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How can my anxiety be treated?

I have had problems around people for years now and every therapist I've had hasn't mentioned it and what it could be really. I know I have some kind of anxiety but I haven't been diagnosed with anything. I get severe anxiety just being around people and I often get awful panic attacks when people talk to me and when I'm around crowds. I've learnt to hold them in a lot of the time due to trauma and during that time me showing any kind of negative emotion was dangerous for me, so when I'm in public I get super anxious and shaky but I have grown to hold it in unless its safe for me to go cry and have a panic attack somewhere. I don't get anxiety due to me worrying that people are looking at me or judging me, I really don't care how others perceive me, it's just an overwhelming anxiety of being near people (aside from family), I also cannot talk to people almost entirely, most days when I go to college I don't speak at all. My therapist says my case is interesting as I have spent years trying to practice getting better at talking to people but nothing seems to work. CBT wouldn't work as my anxiety has got nothing to do with my thoughts, it's just there and its debilitating. Is this just untreatable since there seems to be no cause and it's not based on my thoughts? Do I just have a fear of people and awful communication skills? Can I actually be helped or do I have to remain terrified of everyone forever?
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973741 tn?1342342773
Social anxiety is real!  It falls under the umbrella of anxiety disorders and it can be debilitating.  It runs on a spectrum from mild to severe.  Anxiety medication does help to treat it with several having this specific indication for treatment.  SSRI's for example work well for social anxiety. I have some of this and my son has it.  I hate it!  

One thing you can do in your control is WORK on those communication skills.  Learning the art of conversation is very helpful.  I also have learned to accept that no one knows what is going on inside of me.  So, I can portray my outside differently than the anxiety felt on the inside.  People love love love to feel heard and I've learned to be a very good listener.  I ask questions, pay attention to their details and it warms people to me and that in itself makes me less anxious.  :>)  

Do you work?  How old are you?
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I'm actually only 17. I don't work, the idea of getting a job is terrifying to me so I've been putting it off for as long as I can. I get awful anxiety over things changing so if I were to apply for a job stacking shelves for example I would find that quite difficult in general as I would be around people but if I were to be asked to help in something else I'd just freak out as I wouldn't be expecting it, I like to know exactly what's happening and since getting a job seems so unpredictable I've avoided this so far. I'm quite an avoidant person since my symptoms are so bad for me but that obviously makes things worse.
973741 tn?1342342773
Ah, you are so young.  Are your parents aware of your difficulties?  It would be very helpful to get them on board and consider speaking to a psychologist/psychiatrist so that you can LIVE life with out this fear and anxiety.  Avoiding people I'm sure makes you feel very isolated.

Don't worry about getting a job now---  I was just asking in case you are older.  At 17, getting your mental health in tow is important so that you can get a job down the road when it is time (go to college, community school or trade school).  

Have you talked to your parents about this? What do they say? Do you go to school and survive okay?
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Yeah they know, although it's hard to explain the extent of it to a lot of people since its not my thoughts that make me afraid and anxious. And since they don't experience anxiety it's kinda hard for them to understand it I guess? I see a therapist once a week, there are a lot of things I need help with at the moment so we're gradually getting through parts of it. Its rather frustrating since both my anxiety and my very low mood are both pretty bad, and since it's not about my thoughts my therapist doesn't know what to do about it. I've just started college,  Upper school was a huge struggle, my anxiety left me not being able to attend most of my lessons entirely so I was given a tutor to make up for the lessons I missed which was helpful. I've just started college and for someone reason I think my anxiety is worse? I used to have a panic attack maybe once a week while i was in school but 8th worse now. They have a lot of emphasis on attendance and due to my low mood my attendance has always been bad in school, about 75%. I've been in college for nearly two weeks and I've already had a day where I couldn't go in and I've had 4 days out of 6 that I've been in college where I've had multiple panic attacks over the stupidest things. So I'm starting to get paranoid they'll kick me off my course if i continue to have days where i cant come in. It's exhausting.  The support team there are lovely but I feel like I've been suffering for so long and no one had acknowledged it. My old therapist refused to put me on medication for my anxiety and I only barely just got given antidepressants because I had overdosed. I feel like the lack of support and and help people have been giving me is making me think that I'm overreacting about my anxiety or that it's not even that bad. It's quite frustrating, I haven't been diagnosed with anything at all which already makes me doubt that there's anything wroulng with me and they haven't given me medication for it makes me think that it's not even that severe. Since I haven't been diagnosed with anything, even though it's clear I have depression and it's genetic it makes me thing there's nothing wrong with me since people have just said I struggle with "low mood" and I'm "socially awkward" or theyll say i have "symptoms of PTSD" so those kinds of phrases make me think that I'm not even that ill, especially with my anxiety and depression.
973741 tn?1342342773
You say this isn't due to your thoughts, but isn't it? Your fears are your thoughts. Social anxiety though is a mental health disorder as a sub category of anxiety disorder.  Treating your depression is a no brainer.  This is done through the therapy you are doing for sure but also antidepressants.  I'm not saying it is impossible but overdosing on an SSRI would probably be tough and is not a huge threat.  That's one of the nice things about it compared to anti depressants in past decades. Anti anxiety medication like benzos are another story.  But, you could take a medication long term for chronic depression that you describe.  You need to be exercising, learning coping strategies like it is a school project you want an A on. Those include self soothing strategies like breathing techniques. Picture birthday candles . , . . suck in air and blow out the candles one at a time (the candles are fake, lol, but visualize), meditation, positive self talk and mantras, yoga, proper sleep and diet.  All of this helps set up a better situation for yourself.  

