Comments on fear of going to work

Ysbeth Wordsmith made the following comment on my post concerning fear of going to work::

Isn't one of the problems with social phobia a near-total lack of recognition and support from other people? That includes not just bosses but doctors (who should know better, but often don't). So you tell someone, and they mock you and say it's all in your head and you should just stop whining. Then you have to can that doctor and try to find another one who doesn't have his head up his ass. That can take a lot of extra time, money, and energy.
Yes, I agree that social phobia is an illness where understanding and support from other people seems sadly lacking. This also is complicated by the fact that the social phobic in general tends to be secretive about it and tells very few people if anyone. The result is often social isolation and a great feeling of loneliness. This can often turn into depression which then makes the psychological situation of the individual even worse. To that extent I think that the Internet can really help. There are any amount of forums out there where people like us who suffer from phobias can find people who really do understand. Also the fact that this kind of networking has a degree of anonymity helps. By that I mean it is probably easier to write and tell about your phobia than to sit, stare someone in the eye and talk about it. The latter would also increase the fears of rejection or being misunderstood.
The picture of how one shoudl be as an indiviual is often painted by the media and we should not underestimate that influence. Television to a large extent makes big money telling us how we should look, how we should dress, what we should eat, etc. But it also does the same in painting some imaginary picture of how we should behave - energetic, social,  outgoing. Phobics thus tend to suffer from a very weak self-esteem since many feel they do not live up to be what they should be. It does take some doing to rise above these fake clichees which we are fed, especially when we feel extremely vulnerable.

Fear of flying - a phobia or just plain common sense.

Perhaps I may seem to be playing the devil's advocate but I want ot try and determine in my own mind if there is a thin line between phobias and just a plain and rational fear of something. I wish to take the common example of fear of flying or fear of driving. Firstly, statistics would show that both activities can be dangerous. Planes do fall from the sky and cars do crash with horrific consequences. Logically I can be afraid of using such means of transport. Even within my life-time flying has become an everyday event for many people. Growing up as a boy in Ireland I imagined it as a once in a lifetime experience. Habit, social conditioning have taught us to treat flying as the most natural hting in the world - perhaps it isn't?
Let me take another example to show you what I mean. If I was afraid to go outside because I had a fear that an aircraft - like the actual one in the picture - woudl fall from the skies and kill me. I think we could all accept that this is a fairly irrational fear as the number of people actually struck by an aircraft crashing is very, very small and the chances of it happening are very, very small. There I would agree that this could be described as a phobia as it lacks rationality. Flying, on the other hand, seems to me a rational fear - should we call it a phobia?

Social phobia and fear of going to work

I just read a question of phobias which was sent to yahoo answers a couple of days ago by someone who is unemployed and has been placed to work in a charity shop. She explains how a few days ago she was so nervous about telling her superior she would be a little late in coming to work that she took the flight choice from the "fight or flight options" and did not call. Of course this did not solve the situation. She also has a terrible phobia of using the telephone which makes matters even worse.
From what I gather the person is also suffering from depression which is quite a natural result of the phobias. She was begging from someone to tell her what to do as she also did not attend an appointment with the employment services on the same day.
This is quite a normal situation for the phobic - who had not sought medical assistance and by the way only one in four do seek some sort of assistance with their phobias. I have the deepest sympathy with this person who feels trapped in the situation she finds herself but this is so typical of the social phobia situation in general. My advice, as always. Stop making a secret of the phobic condition and seek medical aid  i.e. go and see your doctor and just tell the plain truth - it is as simple as that. I know this will fill you with fears of feeling stupid or abnormal or whatever and you will fear what the doctors thinks of you. While this is the typical feeling, it is wrong and you will be very pleasantly surprised by how your doctor reacts and even better, he can help you with some light medical which will make a great difference to how you feel.

Social phobia - it is not as simple as that.

While many believe that the actual symtpoms of social phobia are fairly generic and can be basically seen as a fear of people and a fear of inter-action with people resulting in avoidance tactics, we sometimes forget that such symptoms can take on forms that are difficult to explain. Let me give you one example of a married couple, both successful in their careers - she in spite of suffering from social phobia. One of her greatest fears is not acting correctly around her husband's superiors and she is so afraid of this that she simply avoids such situations.
Since she has not confided in her husband that she suffers from her condition, rather than admit it she just pretends when their is any sort of social meeting with his superiors that she forgot and has arranged something else important work related for herself. Of course this may be acceptable once or even twice but when it starts to re-occur the husband becomes upset.
He sees his as wife as irresponsible or uninterested in his career as she simply avoids any social contact but does nto realise that the underlying reason is a phobia. I give this example as what we would not always consider to be a symptom of a social phobia can be easily misinterpreted.

The Linden Method - success or failure for social anxiety?

Recently I have been reading a lot of reviews on the Internet on the "Linden Method" as a possible cure for social anxieties and social phobias. The inventor of this therapy, Charles Linden, apparently suffered from panic attacks very frequently and eventually decided to do his owned research into the issue.
I have never tried the Linden Method so I am unable personally to formulate an opinion on it. Apparently the therapy focuses on the Amygdala part of the brain, an almond shape area which apparently is responsible for producing te chemicals which result in fear and anxiety in the human body. The first thing I do when reading of about new therapies is to look for reviews on the Internet although this can sometimes be deceptive as many quacks will spend lots of time gettings others or themselves to post positive reviews on web sites and forums in order to convince people to go for the therapy. I would be grateful if any of you reading this who have tried the Linden Method would leave your comments as I would be very interested in learning more about this approach to overcoming social phobia and anxiety.

