I ran into the Psych Central website this year. I am following their blog and it had interesting topics daily.
This is a compilation of their best blog posts and articles throughout 2012 and it's worth digging into:
http://psychcentral.com/blog/archives/2012/12/26/top-10-psychology-and-mental-health-topics-of-2012/
Hope you all have a great new year 2013!
Here's a free e-book that you should not miss. It's a compilation of quotes from the best contemporary minds. It's inspiring. It will make you stand up from your chair and make a difference. I plan to print it and read at least one page a day... hey, it might even get me to start writing again.
Below is one page extract that is significant to this blog... Just like the author below, I found that once I became free of my anxiety I became much more skilled socially than most of the people around. While being trapped in social anxiety and trying to find a rational way out of it, without even realizing it, you learn a lot about human nature and being social.
S O C I A L S K I L L SPenelope Trunk is the founder of BrazenCarerist.com. Her blog is
I have really bad social skills, so I am constantly noticing
how the whole world revolves around social skills.
Research that really blows me away is that people would
rather work with someone who is incompetent and
likable than someone who is a competent jerk. And
then I saw that in some cases elite British crew teams
will put a weaker, but very likable, rower on a boat
because people row faster if they row with people they
like.
In my life, I have had to learn social skills one by one,
because I have Asperger Syndrome. I learned to smile at
jokes even though I’m too literal to understand most of
them; I listen to the rhythm of a sentence to know
when it’s time to laugh. And I learned how to say, “How
are you,” with the right tone of voice – to express
interest – although to be honest, saying that phrase
gives me so much anxiety that I never actually say it.
A few years ago I found myself smack in the middle of
the recruiting industry. I ended up, somehow, being an
expert on how to attract candidates, and an expert on
how to present yourself well to employers. At first I
thought it was absurd. I’ve never worked in human
resources, and I’ve never been a recruiter. But then I
realized that I’m an expert on the hiring process because
it’s all about social skills, and I’ve been studying them
my whole life so that I don’t look like a freak.
In fact, it’s not just getting a job. Or giving a job.
Getting or giving anything is about social skills. The
world is about being comfortable where you are and
making people feel comfortable, and that’s what social
skills are. What’s important is to be kind, and be
gracious and do it in ways that make people want to do
that for someone else.
Last Thanksgiving weekend, many of us bloggers participated in the first documented “blog rally” to promote Engage With Grace – a movement aimed at having all of us understand and communicate our end-of-life wishes.
It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it was timed to coincide with a weekend when most of us are with the very people with whom we should be having these tough conversations – our closest friends and family.
Our original mission – to get more and more people talking about their end of life wishes – hasn’t changed. But it’s been quite a year – so we thought this holiday, we’d try something different.
A bit of levity.
At the heart of Engage With Grace are five questions designed to get the conversation started. We’ve included them at the end of this post. They’re not easy questions, but they are important.
To help ease us into these tough questions, and in the spirit of the season, we thought we’d start with five parallel questions that ARE pretty easy to answer:
Silly? Maybe. But it underscores how having a template like this – just five questions in plain, simple language – can deflate some of the complexity, formality and even misnomers that have sometimes surrounded the end-of-life discussion.
So with that, we’ve included the five questions from Engage With Grace below. Think about them, document them, share them.
Over the past year there’s been a lot of discussion around end of life. And we’ve been fortunate to hear a lot of the more uplifting stories, as folks have used these five questions to initiate the conversation.
One man shared how surprised he was to learn that his wife’s preferences were not what he expected. Befitting this holiday, The One Slide now stands sentry on their fridge.
Wishing you and yours a holiday that’s fulfilling in all the right ways.
To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team. If you want to reproduce this post on your blog (or anywhere) you can download a ready-made html version here
Dr. Rob has a great post on anxiety. Make sure you read it. It's worth knowing what happens in a doctor's head when you have anxiety.
http://distractible.org/2009/10/09/anxiety/
Long time, no see!
No man is an island, and as human beings, we have to interact with society in some form or the other if we are to survive on a day to day basis. So you can understand how social anxiety becomes a problem for those who live with it day after day and restrict their lives because of this mental disorder. When you’re afraid of communication and other aspects of public life like driving, flying, walking on the streets, shopping and the like, you can see how it becomes a problem to do perform even the most basic activities.
While some people turn to medication as a way to resolve these feelings of anxiety and fear, drugs are not recommended unless your symptoms are severe and unmanageable. Besides, medicines that are used to treat such disorders include anti-depressants, beta blockers and benzodiazepines that are full of chemicals that could turn out to be addictive and that also come with their own side effects. Instead of relying on medicines, one of the best ways to tackle social anxiety is to try exposure therapy.
For those of you who know how to ride a bike, this form of treatment is just like learning to ride your bike for the first time. You’re scared, you have no sense of balance, and you’re terrified of hurting yourself. But you go ahead and try it because you so badly want to ride that new bike. Exposure therapy is all about overcoming your fears too, step by step, bit by bit. Just as someone holds on to your bike for the first few minutes and then lets go so that you try to gain a sense of balance, exposure therapy too involves breaking down your fear into smaller pieces and tackling the smallest one first.
So if you’re scared to talk to the opposite sex, start out by talking to someone you already know, like the girl/boy next door who always smiles at you, the smile that you were too nervous to return until now. Then move on to talking to people who are normally courteous, like salespeople and customer service representatives. It’s not going to be easy, and just like in the biking lesson, you’re going to end up falling quite a few times. But the key to success is to pick yourself up, brush the dust off your clothes, forget the minor bruises that you may have, and get right back on that bike again.
xposure therapy works best when you have someone to support you, just as your dad or mom would hold on to the bike till you’re able to find your bearings. You also need to know when to push yourself and when to stop – go as far as your fear will let you go but stop once you reach that point. You need to keep at one level till you feel no fear at all, and only then can you move on to the next level. It’s a slow process, but the infusion of confidence you feel when you master each level and move on to the next one will help you cross the next one faster than you did the first. So stick with it, and you’ll find yourself managing your anxiety in no time at all.
