Social anxiety: The truth about recovery processes

Guest submission:

I am an introvert; I always have been and perhaps always will be. Of course, there isn’t anything wrong with being introverted. I enjoy having my alone time to work on hobbies and recharge my energy levels, because even now, after the remarkable progress I’ve made, being constantly surrounded by people would be exhausting. And that’s perfectly okay. But when the introverted lifestyle is intensified by something pervasive, something like anxiety - or in my case, social anxiety - then there is a problem.

My memory is poor at best. When asked about people or places, or what I did last week, my response is usually a confused shrug. I don’t remember. At least, not in any great detail. However, if I was asked to recall as many anxiety-inducing situations as possible, then I remember nearly all of them. Vividly.

The first of these memories was from Year 1 at primary school. I don’t remember the reason, but my class was tasked with writing a poem and presenting it to the entire school and our parents. On the day, my class was sat across two long wooden benches. Working from the outside in, each class member would stand up and read their poem aloud; I was sat more centrally and so was one of the last to speak. I looked down the entire time while waiting for my turn. I don’t remember any of the poems. I do, however, remember the fear in my heart ever increasing as each class member read their poem, until it was finally my turn. Shaking and stuttering, I awkwardly performed my poem. It was a horrible experience. It was probably horrible to watch, too.

This memory has been engraved into my brain ever since.

Any situation where I was the centre of attention would leave me feeling very uncomfortable and ready to activate my fight or flight response at a moments notice; presentations, sports, public transport, shopping, and basically any situation where there was a large number of people with whom I was expected to interact with. And, at the back of mind the whole time was every anxiety-induced memory.

I was always told that the more times I do something the easier it would become.

Although often said with sincerity, this advice is fatally flawed; I would argue that it would be more accurate to say that the more times you have good experiences with something the easier it would become. No matter how many presentations I gave or how frequently I used public transport, it never became easier, because, from my perspective, I never had any good experiences. For some people simply getting through a presentation would be enough to be considered a good experience, but for me, the transition from near panic prior to the presentation to a blank mind, stuttering and red faced during, to complete exhaustion afterwards, was anything but a good experience. I hated it. I really hated it. How could I possibly overcome this? It felt impossible.

Despite the constant difficulty with social situations I wasn’t aware that I might have a problem until I was 17, prior to this I thought I was just shy. Eventually, I had had enough of the bad social experiences and decided to visit my GP where I was diagnosed with social anxiety and directed to a therapist for CBT (Cognitive Behavioural Therapy). Annoyingly, this was done through a self-referral process. I hated talking on the phone and it took many months to finally convince myself to call and refer myself. In a nutshell, CBT is supposed to help by changing the way you think and behave. Unfortunately, it was completely useless to me; I always thought that I was a fairly logical person, I knew that endlessly worrying about difficult situations would only make them worse, but it made no difference. No matter what I tried, in the end I would ultimately succumb to the panic. With the CBT ending in failure, and now feeling worse than ever before, I decided to trudge through life, avoiding as many difficult situations as possible, instead of returning to my GP. A decision I have come to heavily regret.

Fast-forward a year and I had just managed to finish Sixth Form with enough points to get onto a computer games programming course at university. I consider myself to be very lucky that for the first two years I was able to continue living at home as my university was in commuting range; I don’t think I would have been able to live in university or shared accommodation at the time. As a result I was able to manage the first year by going into lectures and then returning as soon as possible. I didn’t join any societies, although I did make friends with people from my course. The first major hurdle arose in second year where I had to find a years placement in the industry.

This meant going for interviews. How was I going to sell myself if I couldn’t perform? I decided to contact the university for help and was set up with six sessions with a university therapist and a student support worker. I have no recollection of what happened during the sessions, but what I do remember was being introduced to Headspace, a guided meditation app. I tried a few different session and decided that meditation could be just what I was looking for; there were many different modules ranging from anxiety and depression to sleep and creativity, each requiring a different technique. I don’t remember why, but I slowly started convincing myself that I couldn’t keep avoiding every difficult situation. Combined with the guidance from my student support worker, I somehow managed to find a placement and a place to live for the year.

Living alone was a nice change. I could relax as much as I wanted. Do whatever I wanted. But the anxiety was still ever present. For the most part, my placement consisted of programming new features and fixing bugs on a app called Feel Stress Free, which was later renamed to Thrive: Feel Stress Free (contractually, not working directly for Thrive)! There was one major problem however: meetings. As part of the projects workflow, my team would meet on a near daily basis to take it in turns to talk about what tasks had been done the previous day, what tasks would be worked on today, and any issues or concerns which needed to be raised. To me they felt like daily mini-presentations. I hated it. Despite the frequency of these meetings they never got any easier, if anything, they became more difficult as the bad experiences continued to mount.