Great response by Ysabeth to the question: can I stop working because of my social phobia:

Ysabeth responds:
"I think the important question is not "CAN you stop working?" but "SHOULD you stop working?" Let's consider some aspects of this decision.

1) A doctor (or counselor) is a useful *resource* but should be giving you advice, not orders. YOU are responsible for your own life and so you should make the decisions, taking into consideration the best information and advice possible. (People who aren't able to make sound decisions are usually in need of a hospital stay.)

2) If you're asking yourself whether you can or should continue working, then that indicates you have a serious problem. So whatever you decide about work, you should definitely seek help with your anxiety issues. Chances are you need some new skills in your head; and there may be physical, spiritual, or other aspects needing attention as well. Do not simply quit working and use your anxiety as an excuse to sit on your arse doing nothing forever. That way lies misery.

3) Explore, and actually list if you can, the practical ("My boss has complained that I am not doing my assigned tasks.") and emotional ("ZOMG I CAN'T DO THIS!") and financial ("I have some money saved, but it won't last forever.") reasons for and against stopping work.

4) Ask yourself some questions, such as:
* Have you had to stop one or more tasks due to anxiety issues? How many, how often?
* Does your social phobia make your coworkers, boss, clients, etc. uncomfortable around you?
* Is your social phobia bad all the time, or does it come in cycles?
* Do you feel that your job is making your anxiety worse? That is, can you point to things (an abusive supervisor, sexual harassment, short deadlines) that specifically make you miserable; such that you might do better in a different job? And do you feel calmer when you are not at work, including when you are with different people?
* Does it seem like you are simply overloaded, such that you get better when you have some time to relax and get more sleep?
* Has anyone else suggested that you stop working, temporarily or permanently, or switch jobs? Do you agree or disagree?

5) If your anxiety issues are impacting your work enough that there is a real risk of getting fired, then seriously consider taking a leave of absence or resigning before that happens. Getting fired for cause almost always makes it harder to get another job. However, check with your company first because some make counseling available to employees who need it.

6) As a possible alternative to leaving the workforce, temporarily or permanently, consider switching jobs or even careers. Some people find a particular field really stressful but are fine when they change to one that suits them. If your job is crushing or unsatisfying or terrifying, that's not good for anyone! Spend some time exploring whether there is some other kind of job you would enjoy and do well.

7) Avoid making permanent, long-term decisions like "I'm going to quit my job and never work again!" at this time. If you're so strung out with anxiety that you're thinking about stopping work, then you're not in a suitable frame of mind for making important decisions. Instead try to focus on short-term things like getting help or discussing your job situation with a counselor if you already have one, and maybe taking a brief leave of absence. That may put you in a better state of mind for considering your long-term plans."

Can I stop working because of my social phobia?

This was a question asked by one fo our readers this week. And it is a question which is not so easy to asnwer. Firstly, do you mean can I stop working for ever because of my social phobia. Basically, anyone can stop working whenever they want but they might have trouble finding the means ot live. If the question is intended in the sense of is this a medical reason to stop work, my inital answer would be no.
Firstly, it is the decison of a medial doctor if you are fit for work or not. If a doctor thought would phobia was so severe when he/she would likely stop you from working for a limited period while you were undergoing treatment.
It is highly unlikely that a doctor would decide that on account of social phobia you would never be able to work again. And actually I think it is wrnog that you assume you want to stop working. I can understand your situation but would your goal not be rather to overcome your social phobia and continue working rather than just giving up right away and saying I never want to work again.

Tunnel phobia in Norway

It is interesting when - as is seldom the case - phobias gain some sort of media notoriety for one reason or another. This was the case with the island of Hitra in Norway which was served by a ferry from the Norwegian mainland. All was fine and good strangely enough in that there were no complaints from the islanders about experiencing phobias on board the ferries. Then the Norwegian government decided to build a tunnel to connect the island of Hitra with the mainland. But this was no ordinary tunnel, this was the deepest and one of the longest tunnels in the world. In fact the tunnel was 264 meters below sea level and had an overall length of 5.6 kilometers. So as a result the islanders were forced to use the tunnel to cross over to mainland Norway.
Some 18 people living on the island complained of having anxiety and panic attacks when using the tunnel so the Norwegian authorities set up a special programme to try and remedy the disorder. it was based on cognitive bahvioural therapy and gradual exposure of the individuals to the tunnel situation.
The programme reports that at the conclusion all 18 taking part were able to drive through the tunnel on their own without experiencing panic or anxiety. You will find more information on the cognitive behavioural therapy for phobias here.