A commenter asked me to recommend other books like Michael Pollan's. I did not read other books like Michael Pollan's, but here's another recommendation: brand new, released on March 17, David Romanelli's book: Yeah Dave's Guide to Living in the Moment - Getting to Ecstasy through wine, chocolate and your iPod list.
6 years ago, on Valentine's day, I was admitted into the hospital. I was 24 weeks pregnant and I was feeling great. But my doctor's appointment showed a blood pressure of 180/100, and my kidneys were spilling a lot of protein - sign that they are not functioning well... I had preeclampsia. It is a disease that could be very dangerous for the mother and the baby. The only known cure is delivery of the baby, and at 24 weeks of pregnancy, this is problematic as the babies cannot live without a lot of interventions and they risk blindness, deafness, cerebral palsy, and all sorts of other issues.
For the last couple of years while I was blogging about social anxiety, I also followed a number of other social-anxiety related blogs. And, happily for all of us, it seems that we all graduated:
I heard a few people positively mentioning Michael Pollan's - The Omnivore Dilemma, so I read it and I loved it so much that I had to also read In Defense of Food.
I had a post earlier this year ranting about health websites that try to buy small blogs like mine. The website that contacted me was Wellsphere - basically a collection of medical blogs. I answered to the mass email by saying that i am not interested and that if they really want to help people they can link to my blog. I did get the link and as opposed to people that gave away their posts, I actually got a few hits from them.
A yoga teacher friend of mine, Kitty had a heartbreaking post today about her hearing getting worse. She a great yoga teacher and she's taking beautiful nature pictures. If you want to see and buy some of her stuff, you can visit her on Etsy. She's a wonderful person, one of those that I probably would have never known if blogging and social networking wasn't around. I am so moved by Kitty's inner beauty and by the fact that people like her exist and they are around us. One more time, social networking is heaven for us the socially anxious.
I visited a friend yesterday and met her nice husband. This gave me a moment of reflection on how my life changed over the last couple of years. Two years ago, I thought I only have my husband close. I looked at anyone with suspicion: I was scared of being cheated, abandoned, ignored. I was scared to leave my kid with anyone. I only trusted one or two doctors.
I am yogileana on Twitter.
Oh, wow! I was nominated in the finalist list of best patient blogs! That's pretty neat! Here's the list of finalists. The voting starts tomorrow. If you like this blog, feel free to vote for me.
I disappeared for a while in a "holiday anxiety". I suspect this is not unusual to those of you that struggle with the same issues as I do. I decided to go with the "presence is the best present" this holiday and to share time and love instead of buying presents and sending cards, but I did not tell anyone and when the time to give love came, I just got ashamed of going outside the box and avoided it all.. This is too funny and a good lesson that if I will try this again, I need to better plan who do I send love to, when and how, because picking up the phone and calling is not my thing apparently! It's all behind now and next year there will be a new holiday season.
2008 was a great year. It was an year of change. I came to terms with my anxiety, I learned to love my job, I learned to be a better mother, wife and person, and to be nicer to myself especially. I got someone to help with the household and this was major: because I learned what it takes to work with someone successfully, mostly trust and the knowledge that everything will be well. She is a wonderful person too, but I saw that it is possible to find wonderful people. This freed my time for myself, and my family. My health was so and so, but I learned that I am not my diseases and I learned to put my health in the background. I also learned that I am the best person to take care of myself and it is my responsibility to figure out what my body needs or doesn't need.
What about 2009? More and more I realize that I want to write, I need to write, and it is also my best way to communicate with others. So I hope I'll find a way to incorporate more of that into my life. I want to continue to add more exercise and fun into my schedule. And continue to work on my health and my relationship with my family and others. I think it will be another even better year.
Happy New Year!
This post might come as an unexpected and unpleasant surprise to some of you. It might even push some away if you haven't yet seen this idea. The first time I read about it, I was uncomfortable and resistant, but thinking about it some more, I realized it is so true.
This condition might look like we are caring a lot about others, but we mostly are caring about others in relationship to US: do they like ME, do they think I'm looking good, writing well, doing the right thing? We are quite self-centered. We bask in the happiness that someone likes us, we are anxious about saying the right thing or saying anything or not blushing, or not sweating. We fear that the wrong look or attitude might push some away. It's important for us to be called someones best friend, the best employee, the nicest person, etc., and we're desperate if someone else becomes the employee of the month, the best friend, etc.
I want to be nominated in the 5 best patient blogs, but I do not want to win, this would be disastrous next year when I might not even be nominated anymore. I will probably quit before that happens - running away is better than being demoted. I think this is actually a common trait, probably most people think more or less about things this way, we just take it to extreme.
So, what to do about it? It's ironic, but the first thing to do is to accept that we are normal, OK, looking good enough, acting OK, saying the right things, and when we don't, just accept that it happens to everyone: we all say stupid things every now and then, we blush at the wrong time, friendships die, relationships end, with or without our help. It's just stuff. And while being relaxed about us, we can now look at others with more compassion and love: see what they really are about, hear them, help them without caring what they think about us. Most people would feel more honesty in this approach and will be more attracted to us.
We need to relax, and we'll start seeing a bigger picture and doing things to help everybody and we will be appreciated even more. And if not, it just happens, just move on. We all are just fine and normal.
My world has changed a few days ago. One of our acquaintances, a young guy just out of college, died from an overdose of medication. He was battling depression for a long time and addiction more recently. Over the last couple of months his family and friends (my husband included) tried an intervention on him. Everybody tried their best, but in the end none of this worked. Maybe I, probably just like everybody else around him, feel a little bit of guilt. As it happens he was one of the nicest kindest guys I ever met.
I knew about his depression, I heard that he feels worthless maybe an year ago. And I just listened and didn't do anything at the time. So I am doing something now. I am doing it for any of the guys out there that might be depressed and feeling worthless. I am doing it in the hope that someone will understand that their perception that they are worthless is just that: a perception. That depression and any other mental health issues can be treated and resolved, that the stigma is not as huge as it seems, that opening up is possible and helpful. I am working to get this blog more popular. It's not about me anymore.