I continued to meditate throughout my placement year. I found that meditation had almost zero effect on anxiety-induced situations in the moment. That’s not to say meditation isn’t helpful. I found it most beneficial as a way to calm myself and my thoughts on a daily basis, to prevent the stresses of life becoming too much; meditating after a stressful situation also helped me calm down and relax. But during these situations nothing seemed to help, and this was a problem which continued to plague me for years.

My final year of university was certainly my most unstable period. I chose to live with my friends in a house-share as I thought the experience would be good. Although they were lovely people, the combined stresses of coursework, life, and housemates were almost too much for me to handle. I spent most of my time locked in my bedroom. I rarely socialised with them outside of university. Although I regret this, the perpetual anxiety caused me to be so fatigued that if I wasn’t working on coursework then I was sleeping. A combination of events around the end of the first semester led me to be the lowest I had ever been. I was very anxious. I was very depressed. By talking with my student support worker and focusing on my dissertation I was able to slowly regain a little control, but I couldn’t wait for university to be over.

With my degree completed, I joined Thrive and worked directly on Thrive: Feel Stress Free. Despite working for a mental health company, I had never spoken about my own mental health issues, and it wasn’t for nearly a year after I had joined that I first talked about it. After years of struggling with the constant anxiety I had finally broke. I was angry. I was really angry. No matter what I had done to try help myself, nothing ever made social situations easier for me. After five years, I finally decided it was time to return to my GP.

Years of meditation and mindfulness taught me a lot about myself, and for this reason alone I would encourage anyone to try it for themselves. I learned what situations caused my anxiety to flare up and more importantly I learned why. Perhaps this is why it took me so long to finally return to the doctors; I arrogantly thought that because I knew why I was always so anxious that I would be able to fix it myself. I didn’t need the doctors help. More pertinently, however, was that I had convinced myself that my anxiety wasn’t severe enough to get additional help from my GP, and that even if it was, there wasn’t anything else they could do. This was utterly false. Had 17 year old me returned to the doctors after the CBT had failed, then I could have saved myself from 5 years of perpetual anxiety.

Social anxiety is a mental health disorder, so it makes sense that the mental anxiety is the focus. By managing my mental chatter and thought process I would be able to reduce the intensity of my anxiety and, in turn, reduce the associated physical symptoms. Or at least that is what I kept reading online and in books. The problem, however, is that this was not how my anxiety manifested itself.

My experience with meditation and mindfulness had taught me that although there was a lot of perpetual internal chatter, my thoughts were not the cause of my anxiety; rather, the physical anxiety was the catalyst for my mental anxiety. After years of being mindful (or at least as much as I was able to) during social situations, an irrefutable pattern emerged; time and time again, whenever I was in an anxious state, I found that it almost never began with a thought.

Invariably, the physical anxieties would always come first - an increased heart rate, shallow breathing, sweating, shaking and blushing were all experienced frequently. Only then would the familiar mental chatter begin. How did I look? Was I noticeably red? Would other people tease me about it? Why am I sweating so much? I feel so uncomfortable... Most of my mental chatter was, in fact, about the physical anxieties and not the situation at hand. I didn’t care so much about being the centre of attention, I cared about the physical symptoms that would arise as a result. Knowing this, I was sure that in order to manage my social anxiety I needed to deal with my physical symptoms. And I was right. Except, I set about it the wrong way.

The correct approach would have been to go to the doctors who would have been able to help. Instead, I spent years trying to solve this myself. A courageous but ultimately futile decision.

The wait to see my GP felt endless. I felt the most nervous I had in years. Yet, within a few short minutes of the appointment I had explained to my doctor what I knew about my anxiety, how I had been trying to deal with it, and what I thought I needed in order to overcome it - that is, to reduce the physical anxieties. I was offered two medicines. The first was an antidepressant, which I didn’t expect to be given, but has helped stabilise my mood significantly since I started taking them. The other medicine - the one I was really after - was a beta-blocker. Antidepressants are fairly ubiquitous with anxiety and depression, and so is the medicine people most frequently talk about, but for me, the beta-blocker deserves some attention too. They work by blocking the effects of adrenaline, and consequently reduced the fight or flight response I had become so accustomed to.

The combination of these two medicines over the past four months have reduced my anxiety to levels I thought impossible; I have enjoyed more social engagements than all the other times in my life combined, and I am starting to have many more good experiences than bad experiences. Even the bad ones don’t feel so overwhelming anymore. The first few months were not easy, however. Both medicines are well known for their myriad of side effects and I was no exception to them. They made me feel very ill for the first three weeks, and I was unable to sleep for two months. Nevertheless, after trying several different combinations, I finally found the ones which worked for me, and I certainly do not regret taking them.

Despite being the most stable and relaxed I have ever been, I am not completely free from my problems. A lingering side effect of anxiety (and perhaps the medication I am on) is fatigue, which I am having to manage on a daily basis. It would be foolish, however, to think that a lifetime worth of anxiety and fatigue could be treated in just a few short months, so this is but a small price to pay for a stress free future.

Sam GlassComment