say that most of the people I have met online that are SAD'ers have found the NHS much more helpful than I have. Maybe it's because of my age, the fact that I am single and have no dependents or because I am teetotal have never taken drugs and therefore unlikely to cause myself any harm through substance abuse, but I have basically been pushed aside and forgotten.

              On the upside, there are a lot of very wonderful people on www.social-anxiety.org.uk/ that helped me and can help you too. I don't post there much but reading the struggles and coping mechanisms that other real sufferers share is of great help to me. Of course I envy those that have a GP that sent them straight for CCBT treatment (find out more about this at www.social-anxiety.org.uk/) but I am very happy for anyone that overcomes this disorder.

              As for me, I found my own solution in taking temporary work when I can get it. Apart from brief introductions temps are mostly ignored and as I am a natural born southerner living in the north most probably just consider me an unfriendly southerner. Doing temping I can feel nervous for a few months then take a break from people. It works for me quite well and I'm actually in a good place mentally these days. My way may not work for everybody however. I'm sure most SAD'ers have a desire to mix with people but are just afraid. I tend not to miss social situations when I don't have them. Maybe it's because of so many years of being afraid that I'm just so used to being alone now.

              Rest assured there is help out there whether on the Social Anxiety website or though your GP. I would definitely say that if you are to get help from your GP you'll have to fight against your anxiety and not be afraid to lose face or make a fuss because that could count against you in the long term.

              My last piece of advice would be to never start hating yourself because of your SAD. Hate the SAD and fight the SAD as best you can but always take good care of yourself.

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                18.02.2009 18:31
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                A wearying condition, but one that is starting to be taken seriously at last

                It is late December and I am sitting in the office on my own desperately trying to make the piece of work I am doing last as long as possible. Next door, a classroom has been appropriated by my team for our office Christmas party and I know that I will have to attend once I have finished this one task. From where I am sitting I can hear the sounds of music, people gathering and laughing, and the chink of wine bottles as they are removed from the kitchen fridge. I know that I will soon have to join in as the party is being held in office hours and I wasn't able to admit that I really don't want to go to it; so I paid up, and regret my weakness more and more as the party approaches and I can do less and less to avoid going to it. Rationally, I tell myself that I enjoy wine, I know there will be good food there and I am familiar with most of those attending so there should be nothing to worry about - but "shoulds" don't really work with phobias. Instead, I focus on my feeling that there will be too many people there and I am not good with people - the word "party" is one of the most terrifying in the English language for me. What if I can't make conversation? What if I do or say something that humiliates me in front of people I have to see on a nearly daily basis thereafter? What if I become the butt of a joke as so often as happened at social events in the past? As I enter the room I can feel the eyes of the people already there turn to face me; I feel very self conscious and hope that my fear isn't showing. Even if they seem nice, everybody must surely notice me blushing, and how can they fail to realise how hard my heart is thumping in my chest or how weak and trembling my voice is when I do manage to speak? They must be thinking awful things about me and the only way out of this is to make up a fake doctor's appointment and leave early, although I sit and analyse the party in minute detail afterwards, ruminating over how silly I must have appeared and feeling embarrassed just thinking about how I behaved. I feel bad about it for days afterwards and make sure I avoid any other social engagements in that time in case those feeling start up again. Instead I stay at home, where I feel lonely but comfortable. Again.

                Welcome to the world of the socially anxious.

                Reading my opening paragraph will no doubt have left many of you thinking that I'm weird (if not downright crazy) and I can't really blame you for this as I felt this way myself for many years. The reason for me behaving in this odd way - and I can assure you, I do understand it is irrational - is because I have suffered from something known as social phobia or social anxiety disorder (not social phobia disorder as dooyoo would have it) since late childhood. I suggested this category to the site a few months ago because I think it is something that there should be more awareness of; it is considered to be the third most common psychological disorder in the Western world (after depression and alcoholism) but it is far less widely known or understood, having only been recognised as a distinct condition as recently as 1980. I cannot find any figures for the UK, but in the US population, it is estimated that around 3 - 4% of people suffer from social phobia at any given time, with there being twice as many female sufferers as male. Since I put in that suggestion, however, I have been putting off writing about something so very personal that could well make the friends I have made on dooyoo think less of me. But that is the very nature of the condition, and it is only after having three months of therapy for it that I feel confident enough to write this without embarrassment; a small thing, but one for me that feels like a step in the right direction at least.