Online Therapy for phobias and anxiety

I found it extremely interesting to discover that the first International E-Health Summit 2009 is due to be held in Amsterdam on 16-18 October 2009. When I look at the sponsors and those who are attending from the academic world, this gives great credibility to the possibilities of on-line therapy for mental disorder.
I also found it interesting to note that there will be a symposium on social phobias and anxiety: "Online treatment for anxiety and social phobia,  presenter T. Berger, PhD" on the first day of the conference. There is a great deal of research going on presently on the topic of on-line therapy and it will be extremely interesting to follow the results of this conference. The web address for the  International E- Mental Health Summit is here. Although there have been reservations expressed abou the the potential risks of on-line therapy, the topic is still very much debated.
Craig Childress has written an excellent article on the topic of  "Potential Risks and Benefits of Online Psychotherapeutic Interventions". In his view the main potential drawbacks ca be summed up as follows:
1. A loss of visual and auditory cues,
2. Confidentiality,
3. Competence,
4. Crisis management,
5. Legal and juridicial issues.
On the other hand  Craig Childress sees the following potential:
1. Screening,
2. Treatment of non-clinical problems,
3. Unique advantages of on-line communication,
4. Support groups,
5. Adjunctive Internet use.

Next month I shall be updating you on some of the conclusions of this world summit.

Stuttering and social anxiety. Chicken or egg?

I have spent most of the week-end reading about stuttering and stammering a it is seemingly in some way related to social anxiety. To me it would seem perfectly obvious that anyone with a (severe) speech impediment would be extremely prone to avoid embarrassement, social situations etc. Inititally this could seem to be a clear cause and effect situation. But then I thought back when my social phobia was at its worst and remembered that, although I did not stutter, I had a severe fear that I would do so in a social situation.
What I find of particular interest now is that some of the drugs used to help those of us suffering from phobic disorders are alse being used  today in the treatment of stuttering.

There has been a magnifient amount of research done into the disorder known as stuttering and a great deal of empirical research. Although there is no scientific or medical consensus on the actual causes of stuttering or on a definitive cure, it is interesting to note that this disorder, like phobias, is the subject of exploitation by those who will stop at nothing to earn their living. I am referring to scam websites such as this one  which promise the earth for $97.
For those of you looking for a really great website on the topic of stutteirng this one I cam highly recommend.

Comment by Ysabeth which is really worth thinking about on phobias

Ysabeth, a frequent visitor and contributor to this blog wrote the following comment:
"
Most phobias are based on a rational concern, which has overgrown into an irrational fear that interferes with ordinary activities. For instance, a fear of snakes is based on the fact that some snakes are dangerous and most will nip if they feel threatened, which makes it prudent to be careful about them. But a phobia can be triggered by a *photo* of a snake, even though the photo cannot cause direct harm. The challenge is to bring the phobia back into the rational and managable range, without denying whatever factual basis it might have."
I find this an extremely interesting comment. Even a pictorial representation of the dreaded object can trigger fear, even though the individual knows that he/she cannot be harmed by a picture. In my view this would seem to strenghten the case for behavourial desensitization. By that I mean in this example gradual exposure to anything related to the presence of a snake - perhaps starting with a picture, then a model, then a video then actually visiting a zoo etc etc.

A fear of accidents?

Dystychiphobia - This is the word which a reader my blog is looking for and it means fear of accidents. I consider it to be quit natural to have a fear of accidents as no one wishes to have an accident. I think the important thing to recognise is the degree to which you fear such accidents. If it is excessive then yes I would imagine it could be called a phobia. Looking up the list of known phobias I find the length of the list of phobias quite incredible.

Who can answer the following. What are the following four phobias? (It helps if you speak Greek!)

Didaskaleinophobia

Elurophobia

Genuphobia

Heliophobia 



 

The scams for phobias which I hate

Dear Readers, 

Apologies but scams sich as the one you see below get me very upset. I received this just this morning and when I read the nonsense it is really not worth even reading, much less purchasing. The reason I object to this Clickbank products is that it is exploiting an illness and offering immediate cure with 10 minutes a day. Just take a second and read it through and you will see what I mean



            Secret Of Meditation:

	Instantly Relax and Meditate anywhere, anytime you wish. There is no ritual or certain rules you have to follow . (Editor: well that sounds very handy, indeed, I really can do what I want when I want to?)
	Improve your health dramatically - physically, emotionally, and mentally. (Editor: This sentence says absolutely nothing about the product at all. It is a complete and utter generalisation which could apply to anything.)
	Empower yourself for Greater Success, Better Health, Relationship and Financially. (Editor; Equally meaningless sentence which says absolutely nothing, all it is doing is filling the page but not giving you any information.)
	Get rid of limiting belief, never let fear control your life (Editor; So I can jump of a ten storey building without fear.)
	Ability to Heal Yourself and become a facilitator to heal others instantly (Editor: wow, that is not. Not only does it heal me instantly, I can start healing others immediately!)
	Increase vitality and feelings of rejuvenation, face your life with positive attitude. (Editor: Better than any vitamins you will ever buy.)
	Decrease symptoms of Panic and Anxiety , start and end your day with Pure Unconditional Love
	Create emotional stability, stop suffering from mood swings.
	Increase your intuitions and boost your sixth sense (Editor: Boost my what?)
	Activate 7 major Chakras and preparing youself for KUNDALINI Awakening (Editor: I bet, just can't wait!)
	Naturally Cure Insomnia, Stress and Depression

Well as you see I could continue, this text says nothing, it promises the earth. You have to do nothing to get rid of your phobias or panic and anxity attack - just pay $67 dollars and everthing will be fine! Problem is there are so many desperate phobics out there, I wondered how much he sold?

