Tag Archives: social anxiety disorder

nardil blues

I’m really tired. One of the nasty side effects of Nardil is insomnia. It usually happens at a higher dose than the one I’m on now, so when the insomnia hit me earlier this week it caught me off guard. I’ve always been one to get at least 7 to 8 hours of sleep a night. This week, however, I’ve been getting between 4 and 6. It’s starting to take it’s toll on my system.

It’s hard enough being overworked, underpaid, and undervalued at work but when you throw insomnia into the mix, it just makes it all so much worse. Last week I felt so great. Both the depression and anxiety lifted. I was euphoric. Everything seemed to be going well. I felt like I was going in the right direction.

Now the depression has really swept back in and the anxiety is starting to creep back as well. I’m starting to lose a little bit of hope.

On a lighter note I got my tattoo finished last Sunday. The session went great. I’m running a half-marathon this Sunday, which should be interesting due to my fatigue. I have been training fairly consistently over the last few months but this past week I’ve sort of given up a bit but that’s okay because I should be resting this week anyway.

I’m really stressed about my job and school situation. I have four more classes to take to graduate. My original plan was to take two classes in the Fall, one in the Spring, and one in the summer. I’m making very little money at this point at work so getting financial aid would help, but I really don’t know if I can handle taking two classes in the Fall plus work full time. (I have to take at least two classes to be eligible for aid.) I also desperately need to get some experience in the library.

So I am thinking about taking one class in the Fall plus volunteer at a library, and then one internship in the Fall and one in the summer as well, and then take my final course the following Fall. So I won’t graduate until December 2012. This seems ideal, but I’d like to find a new job that pays more. I started looking for jobs earlier this week, which always puts me into a foul mood to begin with, but the insomnia and subsequent depression has kind of put a damper on that.

Ugh. I’ll stop complaining.

tattoos and hasty conclusions

I think I mentioned briefly in a past post that I had just got a tattoo–and if I didn’t, well I just got a tattoo. Not going into too much detail, I’m a fan of  dialectics–thesis, antithesis, synthesis–so I got a tattoo of a dragon, some waves, a peaceful river, mountains and a sun–all done in Japanese style–each representing a phase of the dialectic process, on my right arm.

Anyway, during my first tattoo session, which by the way was my first tattoo session for my first tattoo, I felt nervous/anxious/excited/etc./etc. I took an Ativan to help calm my nerves, which did very little if anything.

I had to take off my shirt, and even before the tattooing began, I was, to put it mildly, sweating horrendously (I brought a rag to wipe up the sweat from my underarms), not much worse though than any other social interaction. I was also wincing and wasn’t talking much to the artist who badly wanted to talk. Thankfully my girlfriend did most of the talking. Being a twenty year tattoo vet and slightly insensitive, about halfway through the session, he looked at me and asked, “Why is this so much harder for you that for everyone else?”

Shocked and caught off guard, I said, “It really hurts.” I left it at that.

I didn’t think much of this until a few days later when it hit me–I was pissed. Him saying that seemed akin to a therapist asking, “Why can’t you be like my other patients?” On the surface what he said was not only insensitive but extremely hurtful as well. It’s my job to sit as still as possible while getting a tattoo. The experience itself is mine, though. If I don’t want to talk that should be fine. If I want to wince that should be fine too. Shouldn’t that be somewhat expected, especially from someone who has been tattooing for that long? As soon as I started thinking about it, I realized just how angry I was. I also knew right away that that anger had been building and was ready to burst. I didn’t really know what to do with it so I just put the anger aside for a few days.

And that’s exactly what I did. Inspired by Layara, I came back to the issue when I had some time alone to think a day or two later and came to the conclusion that perhaps I had been jumping to hasty conclusions on what exactly he meant. He could have just been having a bad day and did in fact take it out on me. Maybe he really was just trying to ask if I was doing okay and it came out wrong. Whatever the reason, it’s not my fault. I did nothing wrong. It’s so easy for me to blame myself in situations like that.

Further, I tend to jump to huge conclusions based on the most minute types of behavior. For example–

  • If someone gives me a tired look while I’m talking to him or her then it’s my fault. They find me boring. They would rather be doing something else.
  • If someone doesn’t say hi to me and smile then I’m probably just not worthy of it in the first place and he or she really doesn’t like me.
  • Etc.

My point is that I have programmed myself to jump to very negative conclusions based on outward behavior, which has not served me. My hope is that one day I can catch myself making those hasty conclusions and and provide arguments or other scenarios to counter my irrational thinking. For now though, I’m doing my best to go back and look at situations and try to re-frame them, in order to attempt to objectify the situation more.

