Learn me: 19yo with massive anxiety

I kinda suspect most people have some level of anxiety these days.  It's just the new normal to have a lot on our minds about.....life.  

My step daughter seemed to have it the most acutely of the kids and we encouraged her to get a high school job at the local grocery store.  She's done really well and is getting tagged for promotions quicker than I would have believed which has been a positive for her self esteem. 

As pointed out by others, social interactions become less intimidating if you do a couple hundred of them a day.  "Immersion therapy" is the term for it I believe.

Knowing what anxiety is and where it comes from is a good start. Anxiety is a natural feeling that comes from our primitive brain to be on alert for danger. It is the "pre" fight flight or freeze. Think trying to forage for food while there is rustling and you know that sabertooth tigers are in the area. It is an experience of hyperarousal at ones surroundings and has it's use, like being anxious using a new saw will help you see and recognize all the dangers early on. The problem becomes when the anxiety isn't experienced, it grows worse as the brain didn't get the answers it was looking for.

For example, you enter a room full of new people and feel a little anxious, that is normal. You might notice where the exits are for example. If you experience the anxiety, it will pass. Usually walking around the room and noticing people, probably seeing random little details, and generally just surviving the sabertooth tiger.

Now the next time you enter that same room you will not feel as anxious. Your brain remembers that it has been here before and successfully foraged and as such doesn't ramp up all the chemicals that make the anxious feeling.

If you had avoided the room however and left you would now feel more anxiety the second time you went. By not experiencing it the first time you effectively told your brain that you experienced danger and needed to flee the tiger. You literally made one of the post anxiety choices (flight) and this told your brain that it was right to be extra observational because there was danger.

This chart helps show how that short term avoidance creates a long term anxiety:

So how can you experience anxiety instead of avoiding it when your cycle is already too big? Well, anxiety is a physical state as well, and just like the mental state will induce the physical, the physical will induce the mental.

While sitting in a chair clasp your hands together. Look at the fingers and observe which way they interlock. It feels comfortable. Now unclasp them and reclasp them backwards (if your left pointer was on top, now make it your right pointer). You should actually feel your body start to induce an anxious state. E36 M3 with it and observe your body and it's feelings. Do your hands tingle? Are you sweating? Do you feel a nervous tick, a restless leg, or the desire to leave? That's all good, that's anxiety!

Continue the clasp until those feelings start to subside. That's your brain recognizing that there is no danger in this new situation and making the chemical and physical changes to come down from hyperarousal. If the hand clasping doesn't induce it, try crossing your legs backwards.

Successfully experiencing anxiety without the flight choice will start to retain your brain that anxiety doesn't always mean danger and you can start to experience it successfully in other areas. That's what "working through it" really means, going to hyperarousal, recognizing no danger, and continuing to stay in the situation until it becomes comfortable (regular arousal).

SVreX (Forum Supporter) said:

Most people who know me see me as a confident, capable leader.  OK, some people see me as an asshat. 

But you're OUR asshat. 

Try a Dale Carnegie "Effective Human Relations" course.   They are usually 1 night a week for 12 weeks.  Not cheap though.

 You practice public speaking in a non-threatening environment using a well thought out program that has been used for over 100 years.  

  It also gives you some "go to" techniques for dealing with people and resolving potential conflicts before they go negative.    

My grandpa took the course in the 1920's and I did in the 1990's.   One of the best decisions I ever made. 

I agree with those who mentioned music.

Most people who know me can't imagine me on a stage singing, but I did it for years. Usually for small club crowds, but occasionally for a few hundred ( I think the largest crowd we ever played in front of was a battle of the bands and maybe a 1000 or so).  But as a band, we practiced like crazy - usually multiple times per week.  So despite being a generally quiet introvert, I have never really experienced stage fright when playing.  The excessive amount of practice we had done instilled a level of confidence and comfort. 

I miss playing live on stage, although to do that again at some of my other hobbies would need to take a back seat.

My wife is a therapist but out of state for you since I see you're in GA, or I'd recommend her. She tells me anxiety is one of the easier ones to resolve, so I hope that can at least give you some hope.

Her methodology is through the Emotionally Focused Therapy lens, which has saved our marriage, at least.  Here are some in Atlanta that say they use that approach: https://www.psychologytoday.com/us/therapists/emotionally-focused/ga/atlanta  IIRC anxiety is a lot of cognitive work, however, but EFT is kick butt. I can't say with certainty for GA but in MI, KS, and MO, avoid "social worker" counselors. You can still get licensed to practice counseling with a master's in social work but it's not at all the same coursework or focus.

One other little bit of advice is that not all counselors are a good fit. You should know in a session or two if it's going to work for you and if it's not, then find a new one. BUT I would recommend not deciding to switch after like 5 or 6 sessions because it may just be that they're touching on some difficult stuff and as humans our natural reaction is to avoid difficult things.

For me, therapy helps some, and medication complements it.

If one medication isn't working after a couple of months, ask if there's a different one to try. There's no one right answer, each person is different and needs different treatment. Same goes for therapy, if it's not helping, you can find a different therapist.

slowbird said:

For me, therapy helps some, and medication complements it.

If one medication isn't working after a couple of months, ask if there's a different one to try. There's no one right answer, each person is different and needs different treatment. Same goes for therapy, if it's not helping, you can find a different therapist.

this. 

