Trapped in a Box

Welcome to the world of social phobia.  It is a wonderful world, full of panic attacks, completely irrational fears, and utter shame.  It is not a world that I ever thought I would inhabit, growing up as a reasonably bright and sporty child in small-town New Zealand, but nevertheless, I called the box home for a number of years.  Before I get ahead of myself, I'll give you the textbook rundown on social phobia (also called Social Anxiety Disorder).  Here's the skinny from the DSM-IV TR, that I obtained from behavenet.com...

1. A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. 
   Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults. 
2. Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people. 
3. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
4. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
5. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
6. In individuals under age 18 years, the duration is at least 6 months.
7. The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g., Panic Disorder With or Without Agoraphobia, Separation Anxiety Disorder, Body Dysmorphic Disorder, a Pervasive Developmental Disorder, or Schizoid Personality Disorder). 
8. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa.

All fun and games until someone ends up hiding in their wardrobe hyperventilating, huh?

In hindsight, I started experiencing symptoms of social phobia when I reached Intermediate school.  This anxiety was still fairly generalised, but it increased again when I started high school.  It was not until I was probably 16 that the specific nature of my anxiety really began to make itself known, that it began to be noticeable to me, and that it began to seriously hamper my ability to live my life.  At 19 I was a wreck, completely housebound, terrified of the phone ringing, perpetually fearful, having multiple anxiety attacks on any given day, heavily self-medicating with alcohol and cannabis, and hooked on the diazepam that the psychiatrist had prescribed me for my anxiety attacks.  

But let's not get ahead of ourselves.  I'll end this post by making note of the main features I experienced.  The most obvious was a fear of social or performance situations, this was what I began to notice first when I was at high school.  I became convinced that I would humiliate myself in some way if I were in public, and I also formed the irrational thought that other people, even strangers, could see what I was thinking or feeling in some way, and that they would mock and judge me for it.  The next was a fear of eating in public, or in front of others, even my own family.  I developed this idea that I would vomit if I ate in front of others.  Initially I would not actually experience nausea, but later I did, as if my anxiety was trying to create some form of self-fulfilling prophecy.  The third was the anxiety attacks.  Those were frequent, distressing, and entirely out of my control for some time.  The combination of these main elements left me avoidant, in constant fear, and unable to manage even the most basic tasks, like hanging out washing, or getting my mail.  It left me feeling continually guilty and ashamed.  

In my next post, I'll discuss how social phobia progressed for me, and the impact it had upon my life.

What's it all about, Alfie?

So why have I started this blog?  There are loads of mental health blogs out there, why should I start yet another one?  I guess I want to share what it's like to have multiple conditions to manage, which occasionally feed each other, and occasionally oppose each other (mostly the former).  I'm not interested in trying to tell people how to manage their own health, I'm not a doctor, I'm not a psychologist, and I'm not a mental health professional.  I AM an occupational therapy student, but more importantly, I'm someone for whom daily living can sometimes be a mission, despite doing all the right things.  I think it is important for people to understand this about mental health - even when you do everything by the book, things can still go wrong, sometimes just a little pear-shaped, sometimes to the extent that the wheels fall right off.  For people out there with mental health issues, this is important to know because it stops us beating ourselves up any time things happen to our minds that we don't welcome.  For people out there who know and/or care about someone with mental health issues, this is important to know because the person you are family, friends, or colleagues with is almost always trying NOT to be sick, and things happen despite their efforts.

So, what exactly am I dealing with?  My first diagnosis was social phobia, in conjunction with clinical depression.  I was diagnosed with these two at 19.  My second diagnosis was chemical dependence (aka addiction), which I was diagnosed with at 21.  My third diagnosis was bipolar I disorder, which nullified my initial diagnosis of depression.  This diagnosis came a few weeks before I turned 24.  A new diagnosis every couple of years, I know, it sounds like I was sitting reading the DSM-IV and thinking to myself, "I'm bored with this, give me a new set of signs and symptoms", but I promise you, it definitely didn't have anything to do with boredom!  I'll do separate posts about my diagnoses, in order to share some basic information about them, as well as to share my experiences with them.  At this stage though, I think it's important to put that basic information out there.

It's also important at this point, right at the beginning, for me to state that I do not believe that psychiatric disorders are a sham.  I do not believe that they are the invention of a field of medicine that wants to be in the limelight and receive perpetual funding, and I do not believe they are the invention of "Big Pharma".  If you're going to comment that I am some kind of dupe, or that I've been brainwashed, please do not bother, this is not a platform for that, and I am not interested in those kinds of comments, as I have seen too many people die because they listened to those sorts of opinions.  Ultimately, I guess I am here because I live with a host of strange phenomena, and I want to share this life honestly and openly.  If people connect with that, awesome.  If people can help, awesome.  If people receive help, awesome.  A little word on perseverance...

He moana pukepuke e ekengia e te waka!

(The canoe can navigate a choppy sea.)