                **What is Social Anxiety Disorder?**
                To begin at the beginning, let me start by explaining what social anxiety disorder is. Most of you will at some point have experienced feelings of shyness or nervousness in a social situation - perhaps having to give a presentation to your class, speaking up at a meeting or going on a date, for example. This may not be the most pleasant experience, but it is entirely normal and you know you will get over it pretty quickly. Equally, some of you will also have experienced a phobic reaction at some point, when you experience irrational fear (and usually recognise the fear as irrational) to something that you know cannot cause you any harm. A common one is arachnophobia or a phobia of spiders (which I also have incidentally), where you know full well that the little creature scuttling across the floor can in no way hurt you but you still experience intense panic and fear when you see it. The usual response to a phobia is an excessive desire to avoid the feared object - not too difficult when it is spiders you are talking about, but rather harder when you have a complex phobia such as social anxiety disorder. Just try to imagine that horrible phobic response triggering in response to common social situations that you can encounter on a regular basis and hopefully you will start to understand just how unpleasant and debilitating (not to mention exhausting) this condition can be.

                In its simplest form, social anxiety disorder is a fear of being around people, and I have heard it described as such. This is not really the whole story, though. It is more specifically a fear of being watched, criticised, judged or rejected by other people, of feeling embarrassment or humiliation in front of other people, and social phobics hate being the centre of attention in particular - so I am fine walking through a busy city street where I don't have to interact with other people, for example, but put me in a situation where there are fewer people but I have to in some way "perform" socially in front of them, then I experience anxiety. This can range from a racing heartbeat to sweating to a dry mouth to going very pale or blushing, and is occasionally is accompanied by nausea as well. I feel a desperate need to get away from the situation, and once it has passed I have a tendency to dissect what happening in minute detail and beat myself up over how I reacted, what I said, or how I must have embarrassed myself. Needless to say, social phobia goes hand in hand with low self esteem and is often accompanied by depression as well. On a bad day it can even make it hard for me to make a phone call (wouldn't I be bothering the person who answered?), especially when there are other people my end who would overhear what I am saying. This is what is known as generalized social anxiety, which affects around 70% of sufferers - the other 30% have a specific social anxiety tied to certain situations (such as public speaking or eating in public) and do not feel anxious in other social situations.

                Such a reaction in inconvenient to say the least. It can make many everyday situations difficult, and many already difficult situations such as job interviews or driving tests pure torture. What is worse, for me at least, is the loneliness it can create, as social anxiety disorder can make it so incredibly difficult to make (and keep) friends. How exactly do make a new friend when the thought of talking to someone you don't know is difficult and actually doing it can make you feel so nervous you begin to worry that you might faint? How might another person like you when your anxiety prevents you from stringing enough words together to make coherent conversation? I have been fortunate enough to make a couple of close friends, but there have been too many occasions in my life when the loneliness has been easier to cope with than the stress of social events that might alleviate it.


                **What Causes Social Anxiety Disorder?**
                This is still an open question, as no one knows the exact cause of social anxiety disorder. There is certainly evidence of there being a genetic predisposition to it, however, as a researcher from Harvard University has demonstrated. He studied children from infancy through to early adolescence and found that 10 - 15% of children were irritable infants who become shy, fearful and behaviourally inhibited as toddlers, and then remain cautious, quiet and introverted in their early school years. In adolescence, they had a much higher than expected rate of social anxiety disorder, suggesting people who inherit certain traits can develop socially anxious tendencies in later life. This fits in with other research I have read, particularly a book called "The Highly Sensitive Person" by Elaine Aron (http://www.hsperson.com/pages/hsp.htm) that I found in my early twenties, and which was the first thing I had come across that suggested that I might not be alone in my particular anxiety. I don't have space to go into this book here, but I can recommend it as interesting reading to anyone who is experiencing similar feelings to me.

                Another physical cause could be an imbalance of the neurochemical serotonin, which has an important role in regulating mood, and incorrect levels in the brain can trigger anxiety and depression. It is also possible that social anxiety may be a learned response; a child with a parent exhibiting stress, fear or anxiety towards social situations may pick up on these cues and learn to fear them themselves. A further idea is that an event a person finds emotionally traumatic may cause the disorder in some individuals in much the same way that other phobias are started off when fear becomes associated with a particular object or situation. I think for this to be the case for social phobia it would require the person to be a bit shy or predisposed to social anxiety anyway, and for something to happen in a social context; this would be more likely to be the case if it happened either in early childhood when we are less able to deal with these sorts of emotions or in adolescence where we feel more socially conscious anyway. Social phobia rarely develops after the age of 25.


                **What Can Be Done About Social Anxiety Disorder?**
                As I stated earlier on, I developed social anxiety in late childhood, through I believe a combination of a predisposition to this sort of anxiety and a couple of key events that compounded this behaviour (which I have no desire to go into here). I therefore spent a good ten years of my life believing that I was alone in my feelings, that I was odd, weird, abnormal or even crazy, until I read "The Highly Sensitive Person" and first began to think that there were others like me out there. I did further research and found that there isn't a huge amount of help available - perhaps because to seek treatment involves social interaction, putting sufferers in a catch 22 situation. Many people with social anxiety disorder chose to self-medicate as alcohol and some drugs lower inhibitions and anxiety and therefore offer temporary relief from symptoms; I can certainly think of several unavoidable social events where I have drunk more than I should to try and relax and be able to talk to people. This is not a constructive way to deal with it of course; research has found that around a fifth of people with this disorder go on to develop alcohol dependence as a result of doing just this.

                The first port of call for many sufferers is their GP, although finding one familiar with and sympathetic to this condition might be easier said than done. Personal experience of overcoming my issues to ask for help with my more serious case of depression has put me off this as a route to getting help (I asked four GPs for assistance, incidentally, two dismissed me without offering any help, one sent me away with a patient leaflet that told me less than I already knew, and one put me on medication for less than the minimum recommended period for depression). The medication I was on was an SSRI (selective serotonin reuptake inhibitor - medication intended to increase the level of serotonin in the brain), which is often recommended as a treatment for social anxiety disorder as well. However, as with depression, the pharmacological approach treats the symptoms rather than the cause and I don't consider them to be anything more than a crutch to help you get through whatever treatment you need to get to the root of your problem. If you don't feel up to asking for help yet, there are various ways that you can help yourself, including taking non-prescription medication (I find Kalms to be quite effective) and trying to explain to someone close to you what you are experiencing to try and get their support. There is also a support group listing (sadly none near me, so I cannot comment) and a helpful chatroom at http://www.social-anxiety.org.uk/ that social phobics may find useful. Also remember that complete avoidance only heightens anxiety at future occasions that you can't avoid (like a job interview), so small amounts of regular exposure to social situations is actually beneficial, however daunting it may initially appear.

                A few months ago I reached a point where I realised that I would have to find some serious help; I had a forthcoming wedding and all my coping mechanisms and strategies for handling my anxiety were never going to manage me being the centre of attention like that for an entire day. Speaking to my partner resulted in him happily agreeing to a small wedding with only 23 guests, a short ceremony and no public dancing to help me, but the thought of being in the midst of an occasion where I would be watched and judged all day just terrified me. In way it is a good thing, though, as it pushed me to seek the treatment I had needed for years. There are a number of different psychological treatments for social anxiety, such as exposure therapy, cognitive behaviour therapy and social skills training (please see http://www.thehealthcenter.info/ adult-social-anxiety/social-anxiety-treatment-options.htm for further information) but with the NHS offering me so little I ended up having to research private therapies available in my area. I figured that if I could alleviate this disorder the effect on my life would be so potentially beneficial that it would be well worth raiding my savings to fund treatment. My choice in the end was a specialised form of hypnotherapy with a therapist who specialised in treating social phobia. The therapy was not easy, but I feel it is helping me to get better; it is something too personal for me to want to discuss in detail, but if anyone wants to know the name and professional organisation of this particular form of therapy, please message me and I will send you it privately. I hope you will forgive me for not wanting to announce it publically so soon.


                **Final Thoughts**
                Well done if you have managed to make it this far; I hadn't intended this to be quite so long, but I'm afraid my thoughts just ran away with me. I guess twenty years of experience mean you have to lot to say when you end up writing it all down. I do hope that I have achieved something through writing this - even if it is just for one person to realise what is happening to them and be able to start getting better. Social anxiety disorder is an unpleasant thing to be lumbered with, but it is not untreatable any more, and I hope my choice of therapy continues to help me improve to the point where I can relax enough on my wedding day to have fun. OK, I am never going to love parties, but I feel more able to cope with (dare I say even enjoy?) social situations more now than I have ever done before. It doesn't have to be a life sentence and I would encourage anyone reading this with social anxiety disorder to try and reach out for the help they need, whichever therapy that may be.


                **Useful links**
                Social Anxiety UK: www.social-anxiety.org.uk/
                Social Anxiety Self Test: www.thehealthcenter.info/selftest.php?id=8
                Royal College of Psychiatrists Helpsheet: www.rcpsych.ac.uk/mentalhealthinfo/problems/ anxietyphobias/ shynessandsocialphobia.aspx

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                  06.02.2009 11:32
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                  It can be overcome!

                  I have suffered from Social Phobia(also known as Social anxiety disorder) for most of my life. Iam now nearly 40 and find myself in the grip of this very disabling condition yet again.

                  Social Phobia in laymans terms is a fear of social situations where it involves meeting new people, being evaluated negatively thus causing anxiety to build up. The effects on your life can be minimal to the extreme such as affecting your job, your relationships and your mental health.

                  I'm currently out of work as I had to give up my job as a taxi driver because I could not cope with the job anymore and my anxiety was causing me to become very depressed. I initially put it down to being bored with my job, but soon realised that the anxiety was rearing it's ugly head again. It creeped up on me over a long period, such as avoiding taking on jobs to make me feel better. Avoidance is the key thing with Social phobia that keeps the fear alive.