Try not to overanalyze yourself and be flexible and open to things like trying a different med, that this is indeed thought based, and that you can get better.  Taking an antidepressant that has a social anxiety disorder indication may have a huge impact for you.  

And more people understand than you think.  This is not, to be honest, terribly uncommon.  You may have a greater extent of social anxiety (and social anxiety IS also from social awkwardness and improving communication skills and social skills WiLL help---  I'm telling you, been through this myself and with my son)--  but you can overcome this.  
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Avatar universal
CBD oil is actually usually made from industrial hemp, though you can get a variety that is made from the psychoactive marijuana plant.  And the above is correct, it has shown to be effective in early studies with social anxiety.  So much for that.  Look, at your age, I wouldn't recommend medication or CBD oil if you can get better without it, as your brain won't be fully developed for a few years yet.  But if you have to, you have to.  It seems to be you do have a life, it isn't completely unliveable at this point, but some things you've said are not accurate, as Mom has already said.  Anxiety is a thought.  And you're thinking about it in the wrong way.  CBT, for example, doesn't really care how you got to be the way you are, it just tries to change the way you think.  Works for some, and not for others.  It concerns me you say you haven't gotten a diagnosis -- if you're seeing a psychologist and not a social worker with a counseling degree, they are able to diagnose you.  So is a psychiatrist, the docs who give out the meds, but they learn their psychology from psychologists generally.  So again, any psychologist can make a diagnosis.  So have you asked if there is one?  The fact is, most psychologists don't talk diagnosis -- they just start in on whatever form of therapy they practice.  Psychiatrist do give a diagnosis, but that's because the only thing they're going to do for you is give you a medication nowadays -- very few of them do therapy anymore because they can see more patients and make more money not doing it and because psychologists can do the same thing and charge less money and give you an extra 5 minutes of time to boot.  But the diagnosis won't change what's going on, it will just put a label on it.  You're problem is exactly as you've described it, whatever you want to call it.  The other thing I'd like to know is what you mean by trauma.  If something happened to you that you know caused this pattern to occur, then a talk therapist can work on that with you and hopefully help you to see how you got to where you are now and start making your way back to where you'd rather be.  Most anxiety sufferers actually have no idea at all why they get so anxious, it just comes on.  For that, CBT is recommended because you can spend years in talk therapy trying to find out why you are the way you are without getting any better.  CBT is quick, though it has nothing near a guarantee of working.  Think of therapy as an art form rather than a science -- nobody knows scientifically what causes some people to get depressed and anxious and others go through the same thing and don't.  They're looking, but haven't yet found that answer.  So finding the right therapist is very important, and you have to be willing to work really hard.  I was a terrible patient in therapy.  I don't know why, but I was.  If, however, your life is spiraling out of control, sometimes you have to bite the bullet and go on meds.  As mentioned, overdosing on antidepressants is really uncommon and very hard to do.  But again, if social anxiety is the problem, I will repeat that the above post is actually right, CBD oil is becoming more and more accepted as a treatment for anxiety, especially social anxiety, and it doesn't get you high.  It appears to affect serotonin but in a very different and more benign way than the more common antidepressants do.  Lots of things to talk over with your therapist, but Mom is right, right, right, you are describing thoughts.
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973741 tn?1342342773
Don't let these posts scare you.  :>)  The world of psychiatric medicine is not the same everywhere and people share their solo opinion of how it is for them.  Not that way for me and might not be that way for you so don't fear getting proper professional help.  Social Anxiety is not an uncommon issue even though you may suffer to a greater extent than some.  My fear is you will become house bound and that will not work!  There, and I forgot about this, work books directed at teens on this subject.  I got some for my son to do over the summer.  They are written by psychologists and I got them on Amazon.  You can search that up---  go to Amazon and put in social anxiety work book and you will get several by the same authors--  The anxiety workbook for teens, Shyness and Social Anxiety workbook for teens, Mindfulness for teens with anxiety, etc.  They are practical and might help a little and something you can do at home without stress.  Let me know what you think.
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Avatar universal
There are many good psychiatrists, psychologists and therapists out there but if you're not getting better you need to find a new one.  Social anxiety is very common and there are many around you who have it but have forced themselves to go on.  I feel it's a process, one step at a time.  We all have fears we have to face at some time in our life but often have no choice but to face them.  Take small steps.  Start by knowing nobody is going to hurt you and start making eye contact with people, if just for a moment.  The more you do this the easier it will get.  Then move on to smiling when you pass someone, you may not get one back but so what?  Often the person you say hi to is afraid like you and doesn't know how to react.  Sometimes you will make someone's day because you noticed them and they realized that and that they do matter even to strangers.  A smile can go a long way!  Then work on saying "hi" to people, again you may not get one back but for every time you do this you will become more confident.  