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Mental Health (Expert Forum)
Always questioning myself
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
Always questioning myself
by steve, Dec 13, 1999 12:00AM
For the past 2 or 3 years I have had bouts of depression and anxiety. Now I do everything I can to avoid social situations. I am really insecure and don't have any close friends. I used to be really popular, but now I'm introverted and constantly questioning myself. I also have thoughts where I question whether I am gay or straight ... I've had 2 long term relationships and lots of other good relationships with women, and I know I'm attracted to women and not attracted to males. I guess I just don't feel "manly" enough to face the world, and I'm physically small too. Have you herd of this before? I'm depressed to the point where I don't want to get out of bed anymore, but even lying in isn't enjoyable. Please help me!
Doctor's Answer
by HFHS MD - RG, Dec 14, 1999 12:00AM
Dear Steve,
Anxiety disorders are one of the most common groups of psychiatric disorders. It seems you may have Social
phobia or what is now called Social Anxiety Disorder.
Social Anxiety Disorder is characterized by 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 and exposure to the
situation may provoke anxiety. The person recognizes that the fear is excessive or unreasonable and avoids those
situations. Often people assume this is shyness rather than a bonafide medical condition. The good news is that this
is a treatable disorder. A combination of medications and cognitive -behavioral therapy seem to be effective in the
treatment of anxiety disorders. SSRI (Serotonin Specific Reuptake Inhibitors) such as Prozac, Paxil, Zoloft, Celexa
are the drugs of choice. Other medications like benzodiazepines, tricyclic antidepressants and MAOI's are proven
to be effective.
Another possible diagnosis is Avoidant Personality disorder. People with this disorder are hypersensitive to
rejection and may lead a socially withdrawn life. They are not asocial and show a great desire for companionship
but are characterized as being timid with low self-esteem.
There are other forms of anxiety, such as Generalized Anxiety Disorder, in which people unreasonably and
excessively worry. The person has a number of associated physical symptoms such as restlessness, irritability,
muscle tension, etc.
I would recommend that you contact a Mental Health Professional for an evaluation
Anxiety disorders are one of the most common groups of psychiatric disorders. It seems you may have Social
phobia or what is now called Social Anxiety Disorder.
Social Anxiety Disorder is characterized by 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 and exposure to the
situation may provoke anxiety. The person recognizes that the fear is excessive or unreasonable and avoids those
situations. Often people assume this is shyness rather than a bonafide medical condition. The good news is that this
is a treatable disorder. A combination of medications and cognitive -behavioral therapy seem to be effective in the
treatment of anxiety disorders. SSRI (Serotonin Specific Reuptake Inhibitors) such as Prozac, Paxil, Zoloft, Celexa
are the drugs of choice. Other medications like benzodiazepines, tricyclic antidepressants and MAOI's are proven
to be effective.
Another possible diagnosis is Avoidant Personality disorder. People with this disorder are hypersensitive to
rejection and may lead a socially withdrawn life. They are not asocial and show a great desire for companionship
but are characterized as being timid with low self-esteem.
There are other forms of anxiety, such as Generalized Anxiety Disorder, in which people unreasonably and
excessively worry. The person has a number of associated physical symptoms such as restlessness, irritability,
muscle tension, etc.
I would recommend that you contact a Mental Health Professional for an evaluation
