One label among my mix of diagnoses is ‘Social Anxiety Disorder’, which is also called ‘Social Phobia’. It’s probably hard to differentiate it from the PTSD at the same time, but it’s got all the markers of a social phobia. For those who are not familiar with it, the DSM-IV diagnostic criteria for Social Phobia are (for adults, shortened):
A. 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.
B. Exposure to the feared social situation almost invariably provokes anxiety.
C. The person recognizes that the fear is excessive or unreasonable.
D. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
E. The avoidance, anxious anticipation, or distress in the feared social or performance situations(s) interferes significantly with the person’s normal routine or functioning.
F. In individuals under age 18 years, the duration is at least 6 months.
G. The fear or avoidance is not due to the direct physiological effects of a substance or a general medical condition and is not better accounted for by another mental disorder.
H. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it.
As far as I can remember back, I have always had a social phobia. My threshold for anxiety in unfamiliar situations in general is very low and if they are social situations, I often feel physically sick with all the anxiety. My heart rate accelerates, I get sweaty palms, I feel nauseous and like I’m frozen.
School was never fun for me. Interaction with others was the most awful thing. I was always a shy, lonely child. Some teachers were concerned about me and it was the most mortifying thing when they tried to talk to me about stuff. Tried, because I didn’t really talk. I’d nod or shake my head, but rarely talked, or at least no more than a soft ‘yes’ or ‘no’. Most teachers didn’t notice, though, because I was quiet and didn’t draw any attention in class and they probably were happy with that.
When I lived in group homes and attended therapy groups, it was pretty much a repeat of how it had been in school. Only there it started to cause problems, because I was expected to interact with the other girls, to talk in front of them and to share things about myself while other people were watching. That was horrific. I was nervous only being in the same room with them, forget talking. So I remained mute, avoided eye contact and they seemed to understand that as a sign of defiance more than anxiety. And I guess part of it was defiance, but it was protective defiance because I was afraid.
Today I’m still wary of situations where people who I don’t know might talk to me and I’m extremely nervous about going to unfamiliar or busy places. It’s somewhat easier today because I don’t need to go places alone, though. I feel comfortable and unafraid at home, especially with mom, so having her with me helps because I feel like I’m safe in her presence and can “hide” with her. Not physically, but by knowing she can tell how much I can take and will take over when I can’t take any more. That’s fairly liberating, because I feel much better about new situations when I’m not facing them by myself. I feel like it’s safer to be a bit more courageous, too, because in case it gets bad or overwhelming, I’m not alone.
Strangely, at the same time, I also have this whole other, opposite side to me. (Like, because things being easy and unambiguous for once would be boring or something.) Sometimes I go into what’s like an entirely different personality mode, almost, for which social anxiety isn’t a problem at all. I think it’s a semi-dissociated state or something, and it kicks in when I go into a “fuck all the world, I don’t care, bring on the destruction” state. That was the mode that took over when I ran from the group homes, for example, or the mode that ended with me having sex with perfect strangers. I’m not shy at all about talking or being in social situations then, but it’s like I’m not even really being “me” in those situations.
And once more I’m left feeling like a fraud when I suffer from social anxiety symptoms, because I know that I’m also capable of being perfectly anxiety-free at other times. How can two so opposite sides be really there? That’s what I ask myself then and feel like I can’t even trust my own behavior or thoughts or feelings.
Lately those anxiety-free episodes have become far and few in between, though, and I think that’s even kind of a good sign, because those socially uninhibited person that I can turn into is a very unhealthy person for me to be. Kind of a protective, tough persona that I picked up as a means of coping along the way, not my true self.
But I feel like I’m starting to ramble. This post doesn’t really even have a point other than “it’s complicated” maybe. Ah well, I’ll post it anyway. Because it IS complicated and weird, being both extremely afraid socially, and able to just ditch all anxiety in other situations. Complicated. And social anxiety sucks.