Overcoming Social Anxiety and OCD: Seeking Help Without Fear

I feel helpless. These issues have been troubling me for a long time. Thank you for your help?

Hello, Doctor: I would like to describe my current symptoms.

1.
In certain situations or unfamiliar environments, I become hypersensitive when there are people nearby.
I feel tense and uncomfortable throughout my body, experience difficulty breathing, gastrointestinal discomfort, and my hands become particularly stiff, causing discomfort.
I also feel dizzy and have headaches.
2.
My reactions are most pronounced towards the opposite sex.
If I encounter an attractive person or someone who seems unusual, my reaction is even stronger.
I often fear being watched or misunderstood as having feelings for them.
This fear extends even to being near the same sex, as I worry about being misidentified as homosexual.
(During my school years, I had a bad experience with a crush, which led to a fear of being discovered, rejected, or misunderstood.)
3.
This issue severely affects me in the office.
I dislike having people nearby, as I feel constantly observed and lack privacy.
This has led to awkward situations with female colleagues and even the loss of friendships.
(In high school, I felt anxious and fearful even with my parents around, afraid of making eye contact.)
4.
I become very anxious before going out.
I constantly check electrical plugs, whether the gas is turned off, if the lights are off, if the toilet is securely closed, and if the door is locked.
This is especially pronounced when I am under psychological stress, often leaving me physically and mentally exhausted.
I repeatedly test and confirm everything is in order to reassure myself before leaving, which has made me fearful of going out alone.
I even wish for family members to help confirm things for me.
Since high school, I have sought help from counseling offices and external therapists.
I may be overly concerned about my image, as I find it difficult to present my true self in front of them.
I have encountered therapists who focus on Freud's primal drives, attempting to explain all my phenomena through sexual psychology.

These issues have troubled me for a long time and severely impact my interpersonal relationships and ability to go out.
Even walking down the street or going out to eat, the passing cars make me anxious and tense.
However, due to my job, I worry that taking psychiatric medication or receiving a diagnosis could affect my rights, such as workplace perceptions and insurance.
I wonder if this could be social anxiety disorder (phobia) combined with obsessive-compulsive disorder? In high school, I bought a self-help book titled "No More Stage Fright," which helped me through a dark and painful time.
I truly wish to help myself, but I am concerned that medical records or medication could impact my work or lead to addiction and side effects.
I have written a lot here, and I am grateful that you are willing to take the time to respond.
I really want to openly acknowledge that I have a problem, but I worry that it will not affect my professional capabilities.
T_T

Xiǎng fēi, xiǎng zìyóu, 30~39 year old female. Ask Date: 2016/11/24

Dr. Su Zongwei reply Psychiatry

Please feel free to seek medical attention; your medical records are confidential and will not affect your employment.
For any other concerns, please discuss them with your outpatient physician.

Reply Date: 2016/11/24

More Info

Overcoming social anxiety and obsessive-compulsive disorder (OCD) can be a challenging journey, but it is important to understand that you are not alone in this struggle. Many individuals experience similar symptoms, and there are effective strategies and treatments available to help you manage your anxiety and improve your quality of life.

Understanding Your Symptoms
From your description, it appears that you experience significant anxiety in social situations, particularly when surrounded by others. Symptoms such as muscle tension, difficulty breathing, gastrointestinal discomfort, and feelings of dizziness or headache are common manifestations of anxiety. Additionally, your heightened sensitivity to the presence of others, especially those of the opposite sex, suggests that your anxiety may be exacerbated by fear of judgment or misinterpretation of your intentions.

Your compulsive behaviors, such as checking appliances and ensuring that everything is secure before leaving the house, are indicative of OCD. This need for reassurance and control can be exhausting and may further contribute to your anxiety.

The Connection Between Social Anxiety and OCD
Social anxiety disorder and OCD often coexist, as both conditions involve excessive worry and fear. Individuals with social anxiety may develop compulsive behaviors as a way to cope with their anxiety, believing that these actions will prevent negative outcomes or alleviate their fears. It is crucial to address both conditions simultaneously for effective treatment.

Seeking Help
It is commendable that you have sought help from counseling services and therapists in the past. However, it is essential to find a mental health professional who understands your specific concerns and can provide a tailored approach to your treatment. Cognitive-behavioral therapy (CBT) is one of the most effective treatments for both social anxiety and OCD. This therapy focuses on identifying and challenging irrational thoughts and beliefs, helping you to develop healthier coping mechanisms.

1. Identifying Automatic Thoughts: Start by keeping a journal of your thoughts and feelings in various situations. When you notice anxiety creeping in, write down the specific thoughts that accompany those feelings. This practice can help you identify patterns and triggers.

2. Challenging Core Beliefs: Once you have identified your automatic thoughts, work on challenging them. Ask yourself if these thoughts are based on facts or assumptions. Consider alternative explanations for the situations that cause you anxiety.

3. Gradual Exposure: Gradual exposure to feared situations can help desensitize you to anxiety triggers. Start with less intimidating scenarios and gradually work your way up to more challenging situations. This process can help you build confidence and reduce anxiety over time.

4. Mindfulness and Relaxation Techniques: Incorporating mindfulness practices, such as deep breathing exercises, meditation, or yoga, can help you manage anxiety symptoms. These techniques promote relaxation and can help you stay grounded in the present moment.

Medication Considerations
While you express concern about the potential side effects of medication, it is important to discuss these worries with a qualified psychiatrist. Medications such as selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for social anxiety and OCD and can be effective in reducing symptoms. A mental health professional can help you weigh the benefits and risks of medication, ensuring that you make an informed decision.

Overcoming Stigma
It is understandable to worry about how a mental health diagnosis might affect your professional life. However, it is essential to prioritize your mental well-being. Seeking help does not diminish your professional capabilities; rather, it demonstrates strength and a commitment to self-improvement. Many successful individuals openly discuss their mental health challenges, helping to reduce stigma and encourage others to seek help.

Conclusion
Your journey towards overcoming social anxiety and OCD may be complex, but it is achievable with the right support and strategies. Remember that you are not alone, and there are resources available to help you navigate this path. By seeking professional help, practicing self-compassion, and utilizing effective coping strategies, you can work towards a more fulfilling and anxiety-free life. Don't hesitate to reach out for support—taking that first step is a significant part of the healing process.

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