Learn about your phobias!!

This may seem a strange thing to say but many people who suffer from phobias are totally at their mercy partly because they feel totally exposed and at the mercy of phobias. Learning about phobias, in general, is a good idea because it does help you understand what is happening to you and it demystifies the whole thing. One always has a greater fear of the unknown, this is common knowledge.
So, my advice is read literature on the matter, look for and join Internet forums and discuss your phobia(s) with others. You will very soon discover that these terrifying situations you are experiencing are being experienced by thousands of people just like you every day.

In fact, phobias and panic attacks are extremely common and seemingly all the more so in today's stressful and hectic way of life. You would be surprised about the number of people who takes the stairs at work and not the elevator becuase they panic at the mere thought. You would be surprised about the number of people you know who prefer to eat alone and deliberately go to eat earlier or later than the rest - simply because they have a phobia of eaiting in company. You would be equally surprised at the number of people who do not go on that training course they woudl love to go on just in case during the class they might be but in a position of having to answer a question or get up and say something in front of others. So do me and do yourself a favour - read up a little on panic attacks and phobias and come back and tell me how this has affected you.

On a lighter note - it' s a dog's life

Folks, we are not alone with our phobias, our canine friends also have this complaint and there has been quite a lot of research into what causes it. The most common phobia for dogs is thunderstorms and - wait for it - "It's becoming increasingly common for veterinarians to prescribe the generic version of drugs such as Xanax or Prozac for anxious dogs." As yet there is no clear answer as to why dogs develop phobias but they do and many are not detected until their phobic behaviour becomes visible at the age of four or five. Some believe it is through watching humans reaction to storms which cause them to react in this way, Some believe that dogs are much more aware of static electricity and this built up in their body is what makes them feel uncomfortable.

Social phobia - it's all about negative emotions about yourself

The one great thing about the Internet, I find, is that it gives me access to the experience and opinios of thousands of people like myself who suffer from social phobia. What I try to do is look at other people's opinion and feelings about their condition and then try and work out what they all have in common. Only the Internet gives me the opportunity to gather such useful information. It is a magnificent tool for empirical research. Well, havng done so now for some time - and it is something I will continue to do on a regular basis - I have come accross certain common denominators concerning the condition of panic attacks and social phobias. There are some valid points which I think shows what we all need to work on to improve our mental condition.
Nine times out of ten individuals suffering from social phobias are intensely worried about how other people perceive them. Work on yourself. Keep telling yourself you are OK as you are and it really does not matter how other people see you. That is a vital step in the process.
Continue such positive thoughts with your self-esteem and encourage and reward yourself on a daily basis for everything you discover positive about yourself.
Positive thoughts EMPOWER you and really effect your future. Try and fall asleep at night with postive thoughts about yourself. Try and have positive thoughts about yourself when you wake up in the morning. You will be AMAZED how this unconsciously influences you. Give it a try.

The unstable ground of psychiatry as a science

It is reasonable to believe in scientific terms that there is a reason for everything. I just was reading recently on a web site devoted to social phobia amd I came across the following:
Associated Laboratory Findings:

No laboratory test has been found to be diagnostic of this disorder.
I believe it is exactly this which puts psychiatry on very shakey ground at times. If you have no way of diagnosing something, how then can you assert that it even exists in scientific terms? Basically the academic and scientific answer is a simple own - you cannot. But does that mean it does not exist as an illness. Of course it doesn't, there are thousands even millions of individuals who suffer from phobic disorders regardless of the inability of science to find a way of diagnosing it in the laboratory.
I thnk this again ties in with the discussion which we have ongoing about the stigma of social phobias and anxiety disorders. It is hidden, it cannot be diagnosed like a physical illness and as such is always treated with suspicion in the eyes of the sceptics.

Does physical exercise reduce phobias?

I have reviewed many stories relatibg to the effect physical exercise on a regular basis has on individuals who suffer form phobias. In general my research would seem to show that yes indeed regular even daily physical exercise does have an overall beneficial effect. Here is what one sufferer writes:

"I found that as the more intense demands I could put on my body, that a chemical release of maybe endorphenes and dopamine, would give me a high that would last about 1 hr.! It was like floating to the music and everything was wonderful! After the high wore off, there still was a good feeling lasting all day which helped me face my fears much better.".

While in the vast majority of cases, individuals recognise that psychical exercises is not actually a cure for phobic disorders, it does place one in a better physcial and mental position to deal with them.

Excellent thoughts on t he stigma of mental illness

Glitteringlynx has responded with such excellent thoughts to my post on the stigma of mentla illness that I feel compelled to post the comment in full:
"What you don't realise is that much of what we know of mental illness has only been acquired in the last 20 years. Mental illness was something you didn't want people to know about your family. A friend of mine has a great uncle who no one ever talks about. When his father developed schizophrenia, they came to recognise that the uncle was probably schizophrenic as well. Even his father was mostly exiled from his own family, though his mother and a couple siblings still keep in touch. Once upon a time we'd just lock up anyone whose illness was bad enough that people noticed. So is it really any wonder that people would try to hide their unusual aspects of themselves and even today refuse to seek treatment or assistance from a physician? Or is it really a shock that so many try to self-medicate through substances such as alcohol or illegal drugs just in order to deal with daily life?

