Tuesday, 30 June 2009

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?

Monday, 29 June 2009

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.

Wednesday, 24 June 2009

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.

Tuesday, 23 June 2009

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.

Monday, 22 June 2009

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.

Thursday, 18 June 2009

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.

Wednesday, 17 June 2009

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.

Sunday, 14 June 2009

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.

Saturday, 13 June 2009

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.

Friday, 12 June 2009

Facing the phobia - killing the bird and shoelaces - but still panic

It was a crisp February morning in Berlin and one of my last sessions with my behavoural therapist. Apart from the relaxation techniques I could use as tools to relax in a panic attack, I had not come far in 18 months - nor had my bank account. Then during one of my deep relaxation sessions the atrangest thing happened. I was again in the lighthouse situation and this particular morning the bird was trying to attack. I articulated the "waking dream" and my therapist encouraged me to defend myself. Panicked I searched for a weapon and looking down all I could see was my shoes and my shoelaces.
In a state of fenzy I undid my shoelaces all the while this enormous ugly bird trying to attack me through the bars of the cage. In fear and trembling I opened the door of the cage and approached the bird, the taut shoelaces in my hands. I grappled with this dirty, ugly animal and slowly got the shoelaces round its neck. And then I pulled harder and harder. Within a few dreadful moments I had strangled this hideous creature, it lay motionless on the floor of the cage covered with its own droppings. it looked pathetic and sad.
Did I rejoice? No, I broke down in tears of sorrow for the poor bird and could not stop sobbing.

Why the ugly bird in the cage - an image of my social phobia?

As I said in my last post, the recurring image in my deep relaxation was this very ugly bird in a cage. What it meant - can only give my own ideas on the matter. I see the bird as being my phobia. It is ugly, it is dangerous and threatening - something I feared intensely, even looking at it made me so afraid, I felt nausea. And don't forget in my mind I was trapped in a small space in between the enormous cage and the circular lighthouse walls meaning I had little means of protecting myself should it attack. The story is interesting as at the end of my therapy I did manage to protect myself.

The cage - I believe was a simply picture in my mind of where I was. The bird was part of me - the phobia - it was caged but could attack at any time. And do not forget that all I could do to escape would be to run around in circles never getting more distant from it at the top of this lighthouse tower. In a deeply relaxed state I confronted this situation more times than I can recall. But any guidance from the therapist to coax me to get close to the bird or even make friends with it, both disgusted me and filled me with fear. The situation never changed until one unexpected morning. But sadly that unexpected morning and my own actions in that scenario did not really changeor help my panic attacks. All the therapy did was give me some tools to relax when I was in the attack.

Panic attacks and why desensitisation in behavoural therapy did not work for me.

Remember in my earlier posting I mentioned my adventure with psychoanalysis and the guy who had a face like a bulldog licking piss off a nettle, the behavuoral therapist is what in physical terms what I would term a pig with lipstick.

As fate would have it, my behavoural therapist resembled a pig with lipstick (no offence intended). . Is it just my bad luck that all the therapists I have ever attended would not make the cover page of Playgirl of Men's Health? Anyway the main idea for treating phobias in behavourial therapy is a mixture of learning relaxation techniques and systematic desensitization. This is how wikipedia describes it.

"Systematic desensitization is a type of behavioral therapy used in the field of psychology to help effectively overcome phobias and other anxiety disorders. More specifically, it is a type of Pavlovian therapy / classical conditioning therapy developed by a South African psychiatrist, Joseph Wolpe. To begin the process of systematic desensitization, one must first be taught relaxation skills in order to control fear and anxiety responses to specific phobias. Once the individual has been taught these skills, he or she must use them to react towards and overcome situations in an established hierarchy of fears. The goal of this process is that an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy. Systematic desensitization is sometimes called graduated exposure therapy.[courtesy of wikipedia.org]"

I like the pic as it shows for me clearly the fight with a phobia.

So Tuesday's and Thursday's at 8 a.m. in typical German fashion off I went. The idea is to face the actual phobia in increasing degrees until ultimate you are desensitized and your fear or phobia is gone. Coupled with this was learning a type of deep body relaxation and articulating my thoughts. I had always the recurring vision of being inside at the top of a lighthouse. The room was round and in the room was a large cage with a massive ugly bird with no features. I was stuck between the cage and the wall waiting for the bird to attack me. Comments welcome!

Panic attacks - self-triggering the gun

Today I was thinking that people like us who suffer from panic attacks are probably during the attack feeling like the most lonely people on the planet. Why? Because, like me, you probably feel in that dreadul state there is no one else in the world who can help you.

While suffering from sudden panic attacks coming from nowehere I recognised sometime ago that I could induce a panic attack. Why anyone would want to do so is a good question but today at the hairdresser, I thought that I would provoke the beast and sure enough out it came in full strength - I had induced it myself. This is a strange phenomenon I call the self-triggered gun. What i mean by the expression is that I knowingly pulled the trigger to experience the attack which makes little sense when we spend most of our time trying to stop them! But in the attack I did feel such a desolate loneliness. Perhaps I am just someone who tends to play with fire. I know it sounds pretty self-destructuve and on that I would welcome your comments.

One useful tip - so simple but in my case it works - which I learned when I was in behavoural therapy and which really helped in today's panic attack situation. I have learned to concentrate on having both my feet firmly on the ground. Just thinking REALLY HARD about the soles of my feet firmly on the earth beneath me reduced the state of panic until it disappeared completely. Try it yourself and let me know if you have any success with this. On days like today when I am not pessimistic about my life, I feel that like being an alcoholic you remain one even if you never drink another drop in your life. I felt the same today about panic attacks - it is a coping strategy, always be prepared to cope because they can and do strike throughout my life. Although I had little success after 18 months of behavoural therapy, the relaxation techniques I learned during that period do help. The therapy did not take away my attacks but helped me cope with them a little better.

Monday, 1 June 2009

My dislocated blog on phobic disorders

I have just been looking over the posting since I started and it all seems a bit dislocated and unstructured. That's because I sit and think about the subject and something I find important hits me about the issue and off I run to my laptop. Anyway I hope to get round to learning to make categories of the postings to make future navigation easier for you.

The reason I rushed back this time is because it suddenly struck me the pitfalls and traps the phobic individual gets into. Through permanent avoidance of a trigger situation life becomes just that little bit smaller. But this continues until it becomes unbearable narrow and depression then also sets in as a side effect of the personal situation.

I knwo in my own case I would spend hours thinking why is this happening to me, what is happening to me - I spent these hours in the past and not in the present and that is the main point i want to make in this post.


Look forward not backwards - I know, believe me, how difficult that is in your situation but that change of perspective alone will help you amazingly. Plant for the future and not for the past. Why? Because it is the start of a positive path to a cure and not drowning in own's one plight. At the end of the day it is more important to get out of the situation than to understand why you are in it. You will not answer that question in any case and if you think you do, will it help your situation, your phobia or your panic attacks. No it won't.

The common symptoms of a panic attack

Let me take own own example, one of my many phobias was standing in line and waiting, it did't matter here, the supermarket check-out, the airport check in, the bank. As the line to the counter shortened I would feel my panic get stronger and stronger. Then comes the fight or flight situation. Either you run out of the bank or you stand and fight the panic attack. The majority run out. The most usual symptoms of a panic attack you will find listed below and I am sure you can tick at least two of them:
  • Shortness of breath or smothering sensation
  • Palpitations, pounding heart
  • Chest pain or discomfort
  • Trembling and shaking
  • Fear of choking
  • Sweating
  • Nausea or stomach ache
  • Feeling unsteady, dizzy, lightheaded, or faint
  • Feelings of unreality or of being detached from yourself
  • Fear of losing control or going crazy
  • Fear of dying
  • Tingling sensations in arms or legs
  • Hot or cold flushes
  • Fear of passing out

The common ro garden symptoms related to a panic attack

When should you consider getting help with your phobia?

There is no single answer to this question but there are certain guidelines which can help you decide if it is time to seek help or not. I would list these as the following:
  • Your phobia is causing you a high level of disabling fear, anxiety or panic.
  • You can come to the conclusion that your phobia is disproportionate to the actual situation.
  • You have already started to avoid situations or places because of your phobia.
  • Your avoiding situations is disrupting your normal routine in life.
  • You have been suffering from a phobia for more than six months.

Basically, I recommend you do the following. Sit down alone, relax - if you can - and decide you are going to do something about it. Enough is enough and it is time to take over responsibility for your own life. You might even be in a catch 22 situation. I am afraid of going out, I am afraid of making a fool of myself in front of the doctor, etc. etc. Imagine how your life would change if you were not cornered by fears which you know in your heart of hearts are irrational. Take one small step, a positive decision FOR your self-esteem, your well-being, your future and YOUR life.