Social Anxiety, Let's Talk About It

In my last post I promised that I was done talking about prescription meds as related to depression. Well…

This isn’t exactly that but it’s peripherally relevant. The point of this post is in interest of getting you caught up on where I am. It’s probably more important to me than you so just roll with it or skip it. Reader’s choice.

So, the problem was this weird sensation of feeling breathless, but actually being able to breathe fine. I never put it next to my depression. I figured it was just part of my generally declining physical health. I couldn’t eat. I vomited a lot. My weight went up and down 10 to 15 pounds a month. I was a mess. Still am. At my next doctor’s appointment I described the problem. He asked a few questions.

When does it happen? Usually mid to late morning.
Where does it happen? Work
What’s your work environment? [at the time] I have a private office but I tend to keep the door open because people often need me to help with their projects.

It went on like that. After a lengthy interview he said it sounded like social anxiety. I’d always been a little disgusted by this phrase. It just struck me as silly. Plus there was that stupid tv ad a few years ago where a pencil drawn cartoon circle with a cowlick lumped along feeling all blue because of social anxiety. Doc said that it’s not always quite so pronounced. Without even consciously realizing it, I could be experiencing the symptoms without understanding where they came from.

Here's a more exhaustive discussion of social anxiety

 from the National Institute of Mental Health (NIHM)

This doctor liked to talk. He also liked to brag. He told me a few stories about other patients with similar problems and how he saved them. Arrogant prick or not, he wasn’t wrong, at least in my case.

Propanolol. Apparently it’s a drug that’s been around for a while. Initially it was intended to be a heart medication. However, it’s been discovered as also useful for anxiety disorders. It’s been the only prescription drug that’s helped me in the head-space. When I feel an attack coming on I take the pill. A bit later I realize the attack never came on. That’s it.

This piece published by the Journal of 

Psychopharmacology, Oxford in February, 2016

 provides a great deal of research

 that's been done over the years on propanolol

 as it relates to mental and emotional disorders.

At first I hoped that, perhaps, social anxiety was the chief cause of my depression. I’m introverted. I was a shy kid. I avoid social situations as much as possible. It all made sense. If I’d built up emotional defenses to social situations over the years, I might not even be noticing problems that were right in front of my face. They built up then suddenly I’m having anxiety attacks that were leading to global depression. Unfortunately, propanolol wasn’t the magic bullet. It did solve one problem and I’m glad for that, but I still have a basketful of others.

I think, maybe, there might be a range of social anxiety – kind of like being on the autism spectrum or the Kinsey scale. For instance, say I’m a number 4 on the social anxiety ladder where someone having a harder time of it is a number 7. I don’t know. Just a thought.

That’s it, I promise. I’m done talking about prescriptions. Never fear, there’s plenty more to discuss. I have a whole list sitting here on my desk next to my mouse. If you like my whining there’s plenty more to come.

Pretentious?

Why is it pretentious to use the right word? I got called out for saying that my uvula is vestigial.

That Space Between a Good Time and Bad Memory

I attended an industry event last night. It was great fun. I got to spend time talking to people who actually DO what I spend my professional time just writing about. I met members of the industry that I hadn't yet and spent time with people whom I truly admire for their craft.

The drive home was very happy as I reflected on the night. I'd had a great time, made new friends, and learned a little more about my industry. I thought about the different articles I could write, the magazines I could sell them to, what I could blog about, etc.

Then this morning I woke up and started to work on a blog post. That's when the social anxiety monster started whispering in my ear. He reminded me of a less than intelligent question that I asked. He pointed out how fat I must have looked next to some of the prettier people at the event. And he plainly stated that I clearly embarrassed myself and should never show my face around any of these people ever again.

If I let my typical pattern continue I'll have myself convinced that the night was a total disaster for me within a few days. By next weekend I should be in full on depression mode.

Even if I'm conscious of the process, can I stop it?

My Big Week

This is probably the only work that I’m going to do today.

Last week was probably the biggest week of the year for me, both professionally and personally. I attended the most important annual conference of my industry, I presented two lectures (and was paid well for the effort), my wife came with me for the first time and I tried to do it all without St. Johns Wort.

This was primarily a packing decision and I’m really not sure why I did it. There were other concerns such as being able to take my thrice daily dose without having to answer questions from my colleagues and being overly cautious about airport security but I think that perhaps I just wanted to see if I could pull it off.