It's also a problem when the symptoms of an illness show up differently in the different genders. For example, women with depression will tell their doctor of emotional complaints, whereas men with depression will tell their doctor of physical complaints. As a result, men will often be inspected for heart disease or other physical ailments, when depression is the actual problem.

Furthermore, it is incredibly difficult to understand why they are "illnesses" when these experiences and behaviours are otherwise normal elements of human existence. Depression can occur during or after a woman's pregnancy or after the loss of a loved one. Mania can seem like someone who just has a lot of energy. ADHD can look only like normal hyperactivity or, at older ages, a lack of mental discipline. Schizophrenia (as in the spectrum) is easily concealed within the scope of religion where hearing the voice of God or seeing visions of angels or spirits would not be considered abnormal. Of course schizophrenia has the additional problem of being confused with Multiple-Personality Disorder (MPD), which is evident in the colloquial use of the word "schizophrenic." Social phobia can be labelled as "shyness" or "introverted" and not seen as problematic. Obsessive Compulsive Disorder can be viewed only as worrying too much. Et cetera.

The ONLY difference between when these experiences are normal and when they are not, are when they negatively impact ones ability to function normally in society. With the "disorders" themselves being so complex, and our enlightenment so recent, it is far from surprising that these continue to be so misunderstood.

The stigma of mental illness

Sincere thanks again to Ysabeth Wordsmith for her extensive comments on he stigma of mental illness. At the end of her comments Ysabeth writes:
"Because ... when your mind is bleeding to death, most people can't see that kind of blood."
She explains as follows:
"...not everyone has the experience of mental complaints. That makes it harder to understand and sympathize what someone else is going through. It is *easier and simpler* to assume the person is just undisciplined and should pull themselves together. They don't recognize the severity of the problem.
I think this is a very obvious point which I simply missed. In stark terms, physical illness is much easier recognised, it is also something most of us can empathise with - unlike mental illness which for many is unknown territory and full of the old cliches. Yes, it is much "easier and simpler" to make false assumptions a bit like all the misinformed though well-intentioned advise, for example, for someone who is suffering from severe depression. "Shake it off, think positively, stop moaning". This entirely misses the point that the actual inability to do such things is, de facto, a part of the illness. Why in society today is this so difficult for most people to understand?

Great comment from Ysabeth Wordsmith on mental illness

Ysabeth writes in a comment to my last post:
"We have some drugs that work great for some people, sort-of for most people, and not at all for many. Mental health care just lags way behind physical care. People are trying, but they don't really have the equipment to do a great job yet, and the social background doesn't help.
I agree with a lot of what is contained in this statement from Ysabeth. I believe there is no "one size fits all" cure for individuals and that the danger with psychiatry is that it tends to generalise and put lots of us under the same diagnosis.
And yes, I agree that mental health is lagging behind physical care why? Less than 50 years ago psychiatry was still sending electric shocks through people's heads to cure there depression. 100 years ago we were being put in baths full of freezing water to stop our seizures. Why does mental care lag so far behind physical care? How does this relate to the whole stigma of mental illness?

Phobia - nothing wrong with you?

Particularly in the 1960's and onwards there has been a growing movement against the omnipotence of psychiatry. Psychriatists such as R.D. Laing were the leaders of such a movement which could be described as antipsychiatry. One of the main critisicms of modern psychiatry is the fact of comorbidity which means the presence of more than one psychiatric disorder at the same time. For exmaple, is an individual with depression and phobias suffering from depression, phobias or both. Accusations were made that pschiatry was simply making up different illnesses as it went along and that these suited the drug companies just fine in their quest for billions of dollars. In other words the traditional psychiatry was justifying their existence through legitimization of new mental disorders.
As a more generalised statement one could say that psychiatry was nothing more than an advocate of social compliance - if you did not fit into the social behaviour society invented for you or if you questioned this you were mentally ill.
Personally I find the body of evidence for this perspective weak. The development of psycho-parmaceuticals since the 1960's has proven beyond doubt that illnesses under which the individual suffers, i e. social phobia can be countered with the proper medication.

Phobias, social anxiety - fear of fear

Many in their comments write to me that they get very upset and frustrated with themselves about having panic attacks. While this is a natural reaction I think we have to look a little deeper at this frustration.
I believe the real frustration and self-anger experienced by many of us who suffer from social phobias or social anxiety stems from the fact that we recognise the illogical nature of the fear and that what we are really confronted with is the fear of the fear of a particular social situation. I am not really worried about giving a speech before 200 people tomorrow, I fear the fear of such an action. It is this gradual build up over time which is so unnerving and energy sapping that all we feel is frustration.
This is the tricky thing, I feel, about phobias and anxiety in general, we fear the fear of the situation and not the actual situation. Perhaps I am not making myself very clear?

