Social Anxiety Disorder

pagandeva2000, LPN · Jan 24, 2008

My son has a social phobia. It amazes me, really, because both, myself and his father are such outspoken people. I suspect it began because his dad was overly critical of him, while my mother doted over him and I was in the middle. My son is literally the kindest person you can ever encounter. He loves animals, children and the elderly. He always believes in following the rules so that he does not get into trouble (although, you will see how he will do strange things as you read this). He always believes that people are critical of him, that he does not know the right thing to say, or do. He also will not tell me of his problems because he 'doesn't want to bother me', even when he is not feeling well. He will not tell me about problems that can easily be resolved until it spirals out of control. An example of this is that he goes to weekly therapy sessions with a social worker because of this disorder. I would give him money to pay for his sessions. If he needed part of the money for something else, rather than tell me, he would pay some of the money. A year went by, and suddenly, I get a bill saying that I owed $500 dollars. When I questioned them, they reviewed his records and told me that sometimes, instead of paying the $25, he would pay like $5 or $10. I paid it, but told him that he should have told me that he needed extra money for lunch, or for whatever reasons. He did it again a year later, and that time, I made him pay it from his savings, because I told him that I have bent over backwards to let him know he can approach me, and I should not have to pay because he was too nervous to share this with me.

At times, rather than share with me what he is feeling, he would avoid me. He had issues with my husband because for awhile, he began to associate all men with how his father treated him. My husband is extremely kind to him and tried his best to comprehend this illness. He would act secretly by hitting and scratching himself, because he was so frustrated with his inability to express simple things. He got into a disagreement with my husband once, and I thought I was doing the therapeutic thing by telling him that he should write down on a piece of paper what he wanted to say to my husband. I told hubby in advance to expect this note, and to respond with empathy. I told my son to go to his room, write it, and give it to me, so I can read it to my husband. Rather than even face the 'confrontation' of writing this note to help dispell this, he climbed out of the second story window. I went to his room, saw the window open and was scared out of my wits. I thought that he committed suicide, so, I ran into the dark back yard looking for a body. Didn't see him, but I didn't know where he went, either. I searched the neighborhood for him. It was hard to even begin to know where he would be, because as a social phobic, he did not have many friends. I called the police, searched the neighborhood. No luck. Then, I received a call from my job. He went to the emergency room, to try and see his old therapist who treated him a few years before I started working there. When security discovered him sitting in an empty hallway, he willingly gave his phone number and told him he was my son. I came and got him with his father, and he told me that he was afraid to come home because he knew I was disappointed in him, and that his father would make fun of him. We all had to talk him into coming home, and he wouldn't, until I told him that I would get him help.

When he was young, at first, he was diagnosed with ADD, but, when he was finally diagnosed at age 14 of the social phobia, it began to make sense. My son used to walk out of class and wander around. He would rarely get into fights, and would daydream often. What was actually happening is that he was teased in school of being a 'sissy' or a 'punk' because he would cry often and could not handle teasing. He hates to see ANYONE be humilated, he will never play practical jokes on people or tease them. The few friends that he has acquired have told him that he needs to 'let up' and that he is too rigid. Many have lost patience with him because he would not tease or relax. He tends to look tense around many people because he feels he does not know what to say.

My son is now 21 years old and is about to graduate from college with his associate's degree in graphic arts. He does okay in school maintaining a 2.6 GPA, but he is still too shy to socialize. I tried to get him to go to church on his own to meet peers of his age (he loved to go to church with his grandmother, who died in 2006). He will only go to visit his cousin, but she had a baby last year, and is a bit busy. He has a few friends that still remain in touch with him from elementary school-one calls him weekly. But, my son is nervous about visiting this boy, even though this friend has accepted him for who he is. He is a very loving child, he looks young for his age, due to non exposure to most things that people his age have experienced. He kisses all over me each day I come home from work. He does volunteer work at a day care center, and he has now learned to express himself with beautiful poetry. Thus far, he has written over 300 poems that all bring me to tears. He loves school, and plans to get his bachelor's in graphic arts and advertising. He is artistic and imaginative; his computer work is out of this world. He creates superhero and comic book scenerios that are surprizingly complex. His therapist continues to work very hard with him, but she told me that she basically sees him as a child that will probably remain home with me, or live in close proximity to me because of his fears. She does see him working and being functional on many levels, but stated that it may really take time, if ever. He does not wish to take medications anymore, and stopped taking it once he turned 19. He took Zoloft for awhile, and then, Paxil, but decided that he didn't want it. I can say that once off of it, he decided on his own to go to school, and his poetry started when he stopped the meds. He says that he is lonely often, but does not speak or display suicidal tendencies. He developed on line friendships with internet poetry books, has a page on MySpace.com, and that is the basic extent of his socialization. I take him out with me often, because my friends adore him because of his impeccable manners and consideration. But, it is hard to encourage him to forge his own relationships, and I stopped trying to 'force' him, because he then began to think that I saw him as a failure because he didn't socialize the way I tried to encourage him to do so.

I love my precious son immensely. In spite of his phobia, he encourages me to be a better person and nurse. His kindness brings me to literal tears and I fight like a tiger when I think someone mistreated him. I look forward to coming home to him each night and simply sharing space with him. His eyes brighted up each time he sees me. I am trying to get him to think on his own, though and I often wonder how he will function if I am not around, but I would not trade him for the world. I'm sorry this was long.

Katie82, RN · Jan 24, 2008

The Mental Health Care delivery system is one of the most perplexing facets of health care today. While other chronic conditions can rely on a Standard of Care across the continuium, mental health standards seem to vary by region and provider. A large part of my patient load (case management) consists of patients who have some major mental health diagnosis, the treatments are as individual as the patients. There are so many layers to the mental health system, and as many levels of outcomes as there are States in the Union. Very few of my patients are receiving the treatment they should be (according tothe APA), and this is as much a fault of the patients and their support systems as it is of the local delivery system. I have tried working with my local resources. but they wrap themselves in HIPAA and will not cooperate. There are so many people I feel I could help with a little cooperation from their MH providers. I have an uncle who was diagnosed late in life with SAD, we all thought he was just a little "high strung". He had what we thought were three heart attacks before a really smart ER doc saw it for what it was. He simply cannot deal with crowds or groups of people he does not know, his reactions and symptoms are very real - I was with him when he had one "attack", and he really had me convinced. He has taken Paxil for many years, and he avoids what to him are stressful situations. He is ok in crowds as long as he does not have to interact with them. I can take him to Disney World, but he would not attend my daughter's wedding. He has been medicated for years, but I don't believe he has ever received therapy, probably by choice. The goal of mental health in many parts of the country seems to make patients at least minimally functional, but not necessarily well....

chadash · Jan 24, 2008

Thank you for sharing about your son.:redpinkhe:redpinkhe

pagandeva2000, LPN · Jan 24, 2008

Many times, these people are hypervigilant; constantly observing for possible situations that will make them uncomfortable, so that they can run for the hills. I call my son 'rabbit' affectionately, because I have seen him do it. Also, we are African Americans. My son does not like to be around the stereotypical Black males in my area, because he sees many of them with their pants hanging down low enough to see their goodies, acting aggressive and angry. He is afraid to go to the barber shop or to the corner stores where they congregate, because these guys see the fear in his eyes, and I am sure that they have antagonized him. So, now, I taught him how to cut his own hair and learned a bit about barbering myself...LOL. You'd be surprized on how they judge what is confrontational. Once, someone called my son a name and when he told his therapist, he said "This person called me a horrible, unspeakable name" and was crying hysterically. The therapist asked him to write what he was callmed on a piece of paper and he wrote "nerd". You would have thought that they told him they would kill him. But we couldn't react that way, because, again, they see it as we are also judging him.

It is amazing, really.

jrt71 · Jan 24, 2008

Just thought I would add my 2 pennies. I have suffered from social anxiety disorder all my life. I have tried many medications and honestly the only one that helps (at least in my case) is a beta blocker. It is extremely difficult to try and socialize and concentrate on what the other person is saying when you have all this adrenaline (from being scared and anxious) coursing through your body. The beta blocker seems to stop alot of this adrenaline from being released into the body. So I can actually hear what the other person is saying instead of being focused on my pounding heart, tingling hands and rapid breath. Effexor also did help me, not so much with the social anxiety but with stopping the compulsive obsessive thoughts that usually come with having social anxiety. The effexor was very difficult to discontinue, however it was a godsend for curtailing the never ending stream on negative self talk that was constantly going through my head.

I went through a short inpatient psych program when I was 19 but I dont feel I benefited from it at all. From there, I tried different therapists, and weekly sessions with psychologists but again, I really didn't notice any improvement. As the years went on I began to self medicate with alcohol more and more. The alcohol would just numb my anxiety and make me forget how mad and disappointed I was at myself for not being strong enough to overcome the disorder.

Then when I was 30 yrs old, I was admitted to the chemical dependency unit at our local hospital to detox and try to overcome my alcohol addiction. I was inpatient their for 4 weeks and then outpatient another 4 weeks. My days while inpatient consisted of constant back to back therapy groups with the other patients that were suffering from addictions. I will never forget the people I went to "group" with, they helped me in so many ways.

When all was said and done, not only did I overcome my alcohol addiction but it was the first time in my life that I was not consumed and controlled by social anxiety.

Will I ever be a social butterfly? No, but I have much more confidence now. I can comfortably go to family gatherings and functions. I can calmly sit in meetings at work and not give it another thought. And if someone were to cut in front of me while Im in line at the post office, I would have no problem telling them "hey, the line starts back there". These are things I was never able to do before.

When your in rehab, you dont really have a choice about weather you want to go to group or not...you pretty much have to. They also, make you participate weather you want to or not (at least thats how the staff make you feel haha). After going through 8 groups a day for 30 days straight, well ...I just didnt have the energy to give to my social anxiety anymore. And after the whole program was over I realized that: Nobody is perfect and Im okay.

putmetosleep · Jan 25, 2008

Just thought I would add my 2 pennies. I have suffered from social anxiety disorder all my life. I have tried many medications and honestly the only one that helps (at least in my case) is a beta blocker. It is extremely difficult to try and socialize and concentrate on what the other person is saying when you have all this adrenaline (from being scared and anxious) coursing through your body. The beta blocker seems to stop alot of this adrenaline from being released into the body. So I can actually hear what the other person is saying instead of being focused on my pounding heart, tingling hands and rapid breath.

My understanding was that beta blockers were used prn for certain situations (giving a presentation, etc)--so do you actually take them on a regular basis? Seems like scheduled beta blockers would help control the symptoms more consistently.

jrt71 · Jan 25, 2008

My understanding was that beta blockers were used prn for certain situations (giving a presentation, etc)--so do you actually take them on a regular basis? Seems like scheduled beta blockers would help control the symptoms more consistently.

Yes I take one every day. I take Ziac. It also helps control my high blood pressure.

pagandeva2000, LPN · Jan 25, 2008

jrt71, I really appreciate your story. Are you living on your own, now? How do you function at work? Are you able to interact with your patients? These are stories that I want to share with my son, to let him know that it can be worked through. Thank you so much for sharing this!

jrt71 · Jan 25, 2008

jrt71, I really appreciate your story. Are you living on your own, now? How do you function at work? Are you able to interact with your patients? These are stories that I want to share with my son, to let him know that it can be worked through. Thank you so much for sharing this!

Thank you pagandeva. I am now 37 years old and have two boys. My husband is a constant inspiration to me and incredibly supportive and patient. If it were not for his insistence, I can say with 100% certainty that I would not of gotten the help I did when I was 30. Being locked up with people and being forced to communicate with them in a group setting was like asking me to voluntarily walk into Hannibal Lecter's living room and have tea with him. I was certain I would not survive the experience.

I work as a dog groomer at a large corporate pet chain. My interactions at work are better now then they have ever been. For one thing, I can actually hold a job now! Something I was unable to do before due to the social anxiety. We are constantly having meetings about productivity and customer service. In the past, a meeting like this would of put me into a tail spin but now I take it in stride just fine. I did not attend our holiday Christmas party because parties are not something I enjoy and I doubt I ever will. However if it was REQUIRED, I would have attended with out being overly stressed about it. I have many regular customers and have developed a fairly large following...large enough that my husband keeps telling me I should just open my own pet styling salon as I would already have a sizable clientele. :)

I was just recently approved to start a LPN program and am thrilled beyond belief. Being a nurse is something Ive always wanted to do but was way too scared to even apply. Now, I cant wait to start!

As far as the other students in my class, Ive already accepted that I will never be miss popular, and Im fine with that. Im not pursing my goals for them anyhow. Im doing this for me. The program starts this March and Im determined to enjoy it as much as I can.

Im so sorry to hear that your son has this horrible disorder. It truly feels like your cursed. It can be a very lonely existence and very debilitating. I remember going through some very scary, very very dark days. I hope that if your son ever experiences one of these days that God himself will be watching over him and keep him from harm. Please let your son know that while Im sure he feels hopeless, change IS possible. It can happen and does happen. And until then, he needs to stay strong, and keep on keeping on.

I sincerely wish you and your son all my best and will include him in my prayers tonight. Please have faith and sustain the hope that he will one day overcome this. It IS possible.