Even the most famous people get nervous around others, but they don't have the choice to run away and have to face it.  I do believe that something has made you afraid and I don't know what and maybe you don't either but you need to do everything in your power to break away from this fear so you can have a normal life.  Not talking or making eye contact just makes you more noticeable to others, so you truly need to work on this.  College is a great place to practice..  Don't worry that you may say something wrong because we all do!  It's okay, and learn to laugh at yourself.  I am in no way lessening the severity of your problem, I would just love to see you push beyond this and have the life you deserve.  specialmom offers great advice and the books would be helpful to you.  Think to yourself...what is the worst thing that can happen to you by being around people?  Yes, your anxiety kicks in but trust me the more you push yourself to do what you fear most with time you will over come that fear and anxiety.  The first time my son had to speak in front of a large crowd he was nervous, and I asked "do you know what all the other kids in the room are thinking" he replied "no".  I said "they are glad it's you up there and not them! He did great! Because things like this scare us.  I think you are smart and strong enough to tackle this anxiety head on and win!  We're always here for you so feel free to talk to us.  I wish you all the best and please keep us posted on your progress.  Take care...
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3 Comments
Just want to comment as I always do with my ongoing and permanent disagreement with Mom on one thing, which is medication.  Mom is much more keen on it than I am, but it isn't because I have a "solo" experience.  The research is factual, not based on me.  It is what it is.  While our reactions to meds differ wildly, and I've been on them for years because nothing else worked -- I'm no exemplar of not using them as I do use them -- my problem is quite severe.  But the concerns I express about meds is from actual research and experience from the true experts, which aren't doctors or psychiatrists you see in their office but the ones who do the research studies on what happens when drugs have been on the market for a few years and enough data becomes available to judge what's going on.  Anyone can find it.  It's on the NIH website, if you don't mind a lot of jargon.  It's in books.  It's on public radio and TV.  It's in the newspaper, if you read a good newspaper.  The implication that anyone expressing caution about taking any medication that affects the brain, especially for young people who do not yet have fully developed brains, are simply not looking at the research.  The only question is a cost-benefit one, which means, does the  potential benefit outweigh the potential harm?  We all have to make that decision for ourselves, but it does help to know what you're facing so if something happens you know how to deal with it -- it's very unlikely your doctor will, unfortunately.  It's a good thing to see disagreement -- it reflects reality.  It isn't a good thing to see dismissal of evidence, something that has become all too common these days and has infected even our political system.  Don't avoid what you need to get by, but do use caution and do your homework first.  Again, despite everything I've read, I still take the meds because nothing else worked for me.  I only wish before I went down this path that I had been better informed; it would have saved me from really bad things that happened and I don't want it to happen to anyone else if I can help it.  Peace, all.
There is a lot of research that I read as well to back my comments. :>))  I don't recommend anyone start medication light heartedly and know that one should always weigh risks to benefits.  But if someone is isolating, close to agoraphobia?  Treat it fully so they can have a life. We're not here to say someone should or should not use medication, we are here to discuss the options which does include medication.
Actually, I think we're here to discuss what we think, based on our experience and research but of course none of us are experts, will benefit the posters.  If that means a particular person seems to be on medication who doesn't appear to any one of us to need it, that's a piece of information for the poster.  What they do with it is entirely up to them, but there is one fact in our society and that is, we are way over-medicated.  Drugs are not risk-free.  I would agree with you, if someone is close to agoraphobia, meds are probably necessary.  I think I might have waited too long, but it's what my docs believed best and I went with that.  So only point I want to make is, it's not a "solo" opinion -- it's one shared by many researchers who are concerned about how many Americans especially are on drugs that profoundly alter the way the brain works naturally, especially young people.  There are long-term problems with it that our docs don't know about and don't tell us about.  I've been at this ridiculous mental problem junk for over 40 years.  Early on I believed whatever my docs told me and did whatever they told me to do.  Much of it turned out to be wrong when I finally was forced to do my own research.  And again, I take the stuff, I don't believe what some on here say, which is don't ever use it.  For some it's the best thing.  But if someone isn't suffering enough to need meds, are you saying this isn't the place to say so?  Isn't that why we all come here, because we had a problem and we weren't getting the help from our medical professionals we were hoping for?  It's certainly how I ended up here.  Again, I don't know if you're right or I'm right or anyone is right.  I do believe more info is sometimes better and sometimes not better.  Life is hard.  That's why we're here, no?  Other than our OCD.
Avatar universal
I agree with both, there is good and bad with all medications even supplements.  If not for medication I know I wouldn't be here today so it was worth the risk for me.  Not everyone has bad experiences with these type of medications, I have had none.  I also don't think we should "scare" anyone away from taking them when it appears to be their only answer.
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