Social phobia and panic attacks - 1 step at a time

In my view there is no short term cure for the problem of phobias and social anxiety. My advice:
- Seek medical help, you are far from alone,
- Confide in a friend or family member and stop the secrecy,
- no matter what you do take one step at a time,
- stop critcising yourself and lowering your self-esteem,
- find others on the Internet who have the same problems and talk about it.
Always bear in mind that Social anxiety is one of the main psychological problems currently in the US affecting about 15 million US citizens in any given year.
Yet the illness is not commonly understood among the population, leading to people withdrawing from social contacts in case....., even stopping work in case ......, avoiding friends, in case ........., stop eating in company, in case...... Interesting piece from a psychologist on social anxiety disorder.

A comment from D.K. - I need your help

I just received a comment from D.K. in which she states:
When it comes to psychological illnesses is a bit hard to be sure. I had disritmia that for long time doctors thought was a depression. I did treatment but was alone with myself trying to deal with what made me had this problem that I found a way to work on it.
My problem is that I cannot find out what distrimia is - does the term come from English or Spanish. Help greatly appreciated.

Great websites on panic attacks and social phobia

I just thought it might be useful to provide you with some of the best webites I have foudn around looking at the topics of panic attacks and social phobia.
Johanthan Berent has done a lot of pioneering work on social anxiety for over twenty years.
You will find an equally good resource on anxiety attacks here.
Lastly, Mental Health America is also worth visiting.

Any related blog looking to exchange links with me?

By the way, if anyone has a blog related in any way to this one and is interested in exchanging links, please leave your details in the comments box below and I will be right back to you.

A comment of anger and panic attacks - finding a cure

Chickenista left the following comment on my post "Don't torture yourself". She writes:
When I get an attack I do the deep breathing and walk. I can't stand to just sit. It makes it worse. But sometimes that doesn't even help and I end up talking my meds..... I get very angry too while its happening because I can't control it. That doesn't help.
Yes, it is a common reaction which I have had too, the anger at oneself. To be honest you are doing yourself an injustice. The inability to control the oncome of a panic attack, is not your fault. If we could control it we would not be having panic attacks. Yes, I understand your frustration but getting angry with yourself only makes you feel bad about yourself and it lowers your self-esteem. I think the good thing about what you are saying is that you have the ability to do your deep breathing and walking inspite of the attack. That is great. Sometimes you are right - even that does not always work. But don't get angry at yourself, be kind to yourself. Anger is a negative emotion and a negative emotion about yourself is to be avoided.

Social phobia and panic attacks - let us not underestimate the nature of the beast

In general we would be well advised not to underestimate the severity of social phobias and panic attacks if they are left untreated. They can and do affect every facet of an individual's life - working life, social life, relationships, hobbies. Avoidance of situations becomes extremely restrictive and worse - increasingly restrictive. No case of the illness shuld be left untreated in my opinion as there is evidence that - untreated - it is a progressive illness.

Take a simple example of a sudden panic attack while driving. This could lead to a fear of driving and of avoiding driving altogether. Consider how that alone could have a negative affect on a person's life. No public transport. How do you get to work? How do you meet friends? And again there is clear evidence that left untreated this disorder can lead to substance and alcohol abuse. Indeed many rehab programms today are a dual programm offering relief from the addiction and from the social anxiety disorder.

Why torture yourself ? - panic attacks are curable

There seems a general trend - correct me if I am wrong - that we can overcome our own unemplained panic attacks if we just try harder. I could not disagree more. Indeed, I think the more one tries to fight a panic attack, the stronger and more frightening it becomes. We tend to procrastinate and just continue avoiding situations we are uneasy with - time and time again. And our world just gets smaller. In previous posts I have already pointed to a number of alternatives. Getting medical advice is the first and most important step. Do it!

Anxiety and panic attacks can be cured - I am the best proof

I just read the following statement on a phobia forum:
"What should I do to get my anxiety under control I have tried medication therapy and have talked with a counselor but none have helped and could this mean that I have a brain abnormalality that is causing the anxiety to be severe and undcontrolable."
Firstly I believe that most of us think we have a brain abnormality when it comes to things like panic attacks simply because we can find no explanation for them.

My advise is that you should see your doctor again. Do not forget there are many different medications for anxiety and some work better on certain individuals and others. I had to try several medications myself before discovering the one that helped my condition. Just because a medictaion did not have the effects you were expecting does NOT mean that you have a brain abnormality.

Autogenics Training - self help for panic attacks

One of the behavoural methods I started early on was a course on autogenics training. Basically, this was a method invented by a German doctor, Johannes Schulz, in 1932. In essence it is all about body and mind deep relaxation and these skills can be acquired by anyone within a three month period. It's aims is to create a physical and psychological feeling of well-being and as well as being used in therapy for phobias and anxiety, it has been successful in stopping smoking and other addictions. Autogenic training is self taught. You will find many good sources on the Internet but I prefer the guide to psychology website Although it did not cure my panic attacks it definitely gave me a life vest when they occured.

An important point - and a growing network

It would seem clear that the current phase of the Internet is focusing on social networking. Even the search engines give priority in their ranking to sites which have no obvious commercial orientation but are there to communicate and inform. There are many great forums on very differing health issues and indeed the area of phobias, anxiety attacks and panic is amply covered by great exchanges between sufferers giving eack other advice.

I believe this is great because we tend to be secretive about our disorder and the Internet gives us a chance to meet up with fellow humna beings going through the same sort of problems. This form of communication can prove extremely useful. However, one word of caution. How ever supportive such forums are they cannot always replace medical advice. This I find to be particularly true in regard to medications. Advice on this issue can only come from a medical practitioner. What works for one person might not work for the other. Keep in mind there are hundreds of crooks out there willing to sell you RX and prescription medication at enormous prices. These people are exploiting your situation - shady little business profiting from your weakness. Look at all the advertisements on the right column in google when you search for panic attacks - half of them are trying to sellyou drugs at highly inflated prices - disgusting!

A useful comment regarding depression from Dr. Palin

I really get encouraged when I get comments on what I post here and I want to flag up a recent comment by Mr Palin who writes:
"It is not true that the old men and women are more susceptible to depression than their younger counterparts and it must be mentioned that an individual is said to suffer from depression when he exhibits symptoms, namely, hopelessness, chronic tiredness, appetite loss, loneliness, sadness et al for one week or more. Therefore, it is important for you to get hold of right information on depression related details before starting to treat your depression."

Remember in an earlier posting I mentioned that anxiety, phobic disorders are a very close cousin of depression and that is perfectly normal - basically you have a reason to be depressed on account of your life situation. I support Mr Palin's word of caution that it is very important to get qualified information on your depression.

Examples of social phobia in children

I would love your comments on these thoughts - are you aware of symptoms of social phobia and anxiety disorders in children. Often I believed that the term "shyness" is used by experts to say that this could be the genesis of social phobia. I am not so convinced about this. I think also that shyness ia soemthing all children go through as some stage. There seems, however, as far as I can see little empirical evidence which links childhood shyness with social phobia or anxiety attacks. It if were the case that it would be evident that there is no proof of chemical imbalance in the brain causing the disorder and one could then maintain that it is socially acquired through one's personal development. What do you think?

Alcohol makes me more social

Yes, the title is a quote from a young female student who has a severe social phobia.While it is easy to see why we as sociophobes turn to alcohol as we think anything is better that the hell of a constant battle with our plight, it is not an answer. Firstly it is self-medication and will only lead to a dependency and secondly it will not be a long-term answer to the problem. If you can only handle your anxiety and panic with alcohol, the real answer is you are not handling it at all. See a doctor, tell the truth and get another less damaging form of medication which in the long-term will help.

Panic attacks - the symptoms are the illness

Whereas symptoms in many illness are only the outward expression of an illness, in the case of panic and anxiety disorders if you can get rid of the symptoms you are rid of the illness. of course you will find many who disagree with this theory and who state that the panic attack is simply characteristic of some deeper illness. I do not believe this. In my view, when the symptoms (anxiety, phobia, panic) go, so does the illness. No matter what specific type of therapy one chooses, psychological counselling, behavoural therapy or medication, if they are successful then you are cured.

The down side of using selective serotonin uptake inhibitors to treat panic and anxiety attacks

Everything in life does seem to be a bit of a trade off. It may seem unfair that even a way of living a calm life has a price tag. Who said life is fair is my reply. In my view it isn't. Most medications do have side effects and paroxetine-based medicines are no exception. Later I will supply a link to a full list of possible side effects of the drug, but, as most doctors will tell you, the side effects are most pronounced at the beginning, i.e. the first four weeks and then quickly diminish as the body gets used and adapts to the medication. You can read here about all possible side effects of paroxetine.

My view on this - apart from medical evidence of increased risk to children and adolescents of the drug, for the adult phobic the choice is living with severe impairment of quality of life if the symptoms are left untreated or you risk suffering certain physical side effects from the drug - I choose the second. This image says a lot to me and I assume to you if you suffer from social phobia and consequent avoidance of situations it will say something to you as well. Our condition makes our world small and untreated the world just gets smaller and smaller. Strangely enough - and I find this interesting - the word in German for fear is "Angst". Guess where the word had its origins? - in describing something that is narrow. And that sums up for me largely the state of the phobic and anxiety sufferer. Life in a shrinking world with fear of trying something new, fear of going out, fear of speaking your mind, fear of making a fool of yourself, fear of public speaking in case you panic. Yes, it is fear of the fear in itself that makes this condition feel like a cancer spreading throughout your life and making you pay a huge price in terms of quality of life for trying to struggle on alone without professional help.

The major breakthrough in the 1990's for social phobics and anxiety attacks

The disovery of SSRI medication - selective serotonin reuptake inhibitors - is claimed by some to be the biggest recent medical breakthrough for those who suffer from social phobias and anxiety or panic attacks. One of the main chemicals in the drug is paroxetine hydrochloride. In brief the SSRI drug impairs the passage of serotonim through the nerve endings in the body as this natural chemical is responsible for the transfer of fear and anxiety to the brain. The following diagram shows how the medication works.

Although the drug later came on to account for great controversy in that it seemed to increase the risk of suicide in children and adolescents and led to the producer, GlaxoSmithKline, paying several millions for its cover up on particular side effects for young people, today some 18 million US citizen are prescribed paroxetine in some form. It goes under the name of Seroxat, Paxil. In addition to its positive effects for phobias and anxiety paroextine is also a major anti-depressant amd is 2007 was the fifth most commonly prescribed medicine in the US for depression.