I go back to get my tattoo finished on Sunday. I’m excited, and the experience will be mine. If he’s not okay with that, I have the confidence now to let him know.

do we choose how others treat us?

This is my entry for July’s Blog Carnival of Mental Health. The topic is Stigma and Discrimination, which I interpreted liberally.

***

I’ve been thinking a lot lately about how the boundaries I set affects how others treat me. As some of you know, after my suicide attempts and subsequent hospitalization in an urgent care facility, I basically told my boss everything that had been going on. Why did I do this? Well, I trust him for the most part, he’s easy to talk to, and I need more people in my life who I can share my inner experiences with. In retrospect, this may not have been the best decision, but what’s done is done. I was in the midst of a crisis, and I may not have been thinking all that clearly. Things happen in a crisis.

Anyway, I also told him about the Nardil and about how it affects my diet (because he’s always trying to shove cheap pastries and hot dogs down my throat, which I can’t have while on Nardil).

Being who he is–older, somewhat wiser, and a wanna-be therapist–he likes to give me his opinions on my condition. For example, sometimes, when he’s stressed, he jokes around by saying things like, “I’d try to kill myself too if I just had the time.” I’ve spoken to him about this–about how that’s insensitive and is not something I want him joking about. He’s stopped. Other times, he gets serious and tries to tell me that, looking solely at my behaviors, I don’t need to be on medication, especially long-term.

Although, I appreciate that he cares, he has no idea what’s going on inside my head. Sure, my behaviors tell a particularly happy story about myself–a story that others interpret as the entire picture. I mean, I have a job. I’m in school. I have a girlfriend. I’m training for a marathon. All good things. Inside my head, though, something entirely different is going on. He, as well as many others, tend to forget this. I think we all tend to compare ourselves to others based on what we see. This is unfair not only to others but to ourselves as well.

Logically, it makes no sense to judge how we’re feeling on the inside to how others look and behave on the outside. I am incredibly guilty of this. It’s a huge reason why I suffer so immensely from social anxiety.

Anyhow, because I chose to disclose my condition and the fact that I am medicated, I have greatly altered my relationship to my boss. He has considerable power over me, even more so than he did before. He could use it against me if he wanted to.

So the question remains: Do I choose how people treat me based on what I disclose? The answer in my opinion is yes. Sure, there’s much more that goes into it than just that, but boundaries are a huge factor.

Most of the time I usually don’t disclose much of anything, and people think (at least in my opinion) that I’m distant, cold, boring, and that I perhaps don’t like them. In other cases, I disclose too much because I need emotional connection really, really bad. There is a happy/perfect medium which I haven’t exactly been able to find yet. Again, it’s something I’m working on, and, again, I believe one day I’ll get there.

nardil update

Wow! It’s already been two weeks since I last posted. So much has happened.

I’ve been on Nardil for about a month now. I’m currently taking 45 mg a day, which is still considered a small dose. It seems like the “magic” dose is 60 mg. I say magic because most people say that unlike most anti-depressants, you actually know when it’s working; it’s not a subtle change.

Although I haven’t experienced anything dramatic, I still have seen some benefits–

  • The best thing about Nardil so far is that it’s kept me from binging on food or alcohol, namely because I don’t eat out and have to avoid many foods or else I could go into a hypertensive crisis. I no longer suppress my negative emotions with food and/or alcohol. This has helped break the binging cycle I used to feel trapped in.
  • I’ve also noticed a slight decrease in anxiety and depression. I don’t over think things too much, which helps with the anticipatory anxiety. I’m also doing things I wouldn’t have done in the past because of my anxiety, like get a tattoo, and saying things that I would normally keep to myself.

The side effects haven’t been that bad so far. I have experienced afternoon tiredness, restless sleep, and loss of libido–all of which are normal–but they’ve all been fairly manageable. I’m scared about increasing my dose, though, because after reading a lot of peoples’ experiences on Nardil it seems as if that magic dose–of 60 mg–is when the major side effects hit, which include weight gain and insomnia.

I’m scared of both of them, but I am mindful of the fact that those side effects are not nearly as bad as the side effects from suicide. I just need to hang in there.

I hope everyone is doing well. 🙂

having a choice

I know this post probably seems to contradict my last past, but I’ve given my last post some thought. I do think that I fall more on the introverted side of things, yet when I’m in a social situation, I want to be seen and heard and enjoy being the center of attention. I guess I am an outgoing, socially anxious person. Sounds like an oxymoron, I know.

***

Anyway. My girlfriend is up visiting her family right now, and I’m feeling a little guilty that I’m not there. I chose not to go.