Conferences like this one mean that you get to interact with others who uniquely understand your professional worries and joys. It’s always a high and I look forward to this one all year long. Plus just the vacationy aspect of the event, even though one is working the whole time, makes it an upbeat thing. Perhaps I thought that I’d try coasting on this energy.

Now, I was worried about the lecture as you know from previous posts. (I survived, by the way. My wife was very complimentary, which she never is so falsely, and a handful of the audience came up to further discuss the topic both hours so I guess I pulled it off. There was also discussion with the organizers afterwards of my returning next year. So I suppose we should put this in the professional successes column.) But it was the first thing of the week and, again, I thought that I could coast on my relief that it was over and leave SJW out of my life for at least one week.

We left on Tuesday. By noon on Friday I was curled up in a ball in my hotel room bed full of self castigation and doubt. I told everyone that it was a dodgy breakfast burrito that I’d had at a local diner.

I slept for a few hours that day, skipping some of the best seminars of the week, before I was able to roust myself in time to catch the last event of the day. There were meetings on Saturday, too, but I was able to make those.

Overall, the week was good. I mostly enjoyed myself and I feel recharged professionally. I’m taking today to decompress but I learned an important lesson. St. John’s Wort works for me but I have to stay on it or risk a crash. I’m not sure if the pressures and eustress of the week got to me or just the fact that I’d laid the herb aside caused me to plummet but either way I’m convinced that it wouldn’t have happened had I just packed it.

Live and learn!

Too Distracted to be Depressed

A comment on my last post: “Are you alright? Please just post a single line to let us know. K”

I’m really touched, thanks. I’m doing OK. Here are some highlights from my rambly life.

For the last few weeks I’ve been immersed in two speeches that I’ve been hired to present early next month. I’ve had a lot of trouble with them because, though I love the topic and the research is a fun to do, anytime I work on them I start to think about the speeches themselves and my mind clamps shut. Given my social anxiety it should be no surprise that I’m pretty nervous about them. I understand that lots of people have trouble with public speaking so I have no way to compare my reaction to others’ but I haven’t been sleeping, I’m drinking even more than usual which was already more than is healthy, my other work has been neglected, I’ve been prone to overreact often with rage– basically I’m a nervous, twitchy wreck.

I have a good friend who’s enthusiastic about everything that I do. I have few friends but she has lots and most of them seem to like me. I asked her if she could gather some of them for a rehearsal of my speech. She did and Sat. night I got to give it a dry run. Things went pretty well although I have some clear holes that need patching. They kept telling me that I’m charmingly disorganized. The interpretation is obvious.

Otherwise life is churning along. One advantage to having a major roadblock in one’s future thinking is there isn’t room for a good, all encompassing depressive episode. Things haven’t gotten really dark since I misinterpreted my St. John’s Wort dosage earlier this summer. That might be the herb or it might be the speech. If the dark engulfs me later next month I suppose I’ll have the answer to that one.

Finally Hide & Seekis being released on Wednesday. I really enjoyed this book. Look for my review here tomorrow or Wednesday.

It’s made me think again about aromatherapy. New-agey flotsam and jetsam aside this might be a helpful thing for me. I think I’ll look into it sometime after the speeches.

Distractions

I ran out of SJW a few days ago and haven’t noticed a thing. But then I’ve been really busy. Sometimes it seems that if I just keep active then I don’t have the time to dwell on depressing thoughts.

I’m behind with work but that pretty typical for me. In fact I shouldn’t be writing this right now – I have way too much paid writing that I need to do but I’m very distracted right now.

Two reasons:
1) I recently noticed a gig for which I’m particularly qualified. Its main draw is that it is quite different from most of the work I do all day so it will be a break from my normal routine. That and another job means more money and I always need that. So I contacted them yesterday and I can’t focus on anything because I keep checking my inbox. This is unusual. I work for so many people and am always signing up for more work so this process is really rather routine. I’m not sure why this job is sitting larger in my mind than most.
2) I have to get my pictures made tomorrow. I’m sure it comes as no surprise that I hate looking at myself. I don’t think I’m an attractive person and I’ve gained a lot of weight. Add that to a big steaming pile of social anxiety and you get a lot of second guessing and self loathing. I have to get the pictures made because I’m at the point in my career that I need a site about me. (ugh!) My writing is all over the Internet and I’m starting to lecture. I need a spot where everything is drawn together so editors and event organizers can see the whole package.

So I’m not getting any work done because these things are keeping me anxious and distracted. But at least I don’t have time to for depression. I can feel it waiting in the wings, though. No doubt as soon as things slow back down it will come swooping in.

OK, I’m off to order more SJW.

Why St. John’s Wort

There are two main reasons that I’m trying SJW. (It hasn’t arrived yet, by the way.) The first is that it is relatively inexpensive compared to more widely accepted therapies. I live in a smaller community, though it’s by no means remote. The options for most specialized needs are usually limited to one or two. For example, the counselor I’m constantly referring to works at a community funded mental health clinic that adjusts its prices based on the user’s ability to pay. It is the only affordable option that is less than a 2 hour drive away. But when I went I felt locked in to the counselor that they assigned me and I did not like her. Plus her first solution was medication; a medicine that my insurance doesn’t cover. So, though the cost of the visits are tempered, the prescription isn’t.

The second reason is that I can order SJW through the mail and I never have to look anyone in the eye during the transaction. I don’t know if its society’s stigma against all types of emotional problems or my own social anxiety, but it’s a helluva lot easier this way and I’m less likely to back out of it.

So, this is what I’m trying. I tell myself that I’m going to start walking each morning. I don’t know if I actually will but that’s what I tell myself. Right now I’ve designed a life that doesn’t require me to leave the house for days at a time and that’s probably not the best thing for my emotional health even if it’s more comfortable. Maybe with a combination of these two things the lows won’t be quite so low.

Of Interviews and Dating

My interview yesterday went pretty well. I wasn’t really even that nervous although I have to admit that I knocked back a healthy slug of bourbon when my palms started sweating about thirty minutes beforehand. Maybe not the best option but it did help.

My wife gets impatient with my fear of interviewing people. It’s something that I have to do professionally and so far I’ve wound up friends and mutual admirers with the every subject but I still become a basket case before each one. The worst part about all of this silliness is that, though it’s virtually required for my job, these interviews are never assigned. I have to seek them out.

I hated dating. In my life I’ve probably only asked two or three women out. Sometime in my twentieth year I decided that that would be quite enough of that nonsense and I haven’t asked anyone for a date since. I got set up a few times but that always sucked. Eventually I met my wife and that part of my life has been without want since. I’ve been very lucky there.

My point is I hate social situations. I always have. My sister and I used to call ourselves socially awkward. Then a counselor put a formal name to it for me – social anxiety. And it is this social anxiety, she told me, that causes my depression.

So, you see, interviews are tough for me. Setting up interviews is ten times worse; it feels like asking for a date. I am so grateful for email! The funny thing is that once the interviews have started I become very comfortable because I’m fluent in the subject matter and it always becomes a very easy conversation. No matter how much I tell myself that this will happen, I’m still a nervous wreck.

But I survived yesterday and got that out of the way just in time. I’m trying to get another interview for Saturday so now I’ve got plenty of time to get unreasonably worked up about that.

Tangents Ahead

If I’m going to blog every day then I can’t continuously write about depression. That would just be too depressing. Besides, there are vast stretches of time where nothing particularly interesting happens and I don’t want a series of entries that say nothing more than “Yup, still hate myself.”

Which I do, by the way. Predictably I completely screwed yesterday up. After doing my hour’s worth of running from 9am to 10 I came home and stewed about it then finally got to work around 1pm. And afternoons suck for me so what little I did get done I’ll have to redo this morning.

I have a phone interview this afternoon. I’m not really worked up about it yet (It’s 6am as I write this.) but I’m sure that as the time draws nigh I’ll have a nice lather going. I haven’t conducted too many interviews although I’m trying to do more. I hope I’ll get more comfortable with them as time goes by but that isn’t likely. It still takes me a few days to mentally prepare for a damned haircut and the event ruins my day.

Sometimes those pills the therapist offered me sound pretty good.

Of Banking and Haircuts

So my weekend went pretty well. No major peaks or valleys.

Today’s ruined though.

I’ve managed to arrange my life so that I rarely have to leave the house. I can sometimes go up to two weeks before having to stick my nose out the door. I know it’s not healthy and it makes me even weirder when I actually do end up having to deal with people. My wife tries to get me out – she has none of these issues – but it’s just so much easier to stay at home.

But, like I said, today is ruined. I have to go to the bank and sign some papers and I have to go get my hair cut. Since I work best in the mornings I try to schedule mindless stuff like this for afternoons but when I do I spend the whole morning dreading the social intercourse and I don’t get any work done. So the logical conclusion would be to get this out of the way early and have the rest of the day for my work. Well, that doesn’t work too well, either. When I get back I spend the rest of the morning reviewing whatever stupid thing that I might have said and by the time I’ve worked through that it is afternoon and I’ve lost all motivation to work.

Disgusting, isn’t it? Believe me; I’m far more disgusted than you.

Tongue-Tied

So, I haven’t posted in a while. There are a couple of reasons that, in addition to being true, have the added benefit of being relevant.

The first is that the first wash of entries in which I stood up and said that I am depressed really felt good. It lifted my mood considerably just to write about it in a public way. I have no idea way. I’m a very private person and generally find sharing to be a particularly icky experience. But for whatever reason I wound up being less depressed and, consequently, didn’t have much depression to blog about.

The second reason that I haven’t made any entries in a while is that I almost didn’t get everything done last month that I was supposed to. I work from home and earn my living from a variety of different sources. In some cases I have my own customers and in other cases I have clients for whom I perform services. Those are measured monthly and my depression became so dark and debilitating in early June that I didn’t get much work done. And the work that I did do was so disgraceful that I simply had to redo it later. Luckily the clouds lifted as a result of this blog and the pure adrenaline brought on by the approaching deadlines. So, I didn’t have time to post those last few days of last month.

But here we are at the fifth of July. I managed to wrap up last month without missing any of those deadlines. It took me a few days to clean up the resulting mess but now I’m caught up and things are on track. In fact yesterday I got ahead! I was feeling pretty good about myself for a couple of hours last night until the phone rang.

No, it wasn’t bad news. It was my step-daughter-in-law. (Is that right? She married my step-son.) She was calling to speak to my wife – they’re great friends – but being a very polite and outgoing person she chatted with me for a bit as she always does before asking to be passed on. I find her to be very intimidating because in addition to being outgoing she is also very smart – a combination that translates into cleverness.

I am a very slow talker; partially because I put a lot of thought into choosing my words and partially because I have a very mild speech impediment. Most people probably don’t notice the impediment. It’s kind of like a stutter except that I don’t stutter, I just stop and the words can’t come out. It’s as though some mechanically has gone wrong and I briefly can’t form words.

Anyway, it’s no big deal and I’m comfortable with that part of me; except when I’m speaking to someone like my step-daughter-in-law. Then I feel like a slow witted oaf. I try to respond in kind to what she has to say but I’m never really able to. My social anxiety kicks in and I just want to crawl under a rock. By the time I handed the phone to my wife last night I felt completely humiliated. Even though it was relatively early I went to bed while they chattered on the phone for an hour and a half.

But before that I was happy, content and carefree for a couple of hours and it was wonderful.

Putting a Name To It

My depression has always been a dull throb for me. It’s like a headache that you’ve carried around for a few days that ebbs and flows but never entirely goes away. Sometimes you can forget that your head hurts but when someone asks if that headache went away you realize that you’ve just been ignoring it but it’s still there.

I’ve done a good job of mostly ignoring it but recently the throb has gotten louder; thus this blog. When I posted my first couple of entries I went scurrying out into blog land to see what others were saying about depression. I found a reference to Dysthymia. One of the main reasons that I thought it sounded pretty accurate was that it is long lasting and milder although no less destructive over the long haul; specifically Wikipedia says in time it lead to things “such as high rates of suicide, work impairment, and social isolation.” Boy, does that peg me. I’ll get into those later, especially the big S. In passing I mentioned Dysthymia to James over at Finding Optimism, who has been very generous to me and my blog, in an email. He replied that it seems unlikely since I wrote in an earlier entry that I suffer from most of the physical manifestations of depression. He’s got a good point. But if I’ve had Dysthymia for a long time then I’m due for some physical consequences, right?

