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Anxiety and Stress Disorders

Information About Social Anxiety Disorder

03/15/2006

Question:

I have been experiencing what I think is social anxiety for the past ten years. I am a 25 year old woman. The problem is that I get so nervous when around most people that I can’t really talk or act anything like myself. I have a socially crippling problem with eye contact. This happens with family members, old family friends, strangers of course, and even some of my close friends. I am constantly thinking about how everyone thinks that I am weird or is trying to avoid me. Even though I know that sometimes I must just be imagining it. I go through periods of it being really bad but it is always present. Alcohol abuse has become apart of the problem.

I am at a point in my life were I realize that this is not normal and I have decided that I don’t want to live with it any more. I think I want to see a therapist. I don’t want to have to take drugs. How do I find the right Psychologist? What should I tell them? Should I say that I think I have social anxiety or should I just tell them my problems?

Also, I have just gotten my first job as an elementary art teacher. Will the school find out about my need for a psychologist and if they do can they fire me?

Answer:

It sounds like you certainly could have social anxiety disorder, or another underlying anxiety disorder.  It seems like you have done some good work understanding your problems, and your decision to seek a therapist is a good one.

Several kinds of professionals offer counseling and therapy, including psychologists and clinical social workers.  Finding the "right" one is not always easy, and it is important that you make a list of factors that are important to you to help guide you in your selection.

Some people, with good insurance who live in metropolitan areas, usually have a choice of therapists available.  Others, who may lack insurance or live in a rural area, may be limited in their selection.  If you have a choice, decide some of the following even before you start looking.

Is gender important?  Would you feel more comfortable with a man or a woman, or does that not matter?

Is location important?  How far can you travel to meet with your therapist?

Are there certain kinds of therapy you want to consider?  For example, cognitive-behavioral therapy has been proven effective for treating anxiety disorders, and most therapist can offer this, but if you are looking for more unusual modes of therapy, you will need to screen potential therapists.

Then, seek recommendations from your primary care physician or other medical providers you may know.  Calling for recommendations from friends and family can also be useful.

Plan your first meeting with a therapist to be a chance for you to interview the therapist, as well as for her to interview you.  Ask about the therapists training and experience in treating anxiety.  Ask how the therapist structures her time with patients.  Get a sense of how comfortable you are with the therapist.

If it seems like a good fit, plan to see a therapist at least 6 times before you know if it will be a good working relationship.  If the first encounter really strikes you as bad, keep looking for another therapist.  If you aren't sure, give it at least one more session to check for sure.

In giving your own history and story, what is most important is what you are feeling, how you are behaving and how it is affecting your life.  Your therapist may be interested in your self-diagnosis, but most important is to share the details of your story.

Good Luck.

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Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati