Coping with Adaptation Disorders: Overcoming Anxiety and Social Fears

Q: Coping with Adaptation Disorders: Overcoming Anxiety and Social Fears

Hello： Your feelings of anxiety and tension may be related to the symptoms of schizophrenia (formerly known as schizophrenia), which can cause heightened sensitivity and excessive associations with the people, events, and things around you, leading to a state of hyper-vigilance.

Adjustment disorder, characterized by increased anxiety?

Hello, doctor.
I have schizophrenia and I'm currently on medication.
I am very afraid of crowds and talking to strangers.
I am very introverted, speak very little, and I am scared to go out.
Whenever I step outside, I feel a lot of pressure, my whole body tenses up, and I get very anxious.
I want to speak but can't find the words, and I feel lost about what to do.
My mind becomes chaotic, and I get headaches.
Every time I go to a different place, my shoulders and neck start to tense up, and my whole body shakes.
Talking to people is also very difficult for me, and I find it hard to adapt.
I'm not sure if I have an adjustment disorder.
Additionally, what I hear on TV often makes me feel like people are looking down on me, and I feel the same way about people outside.
I can't function normally, and I feel like I'm worthless.
What should I do?

Niming, 20~29 year old female. Ask Date: 2016/11/11

Dr. Liang Sunyuan reply Psychiatry

Hello: Your feelings of anxiety and tension may be related to the symptoms of schizophrenia (formerly known as schizophrenia), which can cause heightened sensitivity and excessive associations with the people, events, and things around you, leading to a state of hyper-vigilance.
Adhering to your medication regimen can help reduce the symptoms of heightened sensitivity and excessive associations in the brain.
Additionally, it is advisable to focus on the present moment and try to let go of excessive associations and worries, concentrating on what truly matters.
When you find yourself starting to over-associate or feel overly anxious again, remind yourself that these are just symptoms, similar to a cough; once the cough is over, let it become a thing of the past and redirect your attention back to what you were originally focused on.
If you continue to feel troubled, it is recommended to discuss coping strategies with your physician during your follow-up appointment.
Wishing you all the best.

Reply Date: 2016/11/11

More Info

Coping with adaptation disorders, particularly those involving anxiety and social fears, can be a challenging journey, especially when compounded by conditions such as schizophrenia. It’s important to recognize that your feelings of fear and anxiety in social situations are valid and that many people experience similar challenges. Here’s a comprehensive approach to managing these feelings and improving your overall well-being.

Understanding Your Condition
Firstly, it’s crucial to understand that schizophrenia can significantly impact your perception of reality and social interactions. The symptoms you describe, such as feeling tense, having difficulty speaking, and experiencing physical discomfort in social situations, can be exacerbated by both your mental health condition and the anxiety that comes with it. This combination can lead to what is often termed "social anxiety," where the fear of judgment or negative evaluation by others becomes overwhelming.

Medication Management
Since you are already on medication to manage your schizophrenia, it’s essential to maintain regular communication with your psychiatrist about your symptoms. Medications can help stabilize your mood and reduce anxiety, but they may also have side effects that impact your social interactions. If you find that your current medication regimen is not adequately addressing your anxiety or if you are experiencing side effects, discuss this with your doctor. They may adjust your dosage or consider alternative medications that could better suit your needs.

Cognitive Behavioral Therapy (CBT)
In addition to medication, Cognitive Behavioral Therapy (CBT) is an effective treatment for anxiety and social fears. CBT focuses on identifying and challenging negative thought patterns and beliefs that contribute to your anxiety. Here are some steps you can take:
1. Identify Automatic Thoughts: Start by keeping a journal of your thoughts when you feel anxious in social situations. Write down what you think and how it makes you feel. This can help you recognize patterns in your thinking.

2. Challenge Negative Beliefs: Once you identify these thoughts, challenge them. Ask yourself if they are based on facts or assumptions. For example, if you think, "Everyone is judging me," consider the evidence for and against this thought.

3. Gradual Exposure: Gradually expose yourself to social situations that make you anxious. Start small, such as saying hello to a neighbor or engaging in brief conversations with acquaintances. Gradual exposure can help desensitize you to anxiety-provoking situations.

4. Practice Relaxation Techniques: Incorporate relaxation techniques such as deep breathing, mindfulness, or progressive muscle relaxation into your routine. These can help reduce physical symptoms of anxiety, such as tension and shaking.

Building Social Skills
Improving your social skills can also help reduce anxiety. Consider joining a support group or social skills training program where you can practice interacting with others in a safe environment. These settings allow you to learn and practice social cues, conversation starters, and ways to engage with others without the pressure of judgment.

Seeking Support
Don’t hesitate to reach out for support from friends, family, or mental health professionals. Sharing your experiences with trusted individuals can provide emotional relief and help you feel less isolated. If you feel comfortable, consider discussing your fears and experiences with your family, as their understanding can be beneficial.

Conclusion
Coping with adaptation disorders, especially in the context of anxiety and social fears, requires a multifaceted approach that includes medication management, therapy, skill-building, and support. Remember that progress may be gradual, and it’s essential to be patient with yourself. Celebrate small victories along the way, and don’t hesitate to seek help when needed. Your journey towards overcoming these challenges is valid, and with the right strategies and support, you can improve your ability to navigate social situations and enhance your overall quality of life.

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