Dear Cary,
Recently I took some online tests to understand why I act the way I do when I am around people, and it turns out that I have SAD, social anxiety disorder.
Up until high school this illness never affected me; I can't remember one time in my life before high school where I became stressed out in social situations.
But now in high school with SAD is a living hell. It has stopped me from creating friendships with about 85 percent of the student body, teachers think I hate them when I don't say hello to them in the hallways, and worst of all this illness has led to my depression, which gets the best of me whenever I'm alone, which is most of my day.
My out-of-school friends don't understand what I go through on a daily basis. Yesterday I went for a drink of water but saw an old teacher of mine, so I immediately turned around and walked away before he could see my face and make that awkward eye contact, which I dread more than anything. I then became scared thinking he saw me and became stressed.
Being in situations like those, which may seem stupid to most everyone else, is truly going to be my demise when I have to get a job. What no one else understands is that when I'm in these stupid situations, it feels as if my insides light on fire.
What I'm trying to get at is I really need some advice on how to deal with this disorder since it has taken over my life.
That Awkward Kid In Class
Dear Awkward Kid,
Wow, I feel for you. That has got to be really rough. So for those of you who don't know, here's the facts:
"Social anxiety disorder is the most common anxiety disorder and the third most common mental disorder in the U.S., after depression and alcohol dependence," according to WebMD. "An estimated 19.2 million Americans have social anxiety disorder."
So at least you're not alone. Not that that's any help. Maybe you'd prefer to be alone. That was a joke. Sorry.
But here's the thing that may help you. It sounds like a job for cognitive-behavioral therapy. Definitely. Plus, I am not too worried about you. I had the definite feeling when I read your letter that this is something you can overcome. You show you have the intelligence to look for answers. Now you just have to find the right kind of help.
But the main thing is, OK, so you have diagnosed yourself. But is it being treated? You've got to get treated. So you need to insist to your parents or teachers or whoever has the resources and decision-making ability that you get some cognitive-behavioral therapy. Insist on it. And do the work. Buy the book "Feeling Good" by David Burns and read it and start doing the work in it. You're old enough and smart enough to understand it. This thing can be beaten.
What is the outlook for people with social anxiety disorder? you may ask. Well, according to WebMD, "The outlook for those with social anxiety disorder is generally good with treatment. Many people recover and enjoy more productive lives."
So there you have it.
This thing can be dealt with. It's going to keep happening for a while, but you're going to work with it and slowly you are going to see it change. You are going to find that situations where you used to cringe or run away you can now handle, without worrying too much about what others say or do. You are going to find, as you do this, that by concentrating on what is actually happening rather than on the fears in your head, you will build up a store of experiences you can rely on and recall where things went just fine. Then in a new situation you can say to yourself, OK, I'm having these crazy, catastrophic thoughts that everybody hates me and is making fun of me but I know, because I have been through this before, I know that in reality I am just a normal kid going through a normal high school life. You will be able to say to yourself, OK, I have this disorder but it doesn't need to ruin my life, because there are ways to treat it, and I'm treating it, and I can do this.
Bit by bit you replace those catastrophic voices that say there's no way you can do this and it's going to end in humiliation and cringe-worthy awkwardness, with voices that say I've done this before and I can do it again, I know these people and I know what to say and how to act, and they accept me even if I'm not completely like them, and they also, even thought they hide it, they also have the same kinds of fears I do. You will get to a point where this is the kind of conversation you have with yourself, and you will find, over time, that you can go to parties and events and pretty much behave normally without too much crippling fear. And when the fear does wash over you, every now and then, you will know that you can always just call it an early evening, make a polite exit, and go home and get some rest and tomorrow is another day.
It might turn out that you are not a hugely social person. That, too, is OK. It might turn out that you are one of the lucky people in the world who is naturally introverted, and who can find peace and satisfaction doing things alone, in quiet concentration, and who makes great individual friendships but who does not care so much for the big keg party. And that's a good thing, too. That's a good thing. It simplifies life. It eliminates a whole range of pointless backslapping-type behavior.
I really believe that. And third, one thing that has helped me with fears and anxiety, is good old meditation and exercise. Especially meditation.
Also, not that I'm a doctor or anything, but I'd be curious to know just how you're living, and whether you're getting what you need as a kid. I mean in the area of food and sleeping and your environment at home. Like if you have a place where you can feel safe and at peace. Not that that's going to cure you. But it helps a lot.
Diet can also be very important in how you feel day to day. It might be that you are sensitive to certain foods, or are not getting enough of certain foods. It wouldn't hurt to look into that, in the same way you looked into your anxiety disorder.
So you're going to be OK. And the more you concentrate on knowing you're going to be OK, the better you will feel. So buy that book by David Burns, and find a way to embark on a course of cognitive-behavioral therapy. Get plenty of sleep. Exercise. Eat well. Have a good life.
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