It feels like for me increasing my self esteem was the solution. But there was so much work into this, and I was a successful professional: my husband, my therapist, a successful profession, a healthy child, all my blogging friends and all my friends that supported me even after finding out that I have social anxiety. And the cherry on the top: yoga with their concept that the divine is in each of us. And finally I got it: I am worth something.
If you hear someone repeatedly mentioning how they are no good, then it's time to act and talk to them. If you think you are no good, go get help. We are all worth for living a decent life.
I nominated myself for a 2008 patient blog award. I mostly did it to increase the readership of my blog. There are two kind of people that might be interested:
I want to salute two visitors.
One of them came in two days ago and submitted a comment on my emotional immaturity post. Apparently he found me by searching emotional my entire life. He bumped into my blog and figured it might be social anxiety. He might never come back, but I am happy that this blog is here to be helping people like him. I remember searching for what's wrong with me and reading my first book about social anxiety...
The other visitor... I only see him through statistics counter. As far as I know the visitor never submitted a comment. (S)He comes in every three-four weeks from Paul Levy's blog. (S)He's from Massachusetts General Hospital. I counted 17 visits now, but with changing IPs it could be more than that and it could also be someone else. Thank you for your quiet presence and for coming back. When I see the familiar entry I feel like greeting an old friend.
Paul Levy invited me and 30 other bloggers to participate in the blog rally "Engage with Grace". I think the subject is worth the discussion and I might write about end-of-life discussions and options at a later time.
Here I'd like to share my sense of great achievement with a challenge. Paul asked me if I am OK to be interviewed by a reporter for a newspaper article. I accepted saying that I would be more comfortable on email, but that I could do it by phone.
I talked to the reporter and it was fine. I was not as witty as I would have liked and I did not say all that I wanted to say, but I took the challenge and got through this. The article ended up not mentioning me or any blogger other than Paul, so I did not become famous overnight.
But I was so happy afterward, happy to have done this, happy that next time I will feel better about it, happy that I am just normal. I felt powerful. And I realized that without my social anxiety this would have been just another phone call instead of a very pleasant experience.
Instead of dreading what you can't do, take challenges and celebrate all the stuff that you can do!
We make choices throughout our lives - where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to be treated at the end our lives, often we don't express our intent or tell our loved ones about it.
This has real consequences. 73% of Americans would prefer to die at home, but up to 50% die in hospital. More than 80% of Californians say their loved ones “know exactly” or have a “good idea” of what their wishes would be if they were in a persistent coma, but only 50% say they've talked to them about their preferences.
But our end of life experiences are about a lot more than statistics. They’re about all of us. So the first thing we need to do is start talking.
Engage With Grace: The One Slide Project was designed with one simple goal: to help get the conversation about end of life experience started. The idea is simple: Create a tool to help get people talking. One Slide, with just five questions on it. Five questions designed to help get us talking with each other, with our loved ones, about our preferences. And we’re asking people to share this One Slide – wherever and whenever they can…at a presentation, at dinner, at their book club. Just One Slide, just five questions.
Lets start a global discussion that, until now, most of us haven’t had.
It's almost two years since I started this blog, and the online world is so different now than it was back then. What great opportunities for anyone to get to terms with their social anxiety.
Part of it is this huge reference related to social anxiety: blogs, personal health oriented websites, forums, e-books.
And this is not all. You can find blogs about anything. This is great for people that feel isolated and don't feel like they can match anywhere. I found blogs that are a pleasure to read about anything of interest to me: social anxiety, any area of healthcare (doctors, CEOs, IT people, patients, etc.), people that wear glasses, people that do yoga, meditation, zen living, passionate about tribes, and so on. It's amazing!
I think that part of my success with social anxiety is finding people that have common interests and realizing that I'm not alone out there.
Go look for people that share your passions! I bet you'll find enough! Don't miss your opportunities!
I got a few emails lately from people thanking me about the blog and hoping to follow my steps in overcoming social anxiety. I know I heard this before and I didn't believe it and I know that probably the people dealing with this will feel that overcoming SA is the right way out of their misery, but I did not overcome it. It's still there, every day, every encounter. I just don't beat myself up over it. I'm OK with it and with myself.
I thought that the way out of it was to have at least one close friend, and I tried and I'm still trying to get there. I made a few tries and never quite got to it. Part of it (maybe the biggest part) is that I don't really have time to dedicate to a friendship. Maybe I created this lifestyle to avoid getting to close. It seems to be a pattern either in my choice of friends or in the way I am interacting with them. But that's fine. I just go on and try other people and other ways.
I also hate telephones. They are perfect for getting things done, clarify stuff, setting a meeting, managing an activity and keeping everyone in the loop, but just talking? It seems that anytime I try it, there is a bad signal, there is no return of calls after leaving a message, it's the wrong time, etc. Plus, I like to drive when I'm driving, work while at work, eat dinner with family and spend time with my kid when I'm around. This leaves open the between 9:00 PM and 7:00 AM... who would talk to you then... oh and did I mention that I also like to sleep at night? What a solid argument for avoiding yet another means of interaction!! See? I did not overcome social anxiety. I just accept it as part of who I am. It is my charm!
In conclusion, my advice is to not look for overcoming anxiety, but accepting it. Once you accept yourself for what you are, you become less tense and you do your best in most situations.
I've been slow to write lately and I would so much love to restart writing. I want to write about life and work, not necessary on this blog, but I'll keep you guys updated once I get started somewhere else. This post is another overview of my journey in beating anxiety.
These days I have more subscriptions to my blog than ever before... Don't take this to be in the millions of readers LOL, just around 30.
Anyway I just figured I'll post a few tips that helped me. Paul Levy got me started and I continued to learn by example from him and others. But this was long ago and I can repeat for the new readers that might want to take up blogging.
In blogging, just like anywhere else, the most important thing is to have relationships.
Do you know WebMD? There are now lots of WebMDs emerging. They each come with the promise to help you manage your health and give you a community to support you. It seems that any person that can put together a web site and has the money to support it teams with one or more MDs and they put up these web sites that will resolve the health issues of the world. They need to build communities and they are in need of experts... they can probably easily find their MD experts... hey you can't refuse some money when you're a doctor in US. And they are all over the mom-and-pop blogs like mine. I've been offered $50 per article by one and visibility for republishing my posts by another. I guess negociation could get me more, but I don't care about being an anxiety expert.
I used my blog to help me with the anxiety. And it did. I am pretty much done babbling about anxiety. I still have a post or two of advice planned, but that's it. I love blogging and I'll probably do this with other aspects of my life, but I don't care about talking about anxiety any more. I have no issue with people in need finding my blog and getting the support and encouragement they need, but I'm not sure these websites are the solution to that. Right now google serches gets to my blog easily.
Back to the web sites, for the first one I was recruited by a young out-of-school person. This time it is an Internist with 25 years in practice. Wow! Where did we get? Where did we push these guys. I guess this is where our primary care heads to: the Internet! That's what we want, that's what we'll get!
I actually know what it takes to build a helpful online community. We had it for the Preeclampsia Foundation. You start with a small team and then extend it to the fans in the community that are the closest to the original team. You train people and watch them. These guys seem to recruit anyone that can write anything.
I wish them luck, maybe some of them will succeed, but it doesn't look to me like they are on the right path. I recommend that they read Seth Godin's blog!
This post is probably going to come as a surprise after my earlier comments about alternative medicine. My conclusions over the last couple o weeks came as a surprise to me too, and I took a long time to think about how to write this post in a way that does not offense anyone.
Some of you probably read my vents against doctors. I have since read a lot and understood a lot and it is amazing that there actually are good doctors out there considering what we're putting them through.
This post is about my thoughts on Evidence Based Medicine and managing your health especially with a chronic disease. Last year I complained about having ulcerative colitis. I kept on with flares every couple of weeks ever since. We added more conservative medicine and then tried Prednisone (which worked dramatically well, but would not cause remission unless I stayed on it... long term use of steroids is not my ideal healthcare plan, so I weaned off as soon as possible), tried 6MP, a chemo drug that is sometimes useful for ulcerative colitis as well. My doctor recently suggested Humira - an auto-injectable drug for rheumatoid arthritis and Chrohn's.
Trying more and more powerful drugs gave me pause. Instead I decided to stop and think. My thoughts were that a colon-sparing diet, while not advised by my doctors or any doctors on the Internet should be a better solution. If you cut yourself, you don't just go out and play in the dirt, you add a band aid or a glove, you do something to protect the cut while it's healing. I understand that the flares are not caused by food, but it makes sense to spare the colon while it's flaring and eating milder foods.
I read that Aloe is good and I went with it. I found a place that sells this supplement. The research for it is done by an MD, and I found good revisions about it. And I went against my own advice and got this quite expensive supplement. It came with a chart for my symptoms that I am supposed to fill out and fax each 30 days. It also came with a suggestion of a diet. It still has starches and vegetables and protein, it's just avoiding high-fiber, dairy and gas-causing foods.
For three weeks I finally feel better than ever before. The symptoms are still there, healing little by little, but I can live and feel comfortable at work and not hate my life. And I could have done this an year ago if my doctors didn't discourage me from trying anything... because it doesn't work. I was going to try stronger and stronger medicine without first trying to slightly change my lifestyle.
I don't know if it's the Aloe. I actually think the diet is the main benefit. I think charting is important. And maybe the Aloe is doing its part as well, maybe it's just placebo. I don't really care. I feel great and I wouldn't stop either one.
My doctors went with Evidence Based Medicine. Now, I am not the one to argue with Evidence Based Medicine. I think we absolutely need to go with it. But I think it's misunderstood and misapplied. I think that a lot of doctors don't understand when and how it applies and have no idea how to read the studies. It is so difficult to study all aspects of a human life or even of one disease. You can just make guesses and pick up a few aspects to study. In addition, with the drug companies having the most money, most research will of course go with the drug research - less controversial too because you can make double blind studies. So you have these specific studies that you extend. In my case I think that the studies are about food not causing the flares, but what I needed was something to help me get into remission, and food restrictions might help with that.
On the other hand each person is different and the studies are built to be as general as possible. So maybe diet didn't help 75% of the people, but what if I am within the 25% that it actually helps. (a disclaimer here: I did not actually read any studies, I do not think I am able to interpret them correctly, I am just trying to see where I went the wrong direction and learn something)
So, my conclusion is that with a chronic disease you need to know your own body and know and understand what is good for you. Doctors are essential of course and know a lot about everybody, but only you know yourself. The first step when diagnosed is to log each symptom and start tracking down what's going on. Whether it's anxiety or hypertension in pregnancy or colitis, knowing what's going on and having data is invaluable. Log it down, chart it, learn trends and patterns. And here is where alternative medicine is different and better I think than traditional medicine: it encourages lifestyle changes, noticing what's going on and mild solutions before jumping to the big guns. Of course I don't talk about cancer here or any other acute disease and also not about the potent herbs with side-effects.
In my life, in the name of evidence based medicine, I was told that there's no need to stop going to work when I was pregnant and seriously ill with preeclampsia (yes, there is a study that proved that bedrest is not better than no bedrest for preeclampsia), but my baby died a week later and I had no clue about it. I would think that telling us: you and your baby are very sick; if you need to work, there is no evidence that this will hurt your baby, but taking some time off and resting as much as possible would probably be better (of course someone could argue that worrying to death is not that good either).
I was told there is no need to chart my blood pressure on a chronic hypertension pregnancy, but when things started going down I saw the trend and told my doctors about it. The climbing blood pressure could have been easily dismissed in weekly office readings.
I was told there is no need to diet or log what I'm eating because it doesn't matter... and here we are again... it actually matters. So go to your doctors, listen to them, but know yourself and manage your own health. And if you are sick with a rare or terrible prognosis disease either learn to read those studies or find someone that can read them...correctly!!! probably not your PCP, unless you are lucky.
A good article that summarizes the status of psychiatry and the push towards more medication for insurance-accepting providers.
http://www.kevinmd.com/blog/2008/08/matthew-mintz-as-psychiatry-goes-so.html
While the author mentions that this is not necessarily a bad thing, I think that having divided care especially with the health care providers not having time and not being reimbursed to talk to each other is just another link that can fail you. You know my advice: if you can afford it, go with the providers that do not accept health insurance and try no medication longer than you think!
More and more I am convinced that my recent success in beating social anxiety has more to do with the amount of positive programming about myself that I got. It finally got to that critical level when I began believing it. And it could have been anything: tapes, more therapy, or anything else.
This is not a new idea, I encountered it in more than one self help books: You need to be sure that you are great and wonderful and beautiful and lovable. If people around you reinforce this idea, you will start believing it and acting on it.
Sometimes people make mistakes, even the smartest people act stupid at times. Allow yourself to do or say stupid things. It's not a big deal. Just apologize and move on not giving it a second thought. You will make better decisions if you strongly believe in yourself than if you worry about being wrong about anything you do or anything anyone else thinks.
Having this in mind, it makes a lot of sense to do as many as possible of the following
About.com has a page on social anxiety disorder and the moderator, Arlin Cuncic, released an article about the best SAD blogs. My blog is mentioned in that article positively... pretty neat if you think about it. I'm growing. The website is informative and has a forum and a newsletter. I think it's worth keeping an eye on it.
Thank you Arlin.
Woohoo! I passed the exam. It wasn't that difficult, but while studying I realized how much we learned that other people do not know. I would have loved to go deeper into anatomy and physiology, and to have more power, better balance and less fear, but it only has to start here. I have a lifetime to learn and build my life and my body as I'd like them to be.
I learned an incredible gem yesterday that will probably help me better explain what yoga and meditation does to your mind. Imagine a jar with dirty water. The dirt in the water are our daily thoughts. There are lots of them and they are hanging around popping in and out and moving in no particular direction. You can't see through the water because there are so many thoughts. If you put the jar down and leave it there for an hour or so, all the dirt falls to the bottom and the water becomes clear. Yoga and meditation helps you slow down the stream of thoughts, let them rest, see clearly the things that are important and pick up the important thoughts and make them happen.
For the last week I worked on my treasure map: a display of pictures that inspire me. I never thought how much pleasure this exercise will bring me. I thought that once again I will think about all those cool things that I'd like to have but never will get around to doing them.
Instead, I had an enormous pleasure putting it together and looking at it. It has pictures with my family and all the time that we are going to spend having fun together. It has my dream house on the beach and a cool kitchen and a swimming pool, my organic vegetable garden, and my athletic endeavors: a triathlon, teaching yoga to kids, and the Appalachian Trail. It also has a picture of a hospital and a hospital dashboard and the verses of The Impossible Dream.
It also felt great to share it with my husband and my baby. It was the first time in my life that I actually dared to accept my dreams. Maybe not all of them will happen, but I have something that I'll see every evening before bed and I know that my priorities should be and what should make me happy. I don't think I ever expressed all these even to my husband.
What a great tool to share. On Saturday I will get it to my last yoga session and we will see each others... that will give us something interesting to talk about! Try it! It will give you a few happy moments, and once it's up you realize that it's not really as impossible as you thought.
If you were around for a while you know my hunger for comments. While feeling better over the last couple of months, I (and my blog) survived without many comments for a while now. On Friday I had the great pleasure of finding two very nice comments... Woohoo! I inspired someone to do something about their anxiety.
A new social anxiety blog is out! Please welcome travel.trekker1 and wish her good luck in your journey. She seems like a good buddy for me so I am looking forward to more posts and communication.
And an additional note about the last blog I wrote about: Matt Ambrose at Overcoming Social Anxiety: this is a must read. It is kind and gentle. It is the best writing on social anxiety that I stumbled upon. It makes me feel good about myself when I read it.
The guys at the Mental Health Blog Research Study have their survey up and you can take it if you want to help research anxiety disorders and blogs. Email mhblog@tcnj.edu before July 10, 2008 if you are interested.
In one of the latest comments, a reader talked about how difficult it is to be living in the moment. I've been working on this for the last half an year, so I can tell you what worked for me:
- Some sort of vigorous activity that requires concentration and doesn't leave you time to drift into thinking. Ashtanga yoga does this for me. But it took a while. For weeks I kept just thinking how hard it is, what comes next, this is hard, this is easy, and when is the end of the class, etc. I'm now just concentrating on the current posture and it's great.
- In the beginning, use your senses with strong cues: eat something you really love with great attention and pleasure: enjoy a chocolate truffle for a minute or so, smell a great perfume, listen to the birds singing, or to the ocean waves. Eventually you will start being aware of all the chatter around all the time and you will feel and touch and smell things without judgment, for example smelling something foul will just bring awareness not necessarily disgust.
- Read. You will be surprised how many successful people (like Seth Godin or John Halamka) have some sort of meditative practice and preach living in the moment and utilizing the time while you have it... NOW! to do something rather than think about what you could have done or what you will do.
- When overwhelmed with thoughts, ask yourself if there's anything I can do about this right now (can you write an email, make a call, etc. to make the idea happen)? If yes, just do it, if not, let the thought go. I used to fantasize a lot about spending time with friends and intelligent discussions we would have, etc. Now when I think about this, I just smile, say I love you to my imaginary friends and then think: Hey but you are not really here so Good Bye, I'll see you next time! No beating up, no frustrations, no expectations.
