Anxiety Disorders: Overcoming Social Phobia and Panic Attacks

Q: Anxiety Disorders: Overcoming Social Phobia and Panic Attacks

Hello： Based on your description, you are experiencing a lot of anxiety and worry, which is indeed affecting your daily life. <br>Medication, psychotherapy, and lifestyle changes can all help alleviate these symptoms. <br>It is recommended to incorporate more activities that you

Anxiety Panic Disorder

Hello, doctor.
I believe I have social anxiety disorder, phobias, panic disorder, and obsessive-compulsive disorder.
The following issues are my symptoms, which have led to me having no friends and being unemployed for over a year.
I would appreciate your help in addressing these concerns.
Thank you.
Since childhood, I have been very afraid of facing crowds.
In situations where I need to introduce myself or perform in public, I become particularly anxious and sweat profusely, even experiencing palpitations.
I worry every day about the upcoming events, which leads to insomnia.
When the day arrives, I tend to avoid the situation and freeze up.
Throughout my life, I have not had a single friend with whom I could share my true feelings.
I also don’t know how to express my thoughts to my family and friends.
Every moment in front of others feels tense, and I cannot relax.
When I am alone with someone, it becomes even worse (nervousness, rapid heartbeat, feeling overwhelmed).
I often end up raising my voice at home due to this anxiety.
Whenever my parents have guests or friends over, I hide until they leave.
When there are more people at home, I suddenly feel suffocated, and my mood worsens.
I don’t understand how I became this way; I wasn’t like this before.
Since childhood, I have been very afraid of animals, which has led me to avoid eating meat and become vegetarian.
I fear encountering stray animals on the street and am anxious about animals appearing at my workplace.
If I do encounter one, I sweat, feel my heart racing, and my mind goes blank, unable to remain calm.
Even after the animal is gone, I still feel like it might return, and I sometimes dream about them.
Next month, I am supposed to travel abroad, but I am very afraid of flying (not because of heights, as long as I don’t look down, I’m fine).
I fear the takeoff and landing, as it makes my heart feel particularly uncomfortable, almost as if I can’t breathe, and I feel like my heart might stop.
During my first international flight, I pressed a pillow against my chest during takeoff and landing or held onto my family’s hand tightly, which troubled me.
I also feel the need to wash my hands immediately after handling money; if I don’t, I feel uncomfortable all over (like being bitten by mosquitoes, where I must scratch to relieve the itch).
Before leaving home and after returning, I must use the restroom, and I repeatedly check everything many times.
Even after confirming that everything is correct, I still feel like I have made a mistake, which affects my work efficiency.
Every day, I feel heavy-headed, tight in the chest, and tense in my shoulders and neck.
I often fall asleep while thinking about things, making it difficult to sleep and leading to vivid dreams.
Even if I sleep for a long time, I still feel exhausted the next day.
I struggle with concentration and have poor memory.
Since this year, I have frequently experienced nausea, vomiting sensations, binge eating, irritability, slamming tables, and breaking things.
I often feel that life has no meaning, especially at night when I worry about many things, such as family members leaving or never finding a job.
Even trivial matters can be very bothersome to me.
Doctor, will taking medication prescribed by a doctor help me not feel afraid of anything and effectively treat my fears? Are there any side effects to taking the medication?

Niming, 20~29 year old female. Ask Date: 2016/09/30

Dr. Liang Sunyuan reply Psychiatry

Hello: Based on your description, you are experiencing a lot of anxiety and worry, which is indeed affecting your daily life.
Medication, psychotherapy, and lifestyle changes can all help alleviate these symptoms.
It is recommended to incorporate more activities that you enjoy or find meaningful into your life, such as reading, exercising, listening to music, traveling, painting, writing, and learning.
Try to savor and enjoy those pleasant moments to dilute the proportion of anxiety, depression, and worry.
Your willingness to ask questions indicates a motivation for change, and it is advisable to seek medical help.
With professional assistance, you can discuss and choose effective intervention methods together.
Change is not instantaneous; it requires patience and continuous effort.
If you encounter difficulties, you can also discuss coping strategies with your physician during follow-up visits.
Wishing you all the best.

Reply Date: 2016/09/30

More Info

It sounds like you are experiencing a complex interplay of anxiety disorders, including social phobia, panic disorder, obsessive-compulsive disorder (OCD), and possibly other related conditions. Your symptoms, such as intense fear in social situations, avoidance behaviors, physical reactions like sweating and heart palpitations, and compulsive behaviors, are indicative of these disorders. It's important to understand that these conditions can significantly impact your daily life, relationships, and overall well-being.

Understanding Your Symptoms
1. Social Phobia: This is characterized by an intense fear of social situations where one might be judged or scrutinized by others. It can lead to avoidance of social interactions, which seems to be a significant part of your experience. The physical symptoms you describe, such as sweating and heart palpitations, are common in social anxiety.

2. Panic Disorder: The feelings of impending doom, heart racing, and difficulty breathing during situations like flying indicate panic attacks. These can occur unexpectedly and may lead to a fear of future attacks, which can further limit your activities.

3. Obsessive-Compulsive Disorder (OCD): Your compulsive behaviors, such as the need to wash your hands after touching money or repeatedly checking things, are classic signs of OCD. These behaviors are often driven by intrusive thoughts that cause significant anxiety.

4. Generalized Anxiety: The constant worry about various aspects of life, including fear of animals and concerns about family and work, suggests generalized anxiety disorder (GAD). This can manifest as a pervasive feeling of unease and tension.

Treatment Options
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for anxiety disorders. CBT helps you identify and challenge irrational thoughts and beliefs that contribute to your anxiety. It also teaches coping strategies to manage anxiety symptoms. Given your experience with anxiety, working with a trained therapist who specializes in CBT could be particularly beneficial.

2. Medication: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are commonly prescribed for anxiety disorders. They can help regulate mood and reduce anxiety symptoms. However, it's essential to discuss potential side effects with your doctor, as they can vary from person to person. Common side effects may include nausea, weight gain, or changes in sleep patterns, but many people find that the benefits outweigh these issues.

3. Exposure Therapy: This is a specific type of CBT that involves gradual exposure to the feared situation (e.g., social interactions, flying) in a controlled way. Over time, this can help reduce the fear response.

4. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help manage anxiety symptoms and improve overall emotional regulation.

5. Support Groups: Connecting with others who experience similar challenges can provide emotional support and practical advice. Online forums or local support groups can be a good resource.

Family and Social Support
Given your concerns about discussing your mental health with your family, it may be helpful to consider the potential benefits of sharing your experiences with them. Having a support system can be crucial in your recovery journey. If they are unaware of your struggles, they may not be able to provide the understanding and support you need. However, it’s essential to approach this conversation when you feel ready and safe.

Conclusion
Your feelings of anxiety and fear are valid, and seeking help is a crucial step toward recovery. While medication can help alleviate some symptoms, combining it with therapy and support can lead to more sustainable improvements. Remember, recovery is a journey, and it’s okay to take it one step at a time. If you haven't already, consider reaching out to a mental health professional who can provide personalized guidance and support tailored to your specific needs.

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