In that previous post I described how I self diagnosed my depression. This was later confirmed at a mental health clinic where a counselor, who I did not like, told me after less than an hour of talking that I have a mild case of depression primarily caused by social anxiety. She also promptly told me that I should go on Zoloft (I think) which apparently would help with the social anxiety. This after I explicitly told her at the outset I didn’t want medication.

I’ve been reflecting on that diagnosis over the last few days. Whether she was trying to push the meds for some self-serving reason or she genuinely believed this it would have helped me I’ll never know. I do know that I’ve become very comfortable with her diagnosis. It makes sense, really. I have always been awkward with other people. I wouldn’t call it shy; I’ve often been called that but only by people that don’t know me very well. I’m very opinionated and sometimes quick to take offense and I’m never hesitant to express this to whoever dares cross me. But I do it very awkwardly and spend the next week or more dwelling on the event and invariably beating myself up for it.

Oh yes, I was a joy for my co-workers in the corporate world! Even those I still count as friends were probably as glad to see me go as I was to do so.

The best part about all of this is that any one of these incidents may come up at anytime to torture me. Years later and for no particular reason a memory will jump out at me; refined and distilled by this point to yet another self-told tale of what a blathering oaf I was when this and that happened. I will feel my face heat up and turn red. Typically I’m alone when this happens but if I’m with others I excuse myself to take a moment to savor the bitter taste of the memory once again.

Then the talking starts. This is a new thing and the main reason I try to be alone. No one, not even my wife, has yet caught me and of this writing this is the first time that I’ve consciously dealt with it myself. It starts with a grunt as I try to stop the me in my memory from making an ass of us. Then I babble forth some of the dialogue from the event and finally wrapping it with, “I’m so stupid.” It takes me another few moments to recover then I’m able to move on, generally in a darker mood. Eventually, it fades back down to the dull thud.

My wife says that I talk a lot in my sleep though she claims that she can never understand it. For this first time now, I wonder if I’m reliving these memories in my sleep.

Wow, I really sound like a mess, don’t I? Truly, I’m a functioning adult. These incidents only happen three or four times a month although they seem to be gradually increasing in frequency. They are very swift; usually taking less time than it took to describe them.

Depression brought on by social anxiety – I don’t know if it was a spot on diagnosis or a self fulfilling prophecy but it certainly seems to describe me now.

Herbal Remedies

I really haven’t tried too many herbal remedies for depression. St. John’s Wort seems to be a popular one. I might even have heard once that it’s recognized in Germany as a “proper” drug and covered under whatever sort of health insurance system that they have.

I tried it once a couple of years ago – back when I was still toiling away in the corporate world – and found that all it seems to do was put me on edge. No, that’s not right because it sounds like I had coffee-like jitters. It made my emotions tenderer, like a new wound. And the effect was only on the negative emotions. I didn’t benefit from any super highs, no fits of uncontrollable happiness; only rage, sadness, and self pity. It was like it worsened the depression. I thought that perhaps my body just needed to adjust so I went ahead and stuck with it. But it was always temporary and negative. For the hours after my dosage I was always just on the edge of a meltdown and just about the time that that feeling would wear off it would be time for another dosage. I never experienced and overall lightening of spirit like I hoped I would. I finally stopped taking it after I got in a huge fight with a co-worker. I had indeed been inconvenienced by her but I completely overreacted. Luckily we didn’t work in the same department because I really never could look at her again.

So, what’s it all mean? Don’t take this to mean that I think that St. John’s Wort. With most things I’m a majority opinion kind of guy. If so many people find relief with it then there most be something to it. It just didn’t work for me. There’s another, somewhat conspiratorial possibility: Since the FDA doesn’t see fit to regulate herbal remedies it could be that I had a bad batch. It could be that it wasn’t St. John’s Wort at all. Maybe I was taking lawn clippings and my depression produced a predictably negative placebo effect.

I keep an herbal garden and thought I’d try growing the stuff but friends and family like to come over, point at different plants, and ask What is that? Remember, my diagnosis was depression caused by social anxiety. Think I’m willing to just grow my remedy where everyone can see? My wife knows that I’m depressed; I told her when I went to that clinic. But we never talk about it. She bought me a book once but that’s been it. Other than that I just don’t talk to anyone about it. I didn’t even tell her when I tried the St. John’s Wort. There’s not a chance that I’m going to try to grow the stuff.