Right now, I’ve made a conscious choice to only engage in one social situation, outside of work, once per week. Whether that’s with one  of my friends or my girlfriend’s friends or her family it doesn’t matter–one per week. I’m very fortunate that I have a job right now that isn’t too demanding socially. I have to interact with my boss and co-workers and occasionally I have to engage with a few clients on the phone or in person, but it’s not bad at all.

It’s a pretty firm decision–to only engage in one situation per week–but every now and then I’ll allow another social situation or two depending on the situation and how I’m feeling. I don’t like feeling like there’s a quota in place–and my girlfriend especially doesn’t like that.

Anyhow, giving myself a choice is a powerful thing. In the past, there were times where I felt like I was being forced into social situations. I felt like I had no choice–that my girlfriend or friends were forcing this awful situation on me and I had no control. But I did have control. I made those choices to go, not them. Saying no to social situations is difficult to do. On the one hand, I don’t want to say no to too many, because I don’t want to avoid everything and become a hermit or something; but, on the other hand, it’s important for me to do what feels right for me. Getting flooded in every single social situation only reinforces the anxiety. I need to pick and choose social situations that I don’t get too flooded in to slowly immerse myself back into social situations that I find anxiety-proving–gradually increasing over time–so that I can eventually become a healthy social person (whatever that means). Avoiding too many situations as well just reinforces the anxiety. It’s all about balance.

The important thing is that I realize that it’s my choice to enter–and stay in–a social situation. Knowing that can help ease the anxiety in itself. And, although, I do feel guilty about not going with my girlfriend to see her family, I think it’s the best thing for me–and that’s what matters most.

***

With all that said, I’m feeling very lonely. I can’t ignore that. Yes, I do feel good because I do have a choice, but I miss my girlfriend and wish I would have gone with her to see her family. But I bet if I was there, I would be anxious and want to be somewhere else. I can never win, I guess. *Sigh*

What a pointless post. I wanted it to be optimistic because that’s how I felt like ten minutes ago, but now I just feel sad and lonely. Sorry.

am i really an introvert?

Yes and no. That’s the simple answer, of course. I mean, none of us are completely introverted or extroverted; we’re all floating somewhere in between. So, what I really mean is–Am I really more introverted than extroverted?

Being socially anxious, I think it’s easy for me to automatically assume that I am an introvert, and label myself as such.

In fact, all my life I’ve been labeling myself introverted and shy, and yet in social situations I desperately want attention–I’m just too afraid to get it. My perfectionism keeps me from talking and obtaining attention which further fuels my social anxiety. Inside I am a narcissist, and I really, really want attention. But when the spotlight is on me–I mean really on me–I do what I can to get it off me as quickly as possible because I’m afraid of being judged, and as soon as it’s off there’s a sense of relief but not long after that I feel like crap again because I want that attention back. It’s a lose-lose situation.

I wonder how many of us out there, who are socially anxious, are actually more extroverted than introverted?

structure AND chaos

Please note: This is my entry for June’s Blog Carnival of Mental Health. The topic is hope and despair.

***

Structure is my one true love. I love going to bed every night at ten and getting up at six. I love running three miles on Wednesday, five miles on Friday, and six miles on Sunday, and I love knowing that my distance for each of those days increases by ten percent each and every week. I love reading a chapter from a book on my commute into work every morning and then another chapter at night before bed. I love planning activities way in advance, so when I do have to deviate from my schedule, I can plan accordingly.

I could go on and on and on.

Structure serves a purpose for me: it provides hope amongst chaos. It’s also synonymous with perfection. When I know exactly what I’m doing and when I’m doing it, I can remain free from uncertainty, and anxiety stays somewhat at bay.

The problem becomes when uncertainty, chaos, and despair creep back in, which is inevitable. This sends me into a downward spiral. When an unexpected social situation comes up that keeps me out late and floods me with anxiety, I get worn down and it takes a few days to recover. The more deviations, the longer and harder it is for me to recover.

For those who don’t know, last January I entered a downward spiral that stole all hope and ended in two hasty suicide attempts and one well thought out attempt that probably would have killed me if I had carried it out. There’s plenty of triggers to look at, but I think my obsession with structure is the main culprit.

Up until that point I thought I had everything under control–that is, I had developed a set of routines that I thought were impenetrable. However, I went from only going to school online and being subject to few real social situations to having a full-time job and an internship. It was too much. They broke down my structures so much I couldn’t recover. And so I gave up.

I let myself be taken by chaos. I let myself fall further and further down. Granted, I started planning for suicide, which ironically in itself brought structure. But for the most part, I let all structure go.

Now that I’m stable and can look more objectively at what happened, I know that I need structure. I’m just that type of person. The question, though, becomes–How can I have structure but still allow some chaos and uncertainty in without letting it destroy me?