And because my commenter mentioned Eckhart Tolle, here's the list of things that helped me in my journey:
- The yoga teachers training at the Yoga and Healing Center in Scotch Plains, NJ - graduation in two weeks... need go practice and learn
- A Yoga, Chocolate and Wine seminar with Yoga Dave
- A 3 hours seminar with Bijan and reading Effortless Prosperity daily lesson and trying to practice it
- Reading A New Earth - Eckhart Tolle
I noticed that with anxiety you can't just relax and let things the way they are. You continuously need to push through and challenge yourself. Any time spent in the comfort zone makes the anxiety take over more and more... You can give yourself a dy off, but that's a bout it, next day just start over and get into challenges again and again.
Of course the ultimate cure is living in the moment and realizing that all these things we so dearly care about (like other people's opinions or what X and Z said) ultimately don't mean anything. So complete relaxation is the cure. But even if you get there, there is a lot of work in continuing to do it and not getting back into your anxious spot.
Here's a visual cue that I'm using to think about this: take a piece of paper and write down any activity that involves interaction with other people grouping them from the ones that cause most anxiety to the ones with least anxiety. I would have an interview on TV on the left side and friendly chatting with my husband or interacting with my happy kid on the right. Now draw a wavy line to separate the activities between comfort zone and anxiety zone.
The aim of every day is to push that line more and more to the left including more and more activities that are uncomfortable. Doing them time and time again will make them shift into the comfort zone.
When you relax and don't push, the line will not be stable: it just moves to the right and you get more and more uncomfortable.
So in order to make any progress or even keep the statu quo, you need to work all the time, every day and every hour and push that line. It's a Sisyphus job, but it's the only way you can live and enjoy life.
No rest for the weary! Good luck and keep pushing that line!
An excellent article in New York Times talking about using meditation in therapy:
http://www.nytimes.com/2008/05/27/health/research/27budd.html?pagewanted=1&_r=2&ref=health
Don't miss it!
One of my favorite authors, Irvin Yalom, describes the aim of therapy as opening up first to your therapist and then to the world. I loved his comment, lived by it and wrote a post about it a very long time ago.
However, with anxiety, I think you can be open all you want and still be anxious. It eases up some of the attempts to hide the anxiety, but it doesn't resolve the problem.
I think that with anxiety, the aim of therapy is to minimize the time a problem hangs out in your head. It used to be that I had problems that we discussed through multiple sessions: I worried about those things constantly for weeks: bad, very bad. Those are stale thoughts.
Let's say you have a 10 minutes phone conversation. You hang up and then start replaying the phone conversation in your head over and over again for days. You beat yourself up over what you should have said, you are very proud of what you said well, you interpret what you heard in numerous ways, you have emotions that might not have anything to do with the actual call, they are just emotions brought on by your thoughts and your interpretation of the phone call.
I knew that therapy was over when any of the issues I brought up were about one day old at most. The problems would come and go, wash over me, were processed in real time and went away. No stale thoughts, no interpretations. You can think clearly and not reactive with a fresh problem.
I am a project manager, so I do have problems that last days or weeks, but when I get back home, they don't exist and they shouldn't exist. Tomorrow is another day that I can deal with them, and looking at them with fresh eyes is always easier. Bringing my problems home is a sure way to trigger terrible-twos behavior and upset everyone else.
I am now working on really living in the moment and being present at any time, no afterthoughts, no interpretation. Something happens: it causes emotion: let the emotion be there, feel it, enjoy it, express it and move on to something else.
This is the aim of meditation and yoga, and I recommend either or both for social anxiety or just any kind of anxiety.
And another reason to live in the moment from Dr Rob.... And from Dr Rob again a great quote for good laughs. It's short enough that I am including it all to spare you the need to transfer over, but Dr. Rob's blog is a must read!
"Why did God make it that you have teenagers at the same time you are going through menopause?"
Wish me luck! I think I'll be there! I should perfect this living in the moment thing by then!
One of the first things that my therapist did with me and the most successful for gaining my trust was to explain that everybody has at some level the same anxieties that I have. She used herself and her experiences as an example and it was extremely powerful.
She made sure I understood that I am not crazy and that my thoughts are reasonable and my anxieties not so unusual.
It is tough and very lonely to have social anxiety without knowing what's going on. You feel really really lonely and you think you are some kind of monster that nobody wants to be with. Once you find out that it's not that uncommon, this knowledge comes with a bit of relief that there are other people having the same thing and that there is hope, but on the other side, you have a mental health issue/disease which officially puts you in a I'm at least a bit crazy category. Deciding to do therapy or taking medication is again a step forward, but it comes with the issue of having to admit it to others.
This is why establishing that you are not crazy is a great first step in therapy. Brilliant!
Once we know that we have social anxiety, we tend to identify all our traits that prove that we have social anxiety. Sometimes what is a simple difference between people's behavior becomes in our mind unbreakable proof of our being abnormal. And I think we feel attracted to people that are different and that we desire to be like and don't realize that there are enough people out there just like us.
Just recently I noticed this with me. I considered as a typical social anxiety trait the fact that I only dated two men in my life. I found out that my latest hero, John Halamka, married his first and only date. I don't know that he has social anxiety or not, I suspect not too much, but maybe some people are just more efficient this way. Friends that I stayed with, I liked from the very beginning, so is that so bad? Just like people that start drinking in college because they think that everybody else does. Some people just don't drink and some people don't need to date a lot! Does that make us unusual? Probably, but crazy... no!
So, take heart! You're probably not as weird as you think, and almost everybody has anxieties in one way or another.
So you found out that you have social anxiety. And you read that the best treatment is a combination of drugs and therapy, probably CBT - cognitive behavioral therapy. I'm pretty sure you heard that you probably have a bio-chemical imbalance... oh, that sounds so good: it's not in your head, it's a disease!
Here's my take: forget about drugs... ignore drug advertisements, ignore doctors that insist that you can't do it otherwise, ignore articles. Forget about them. Be strong and work through it for an year. Then you can decide that what you're doing is not enough.
Drug companies and medical insurance companies are not on your side. They are in for making profit, not for keeping/making you healthy. There's a lot of money involved and they are all thrown to convince you that you need expensive drugs. Lots of doctors are biased by the same advertisements. Forget the free samples. They will not last forever and then you'll end up with an expensive drug that you'll probably have a hard time weaning from.
A word on Complementary and alternative medicine: I think it's mostly placebo. I also think placebo is a wonderful thing that you should fully benefit from. But don't spend a fortune on it. Keep an eye on the wallet. Hey, that $2 bottle of homeopathic medicine that makes you feel so good: go ahead and use it! Omega 3s are making you more calm: go for it! But hundreds of $ a month for this stuff, forget about it!
This leaves you with one task: finding a good therapist - the right therapist. Psychologists are OK, but don't necessarily insist on a doctor. My therapist is a psychiatric nurse and she's excellent. Ask around: ask doctors, friends, family. If you can afford it, a therapist that does not accept any insurance is a good sign: probably successful enough to not need it, and less hassled by insurance companies (and more willing to give that time and attention to you, not your co-payment). Insurance companies are not your friends. Forget their referrals, they will send you to the cheapest guy in town.
Two books you need to read before starting therapy:
Check this new very interesting blog about social anxiety: - Overcoming Social Anxiety. Mat Ambrose is a freelance writer. The first articles are very well written... duh!
I'm very honored to be in his blogroll.
In 2004 I was not sleeping well and not feeling well. I visited my doctor and she diagnosed anxiety, prescribed Clonazepam and suggested that I start seeing a therapist.
I felt great on Clonazepam, but I hated that i needed more and more to sleep better. I took it for 3-4 months while I was under a lot of stress at work and then got off of it. The weaning was scary. My anxiety shot up very bad. I didn't sleep for a night or two. I resisted starting it over and after a week I was fine but I started being scared of medication.
I looked for a therapist and it looks like there's one at every street corner. I had the sense that I shouldn't just pick one, but I had no clue how to find the right one. At that time I had no idea that social anxiety was even defined. I had no idea what was wrong with me in the first place. I called a couple of therapists and found out they are really busy. I finally found one near my house that reluctantly found a time for me. I went there for 4 weeks and left disgusted. The therapist seemed to be more interested in my $10 copayment than my well-being. It did not go well.
I had the idea to search the web for extremely shy or something along these lines. I found books and I found that a disorder exists and it has a name. I ordered the books and started reading. I was not alone anymore... there were people that knew what I felt.
I got pregnant and momentarily dropped the idea of "fixing" the social anxiety. In April 2006, I decided it's time to attack it and get it over with. It took me two years. I am not over with it, I just accept myself and my social anxiety as part of myself. It's there, but it doesn't stop me from important things in my life.
I first went to a CBT (cognitive-behavior therapy) specialist. He was teaching at a big New York university, so I figured he must be good. I went there for 5 weeks. I didn't feel we were doing enough, and he felt he can't help me. He suggested that I see someone else, but did not offer any help with a name or anything. I failed again.
A month or two later I called a number that my new doctor gave me. It was supposed to be my last effort with therapy before giving up and asking for medication to help me cope. I was not optimistic. On the phone, this new therapist mentioned all the reasons why I shouldn't see her: too far away, no time, etc. but I said I don't know what else to do and that I need to talk to someone.
I went in once and was hooked. She had a few soundbites that I loved, among others "oh, men, my dear...". But the most important one was: "Ileana, no matter what will happen, I will be here for you." And she was there for me, even if it was difficult at time for me and her.
Next post will be about what I'd suggest that someone does before starting therapy... we all live to give advice, don't we?
I had an offer to write an anxiety blog for a health web site. I just turned it down. I will continue to be my own boss.
But it made me think some and I had a few ideas for blog posts that I would like to write. Two years ago in April I seriously decided to attack my anxiety. Now, two years later, I just finished a long round of therapy and I think I won, at least for the time being. Two or three weeks went by and I didn't need to run back to my therapist for help. I can deal with life on my own! Woohoo!
So my posts will concentrate on what helped me in therapy. I'm pretty sure this might help someone.
As I mentioned before, I started a yoga teacher's training. I love it and it helps me immensely. My articles might sound esoteric and funny in respect to this, but you'll have to live with me.
It's good to be back to my own forgotten blog.
I was asked to participate in a research about mental health and blogging habits. Sounds interesting. If you want to join the details are below.
I will get back soon with more posts!
Hello,
I am part of a research group from The College of New Jersey interested in gaining information on the views of authors of mental health blogs. This study is part of a research project of Dr. Yifeng Hu, a professor in the Communication Studies department at TCNJ. You have been contacted because you are the author of such a blog. Participation will involve responding to surveys about your mental health and blogging habits. The results are completely confidential. No respondent's personal identity will be requested or associated with any set of answers. We appreciate your time and help with our study and as a thank you for participating you will receive a $5 gift card (or you can choose to donate your amount to Mental Health America). If you are interested, please send an email to mhblog@tcnj.edu and be sure to include a link to the home page of your blog as well as your preferred contact email address. The survey will be sent to you via email within the next few weeks. Thank you in advance for your participation!
--
Mental Health Blog Research Group
The College of New Jersey
mhblog@tcnj.edu
I've been up with a lot lately. Lots of work and taking care of my kid, but also lots of thinking and crystallizing my thoughts.
I started a yoga teacher's training. It's wonderful. I knew that the exercise and mediation is going to help with anxiety, but this is so much more than that.
Wendy, the teacher is insisting on being positive: no gossiping is allowed, no push backs... What can a bunch of people (mostly women) do when exercising a lot and being positive and open? A lot! So I keep going on my way to openness full speed.
This being said, I'm not sure I want to delve on the anxiety side so much. It helped me go through a phase and open up, but now I don't feel like throwing in everyone's face that I am an emotional mess... probably because I a not that much of a mess anymore. I'm not much into venting anymore. My new blog is Cool Yoga Mama. It might be a bit too sweet for some. I will strive to keep it all positive. Feel free to visit! I'd love to see you there!
And thanks for the support during this last year. It helped me immensely.