The only other herbal remedy that I tried was indeed from my garden. I cracked my copy of Rodale’s Illustrated Encyclopedia to Herbs and read up on everything that I was already growing. It turned out that quite a few of my culinary herbs were also traditional remedies for depression or melancholy. I went to the local health food store and bought a couple of cups of bulk green tea then harvested large amounts of the alleged happy herbs – I can’t remember all of the herbs that I used but I know that rosemary and lavender were among them. (I know lavender isn’t culinary. It’s my only none culinary herb. I just love the look and smell of it.) I mixed them with the green tea leaves and started drinking the tea.

It tasted absolutely horrible. I’m making a face as I write this at the memory. Nothing I did to it could make it taste better. In the end I drank it with lots of honey. The honey didn’t take the taste away – with enough honey it just made the tea taste like honey and something horrible - though it did manage to make it a bit more drinkable. But here’s the thing: I really made me feel happier - content, really. For a couple of hours after choking down a pot of the stuff I really did feel better. I actually still have quite a lot of the stuff and I’ve almost thrown it out a few times but can’t bring myself to because it really does help. Unfortunately I also can’t bring myself to drinking it, either.

So, I started writing this post with the idea that I would announce a decision to try St. John’s Wort again – the thinking being that now I work at home I’ll give it another try. But why turn my back on the tea? I think that I’ll try to start drinking it again. I’m pretty sure that the green tea is a big part of what I don’t like about it. I will go to the store and find a different base like plain black tea and mix up some more of the stuff. Or maybe I will try it with just the herbs and no tea leaves. Some rose hips, dried apple or cranberries might just give it the lift that it needs. (I will also do a better job this time of cleaning the herbs. Part of the problem is that there is a bit on dirt on some of the leaves where I didn’t clean them very well. There’s nothing worse than getting dirt in your teeth when you drink a cup of tea.)

The only problem with this is that it is a temporary fix. One day of me not feeling like having my tea or being out of town could spin me right down into the depths again. If my problem is a chemical imbalance as Big Pharm would have us all believe then whatever remedy I find needs to be maintained. But if it’s all in my mind, as opposed to the physical brain, then using the temporary fix of a chemical high from herbs on most days could be enough to bring about the right kind of change in my overall disposition.

Tea it is, then. For now I’ll choke down the nasty stuff until I have a chance to go to the store and mix up some more. I’ll let you know how it goes.

The Pursuit of Happiness

This is the inaugural post of a project that I've been thinking of for a while now.

Here's my story: I'm fighting depression.

*Right, see? I'm already rolling my eyes at myself. I'm embarrassed and a bit disgusted about all of this - the blog, my condition (ugh), that I have to write publicly about it, everything. But let's get back to it.*

I'm fighting depression. I've always known that I wasn't as happy as others or, more importantly, as I should be. Then, in a story that I'll tell later, I got diagnosed with depression brought on by social anxiety. Foolishly I said thank you very much and never again darkened the otherwise sunny doorway of that particular clinic.

Since then I started a home business and had to go out and find insurance for myself. In order to get a package I could afford I had to take one with no mental health benefits. Besides, I suppose when it comes down to it, this is a preexisting condition so it wouldn't have been covered.

Predictably, if I have to take the cheaper insurance package then I can't afford to go looking for professional help to be paid out of my own pocket.

I've been working at home for almost three years. At first it was heaven, given the social anxious aspect of my psyche. The depression was still there but a wonderfully supportive wife and a fulfilling job kept me above water.

But now I'm starting to drown. Circumstances that will be fully explored in later posts are conspiring to to pull me under completely. I really need help. I've been self medicating with bourbon and Comedy Central but these are only temporary fixes and they're starting to have their own detrimental effects on me.

So, I can't afford the professional help that I know I desperately need. What to do? I'm trying an anonymous blog. I'll blather on here about whatever is bothering me, the memories that haunt me, and how successful my self help remedies are. This blog is my therapist.

Its anonymous because I work in a pretty happy industry and I don't want to advertise this depression. Also, I'm terribly embarrassed by this and were I reading an in kind blog written by someone else I would lose all respect for them. Finally, I want to confess without worry and bitch about whomever and whatever I want. I feel restricted from that when I do these things under my own name.

This blog isn't going to be my only therapy. I'm also going to try some herbal remedies. I'll be reviewing these in futures posts.