                  How to deal with it? I have had many months of therapy over the years that has helped me deal with other aspects of my life, thus eleviating my anxiety to a more manageable level at home. However, you have to keep looking for ways to deal with it rather than just facing your fears. This involves looking at your diet and cutting out things that make anxiety worse, such as coffee which acts as a powerfull stimulant. Foods such as fish contain Omega 3 which have been proven to help with moods and depression. Excercise is something which stimulates the Serotonin in the brain, a chemical which helps you feel good and remain calm. It's just a case of finding what works either through medication and/or lifestyle changes.

                  As for me Iam learning from this condition all the time so am preparing myself for the long slog ahead to get myself back to work and to some normality at least. It's hard but it can be done!

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                    05.02.2009 18:13
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                    If you think you may be overly anxious, I suggest you find support - its everywhere if you look

                    "'You're quiet"

                    I'm not sure where to start with this one, and how easy it is going to be to get into much detail - but to start with just let me say - don't be mistaken into thinking Social Phobia is just your run-of-the-mill shyness.

                    It's quite a serious and debilitating illness that has the potential to drive into every part of your life, and worst of all can lead onto other things (e.g depression, substance abuse as a coping mechanism) as a consequence.

                    Personally I've struggled with problems with alcohol and depression alongside social anxiety. I can't say which came first (the depression or anxiety) but I can tell you that the alcohol has always been used to self-medicate and inhibit my fear of social situations. If you find yourself getting into this situation, I advise you to visit your doctor and talk about it.

                    There is lots of support available out there, and your first port of call is your choice - but visiting your doctor is always a step in the right direction. As counter-social phobic as it might seem - visting one of the various Social Anxiety websites and communities out there can really help aswell.

                    http://www.social-anxiety.org.uk/ This website has a big community of friendly people mostly suffering from social anxiety. It has a chat
                    room and a very active forum too. I'm registered on there myself and frequent the chat room often.

                    I'm sorry it might not be the article you expected, and I hope to put a lot more into words and update the article in the near future so keep checking back if you're interested. I kind of saw the subject and had pressed 'write a review' before I had thought it through properly. Apologies.

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                    20.11.2008 14:58
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                    Social Anxiety Disorder is a fear of social situations.

                    ~What is it?~

                    Social Phobia, now commonly called Social Anxiety Disorder(SA or SAD for short) is a condition where sufferers feel intense fear when engaged in a social situation or when interacting with people, especially strangers.

                    People with this disorder will generally feel deep dread and fear when faced with a social situation. In it's most severe form, constant prolonged anxiety results and can affect a person as soon as they leave their own home, for instance. SA is like a severe form of shyness or timidity but with an extra dose of mental anguish thrown in!

                    There are two types of SA: Performance and Generalised. Performance anxiety only occurs in specific situations like in a job interview or if you have to speak in public. Generalised is the more common type, affecting 70% of those diagnosed with the condition, and the anxiety occurs in any social situation.

                    ~Symptoms~

                    The physical symptoms of this disorder can include blushing, excessive sweating, trembling, difficulty swallowing, passing out, panic attacks, racing heart, inability to speak, stuttering and others. These symptoms will occur when the person is involved in an interaction or social situation. Common related experiences include hands shaking when writing a cheque in front of a cashier or not being able to eat in a cafe.

                    Long term symptoms can include hypersensitivity, inability to form personal relationships, isolation and depression.

                    ~Related Conditions~

                    Avoidant Personality Disorder is often considered to be the severe form of SA and many of the symptoms overlap. Although with APD the anxiety is caused by inbedded beliefs and thought processes. With APD the sufferer presents themselves as a loner and with SA the person tends to want social integration to be their goal.

                    As someone with experience with this disorder I also find that many fellow sufferers tend to have other problems such as depression, sleeplessness or agoraphobia. Childhood conditions like selective mutism can also be associated with SA.

                    ~Treatment~

                    Although it depends on the severity of the SA typical treaments include being prescribed an anti-depressant drug. This is not always because the patient is depressed but the medication can help encourage sufferers to persevere with difficult treatment.

                    Cognitive Behavioural Therapy is another common treatment. This involves gradual and repeated exposure to the situation causing the anxiety.

                    Counselling or therapy can also be treatments for this disorder.

                    ~Help and Information~

                    Your GP should be your first port of call. Support is essential with this condition.

                    There are also many great websites online. I love this UK based discussion board where you can talk to like-mided people:

                    http://www.social-anxiety-community.org/db/

                    There are also more general websites which can explain the disorder in greater detail:

                    http://www.anxietycare.org.uk/docs/social.asp

                    http://www.socialphobia.org/

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