A quote from The Winter of our Discontent - John Steinbeck that the ones of you that have social anxiety might find helpful:
My sudden fear that I might be showing through was very great. I had made myself believe that the eyes are not the mirror of the soul. Some of the deadliest little female contraptions I ever saw had the faces and the eyes of angels. There is a breed that can read through skin and through bone right into the center, but they are rare. For the most part people are not curious except about themselves. Once a Canadian girl of Scottish blood told me a story that had bitten her and the telling bit me. She said that in the age of growing up when she felt that all eyes were on her and not favorably, so that she went from blushes to tears and back again, her Highland grandfather, observing her pain, said sharply: "Ye wouldna be sae worrit wi' what folk think about ye if ye kenned how seldom they do." It cured her and the telling reassured me of privacy, because it's true.The whole book is wonderful and you should read it!
It's almost two weeks since my father died and I am realizing that I mostly like to do things that I did with him: logic, math, thinking out of the box, hiking, skying. I just re-read the book I love most: The Winter of our Discontent - John Steinbeck and I realized he suggested it. He was reading books and underlining the parts he loved most... and I loved those parts too. I am glad I asked for books he liked this summer when I last saw him and I got a couple of books.
He was the utmost authority in my life. When he approved of something I did, it made me feel very good and accomplished. He was also very critical (did anyone doubt that with my social anxiety?) and I sometimes felt anxiety talking to him.
On a funny note, one thing he was critical about was my French... He was very good at it, and I wasn't that good. I found it ironical that I flew in an Air France flight to Romania to attend his funeral... thus one more time realizing how poor my French is.
When I left for US seven years ago, he had to learn English and to use a PC and do email and he did... at 75 years old. He had a dictionary and taught himself to use the PC and navigate the Internet without previously speaking English. He was pretty amazing and a great guy.
I ran into an article that explains that expressing anger might be helpful for your health and that couples that express anger are happier.
My father had a heart attack when I was 9. We were told it is not healthy for him to get angry. I hope they don't tell families things like this anymore these days. It really put too much pressure on us. Ever since anyone's anger made me very uncomfortable. I don't know what to say, what to do, where to hide and how to make it stop.
Over the last year, I had a different take on that. It's anger expressed in blog posts. Some of my favorites are the angry guys - The Angry Pharmacist, The Angry Doctor (not writing much lately - I suspect he's not that angry anymore), and Panda Bear, MD in hid good angry days.
Their anger is obviously not making me that uncomfortable because I am not expected to do anything, instead, I can appreciate that they might be right most of the time. The article mentions that as well... In anger you forget who you need to be nice to and just cut to the chase and say things as you really see them.
When people are angry, you can really find out what they are thinking.
I keep wondering whether there is a link between my lifelong dealing with anxiety and my excellent memory for details.
I think it's partially an exercise thing... I kept being very attentive to any communication of any sort with anyone and kept rehashing it in my mind forever, that I think my memory got worked a lot. Now that I am not that anxious any more I find myself remembering details that nobody should remember. I know details from blog posts that were written an year ago. When Paul Levy's blog was the only one I read, it maybe made sense, but now I am reading a lot and still feel like I remember too many details.
This might make someone that cares about their privacy very wary, but I think there is a chance to meet people like me on the blogosphere. I pretty much read these things once, maybe twice if they are very interesting or have interesting comments. And I also keep track of a million details in the project I'm managing.
I think I should just be happy about it!
I noticed a few positive things this week. First, I was doing a user training. I did not have enough time to prepare and I didn't do a spectacular job. I did trainings with brand new computer users and I know what it takes to get them up to speed, but this time I just didn't have the time. One of the people at the course gave me an article from New York Times on how to teach computer skills. In the past this would have embarrassed me terribly. I would have been upset for days.
I'm not happy that I was criticized, and I wish I did a better job, but I recognize that the problem is not me not trying enough or not being able to do it, but the fact that you need time to prepare a training course. I am unhappy, but not paralyzed... this is new!
Along the same lines, the other day we had a few friends for brunch and we were talking about the American students not being culturally savvy enough to recognize a well-known Marx quote. I didn't recognize it either and that got me a bunch of sarcastic comments. I would have died from embarrassment. After the initial shock, I thought about why I don't know that... and I came up with an explanation that I think was instructive for everyone.
I grew up in the 70s-80s Romania. At that time Romania was a socialist country, but we weren't very close to Russia. Romania did not want to participate in invading Czechoslovakia in 1968. So I actually did not learn Russian, nor did I study Marx or Lenin. I pretty much kept up with what we learned in school: basically no foreign literature, dry and boring history and geography lessons, very little musical education and no other art education. I learned French and German in school and English in private lessons with my favorite teacher. I read all the books that I found in the house, but without much guidance from anyone. My parents were trying to keep sane at the those insane times by talking to each other and getting feedback from each other on the very crazy things that went on with their jobs.
I don't believe this is my fault. I am able now to round my education, and I'd like to, but, again, I recognize that there is a compromise between all that you want to do and what you can do... and I am choosing having a job, spending time with my child and family, reading other stuff and sleeping 7 hours a night or more. I hope I will be able to read and learn more with my child or when I retire. Until then, whatever culture I have is good enough.
And the third good thing, and the best, is my husband. When I started therapy we were both a bit nervous about it. It opened the possibilities that we will both discover things that we might not like; it is not uncommon for women to discover their power and "free" themselves of the evil men, etc.
Last year, whenever we had friends over or met other people, I would ask my husband to reassure me: Was I OK? Did I do well? How did I come out?
Now, when we go to bed, he cuddles and hugs me and says: I like you, I really like you. I like what kind of person you are, what kind of mother. I like that you are witty and smart and nice. I like the person you are... He used to reassure me to make me feel good about myself, but this is different. I think it's wonderful that I turned out into someone he likes and that I am now coming out of my shell enough for people to see that.
On the uncomfortable note, I am changing my gastro-enterologist and I feel very uncomfortable to face the old one. I called to ask for a test result and the nurse asked me to make an appointment. I got very anxious... There's more work to do. I am very uncomfortable confronting anyone. Bad news are difficult to give, I guess!