Social phobia and anxiety attacks - did they exist 100 years ago

Something which just crossed my mind and would point to whether phobias and social anxiety are genetic, chemical imbalances in the brain or socially determined could be exploring if such illnesses existed 50 or 100 years ago. all the more so in view of the fact that some 10% of the US population will suffer form this illness at sometime in their lives - that is a phenomenal figure!

In 1901 A French psychiatrist, Paul Hartenberg, published an interesting paper which seems to ahead of its in that it concurred with current day accepted theory of anxiaty disorders and phobias. is personal approach in therapy could be equated to what I touched upon on an earlier article on desensitivation and a behavoural approach.

I disagee with the theory that social anxiety disorder does not create panic attacks.

I read the following on a great website on panic attacks
"Also, contrary to current psychiatric/psychological nomenclature, people with social anxiety do not have "panic attacks". They experience extreme anxiety in social settings where they fear they will have to perform or be on display. It is not uncommon for socially-anxious people to use the terminology "I panicked". Again, however, the distinction here is that the person is not talking about the sensations leading to a physical pain or condition. They are referring to a very high level of anxiety and the adrenaline rush that accompanies it."

I fail to see how this explanation of experiencing extreme anxiety is not equivalent to a panic attack. Do you?

Secondly the website in the context of social phobia coins the term that the individual is suffering from "avoidant personality disorder". I think such terminology is extremely dangerous as personality disorders generally are known not to respond to treatment. Avoidance is a natural and one could say in some way healthy reaction to what is seen as an extreme danger. I mean if a raging bull comes down the street towards you what would you do. Wait and stand to stroke its head? Yes, avoid. An extremely healthy reaction. For such reasons I cannot accept the terminology of avoidant social personality. it is in my view extremely misguided and dangerous assumption. Avoidance in these situations for the phobic suffererer is the most natural thing in the world. Indeed he/she would be foolish not to. But to create a personality disorder type out of this condition is acceptable. Even avoidance can be cured - personality disorders cannot. Basta.

Self-medication,however tempting it seems, is not a good idea for panic or anxiety disorders

The symptoms of phobias and panic attacks often can force the sufferer to take up the enticing Internet offers of medication without a prescription - now I imagine a $billion industry. From the outset I advise you DO NOT TAKE UP SUCH OFFERS!

You know the sort of offers I mean that might escape your spam box:

Today Bestsellers
Xanax / Alprazolam only 1.66 per pill. View Offer

Valium / Diazepam only 1.66 per pill. View Offer

Phentermine / Adipex only 2.41 per pill. View Offer

Ambien / Zolpidem only 1.54 per pill. View Offer

Klonopin / Rivotril only 1.29 per pill. View Offer

Such offers are nothing short of criminal. Firstly the prices are hugely inflated and secondly you have no idea about the quality of the medication you are actually paying such high prices for. Although I have done this as well, please take my advice AVOID, unless you want to get broke or poison yourself. Should you feel you need medication your doctor would be the last to refuse it.

An alternative solution is to turn to natural herbal remedies, many of which clain they can help sufferers of panic and social phobias and disorders. I keep an open mind on this but in my case I had no success with natural remedies making outrageous claims and all I did was spend a lot of money for a heap of unused bottles in the medicine cabinet. Here again I believe your doctor should know what is best in your particular situation.

Making a secret of phobias and panic attacks

I believe that, like myself, most sufferers from panic disorders and anxiety attacks are hell bent on keeping their condition secret for as long as they can. And also keeping the condition secret from their nearest and dearest. Is this the case with you? If so, have you asked yourself why? In my view sufferers of panic disorders are motivated not to talk about their condition to anyone unless it becomes utterly unavoidable.

In my view there are a number of reason for this:
(1) The sufferer may feel that others may think he or she is going insane.



After all if you can not explain your situation to yourself, are you going to expect others to understand it?
(2) The sufferer may simply feel too embarrassed and ashamed to tell anyone about what he or she considers to be a personal weakness




(3) The sufferer may feel that by telling friends about their phobias and panic attacks he or she may lose them.




I made just these mistakes and they are genuine mistakes. Ask yourself now, do you not have one person in the world you can turn to when you are facing such a difficult time in your life. Of course you have but you need the courage to do it. My serious advice, take the courage and you will find that having one individual that you can turn to in such a situation is worth its weight in gold.

Social phobia, anxiety attacks and its relationship to depression.

As if the affliction of panic attacks is not enough, in many cases the illness is also accompanied by some form of clinical depression. Although this is a general agrgavation of the overall condition, it is a natural progression and even logical.

In my case where my phobias had spread like a cancer and hampered me from mixing with people or leading one day of life without avoidance and fear, it is obvious that over a period of time I will have every good reason to be depressed. Indeed there would be something wrong if I was not depressed. Phobias will general lead to a feeling of low self-esteem, lack of energy, motivation and general negative and introverted thinking. This is perfectly natural. In my cases as in mine, my treatment for phobias was also accompanied at a later stage for treatment for clinical depression through medication.

My personal opinion and experience is that medication to treat the depression is a good idea. Why? One is busy enough coping with the phobias without having to cope with the crippling symptoms of strong depression. Note that this type of depression is very different from what is called endogenous depression, i.e. depression which has no external cause. You have every reason to be depressed on account of the effects of your phobias - so it is equally logical to get rid of them.