I don’t have an answer. But I do believe it starts with awareness. It starts with knowing that life is full of uncertainties and I cannot possibly plan for every little thing. I mean life isn’t some science experiment with set variables, yet so far it’s been my best defense against anxiety to treat it as such. I am learning that there is a balance between structure and chaos; it’s not an either/or situation. There will always be hope and despair in my life, sometimes at the same time–and I’m learning that that’s okay.

no direction

There’s no way around it: the depression has lifted. Unfortunately, now that I’m no longer depressed, I have to deal with the triggers as well as finding preventions so I don’t get trapped again.

I feel good so far about Nardil. I’m still in the early phase, so I’m on a very low dose and experiencing no side-effects (but no benefits either), but I do feel hopeful about this drug. I’ve never felt good about medication in the past. I question it. I think about it too much–Is it working? Is this me or the medication? Etc. But I’m not doing that this time. I have faith, I guess.

The bigger issue for me is what direction should I go in career-wise. I feel stuck. I don’t like my accounting job–and I dislike my boss even more–but I could stick it out just because it’s easy if it paid more. My boss, on the other hand, believes I want more from the job. He wants me to eventually take over running the business. Again, I have no idea what he sees in me. Regardless, the work is not something I particularly like doing and I don’t feel like the work helps people–so I’m not fulfilled at the moment.

Then there’s my education. For those who don’t know, I’m in graduate school, training to become a librarian. I have 3 classes left to take. I guess this is the ideal path for me because I may get more enjoyment out of the work and it definitely helps people. But I’m worried that I won’t be able to find a job after I graduate. I wish I could just push my worries aside, let things happen, and worry about finding a job when I’m actually finding a job .. but that’s not me.

So, at the moment I feel lost. When the episode of major depression hit, I had just started my accounting job. I cannot ignore that. I think that when you’re already dealing with mental health issues, dissatisfaction with other life circumstances–i.e., my job–can make it seem like your issues are even more insurmountable, which exasperated my depression.

I have no answers right now, and I probably won’t have any answers for a while. One day I may be content with my circumstances, just not today. I guess that’s okay for right now.

starting nardil

I just picked up my script. I’m scared. This drug is old and nasty and has terrible side effects, but apparently it really reeeally works. It seems like it’s the last line of defense, medication-wise, for depression. It’s also supposed to be really reeeally great for social anxiety.  But there’s so many food restrictions–http://www.dr-bob.org/tips/maoi.html

I have to eliminate so much from my diet. I’m vegetarian, and I can’t have soy products or protein shakes or nuts. I guess I’m going to start eating meat again.

Aside for the food restrictions, there’s, again, really reeeally bad side effects, which apparently according to my research mysteriously go away after a few months and you’re left in bliss. With my history of medication, though, I’m not feeling very hopeful.

I just want something to work. I just want to feel better. I’m not expecting a miracle or a quick fix, just a little relief.

If the ends justify the means ..

an example of avoidance

Yesterday my boss asked me to go downtown today to pick up some tax documents at the state’s local field office. I didn’t think they could provide the documents, but I didn’t have the nerve or desire to argue with him so I reluctantly agreed.

I’ve had to go to this field office a few times before. Each time, I’ve had to endure a rather difficult social situation because the receptionist is very attractive and socially adept. In other words, she’s beautiful and perfect, and I’m not. These thoughts happen in a split second and ensure that I will fail. Now, CBT has taught me to catch these thoughts before they happen, to counter them with positive, rational thoughts. But this never seems to happen quick enough. I sum up that she’s perfect and place her on a pedestal before my rational mind has a chance to kick in–and I’m left playing catch up.

Anyhow, earlier I started having anticipatory anxiety about the situation: Not only would I have to face this perfect being but I also don’t feel comfortable asking for the documents since I don’t think they could provide them. And so, I started coming up with ways to get out of going–

  1. I could lie to my boss by telling him that I went and that they either didn’t have the documents or couldn’t give them to me.
  2. I could call in sick.
  3. I could call the tax office to see if they could even provide the documents.

The third choice seemed the most logical, but I’m terrified of making phone calls, especially when I have time to think about what I’m going to say beforehand, so I wanted to do the first choice. Eventually though, I talked myself into calling, which was horrible in itself, but I found that I was right: They couldn’t give me the documents after all.

I’m now beating myself up, telling myself that it wasn’t that bad and I shouldn’t have been fretting about the situation at all. I’m also disappointed in myself for avoiding another social situation.

Why can’t I look at the good parts? I mean, I made the phone call even though I was terrified and obtained an answer without lying. Those are positives, I guess.

If I’m not perfect then I’m nothing at all.