OP has described my experiences very well.  For me, it was a work-sponsored "Effective Presentation Skills" week long seminar that changed everything.  Who knew? I'll try to break down what worked for me and why.

Video - when I would be in social situations, or giving a presentation, I could hear every stutter, every waver in my voice, and I thought everyone else could, too.  I'd start a self-reinforcing cycle of greater and greater anxiety, flop-sweat and flushing that would drive me to mumble, avoid eye contact and generally trying to shrink into invisibility.  Seeing myself on video, I could see what others saw.  Those little "tells" I thought were so obvious were not visible.  I could compare my performances with others who looked successful and mirror their gestures, cadence and voice modulation.  It didn't take long before I could totally act like a smooth operator.

Scenarios - understanding how to react to hard questions or awkward situations.  Practicing these sort of things gives you a playbook to draw from if things go south.  Being comfortable with confrontation and understanding a number of techniques to use relieved a lot of anxiety.  Understanding that you can use others around you or in the audience to help control/corral troublemakers is another big plus - then you don't have to feel like some kind of a-hole, you instead put the other party in the hot seat.

Act - I still feel anxiety in many situations, and I don't think it will ever go away, but it went from a 10 down to a 2.  However, nobody even knows this because I know how to act confident, keep control and never lose my cool.  Building off the video and scenarios, I've developed a "character" that is a super-accomplished engineer capable of selling ice to Eskimos and getting a Christmas card every year because I made such an impact in their lives.  Is it really me?  It is, even though the anxiety tries to convince me otherwise.  

Although this training was geared towards work situations, most everything has been transferrable to other parts of my social life.  I'll never be mistaken for social butterfly, but neither will anyone suspect the sort of terror-stricken wallflower I used to be.  Hope this helps.

In reply to 11110000 :

I developed anxiety as an adult. While I felt anxious as a kid I covered it with bluff and bluster as a means of compensation. 
 

In my adult life I've had several misdiagnoses of medical conditions. A broken femur misdiagnosed by the school nurse when it was a compound green stick fracture which almost cost me my leg. A broken neck treated with pain relievers. A new medicine ( Tolwin ) which Nearly killed me. Thanks to a RN Who took it upon herself to proscribe an antidote when no doctor could be found. 
 A doctor who came in drunk to perform throat surgery. Was later stopped by another RN  and several other such incidents. 
Since my brother has had an incident where he has cost the life of one of his surgery patients, I realize just how vulnerable I am. 
Now  days the slightest medical issue can trigger a severe anxiety attack.  Since the Covid 19 came up in February and I saw how poorly The medical community treated it I began to consume medication ( Alprazolam ) every few days.  
Now I take a single tablet of Escitalopram  10 mg daily. And I still have Alprazolam  .05 mg as a back up. 
A decade ago I took anti depressants for about a year and a half  until that situation changed. So I know medication can help and not to be afraid or ashamed to ask for help.  

Several years ago I talked with my doctor about my inability to focus at work.  I figured he would give me ADD medication, but, nope, he started me on an antidepressant.  Went through several at varying dosages.  None helped with focusing at work.  But I noticed beneficial side effects in that they worked wonders on anxiety and anger management.  I had no idea just how bad my anxiety had been for as far back as I can remember.  When I retired I stopped taking them, because I figured the stress and shot would be gone and I wouldn't need them.  WRONG!  I had to go back on them and ended up on Cymbalta.  It seems to work OK with fewer side effects.  I had always been a it-antidepressant up till I started them and felt ashamed to be taking them.  Now I don't care what people think for it gets me through the day.  
 

Big disclaimer: antidepressants can be problematic with yutes.  

In reply to spitfirebill :

There are a lot of people that just believe you can "think happy thoughts" to beat depression and anxiety. It's not that easy. When your brain stops making enough of one chemical, or too much of another all the happy thoughts in the world are not enough. With that said, a pill is not always THE answer. It can be one of the answers. But always consult professionals on this. 

My 14YO has been on ADHD meds for about 6 years, meds have had to change up and down in dosage, meds changed to different types.  We tried adding an anti-depressant 2 years ago to help stabilize his mood, but because his mother won't monitor using his meds at her house, he has gone a week or two at a time without meds this summer.  It's too dangerous for him to be on and off his meds like that, so now we are going to ween him off the anti-depressants.

Anti-depressants are usually best used in conjunction with therapy.

Thanks errrybody.
 

Many good ideas. Hopefully he is going to get a job at a drive thru car wash which will have some public facing interaction. And we're gonna get after the counseling. 

Here's one from left field. When you're looking for counselors see if there are any that use farm animals as part of it (you need to be in a rural area). Talking to someone while walking over to the cow, or looking for the horse, etc. doesn't feel like someone lecturing you. One of the best things for my daughter was getting and raising chickens, it gave her something she had to do, and something interesting to talk about if people asked her questions. 

You may be surprised by how much the job may help.  My daughter was a wreck around new people and different situations for ever.  It was so bad she would barf.  Something happens at school?-barf. Go out to eat with grandparents-barf. Doctor's appt-barf. Too many people she doesn't know-barf.  Any new situation-might barf.

She has a brain that runs at a different speed than most. Skipped a grade, tested in the 99% percentile in every test ever.  Just too smart for her own good. The battle has been to give her street smarts.

When she was 15 she decided she wanted a job like her friends(her friends were a year older)and got one at a t-shirt shop in Treasure Island.  Her logic was her desire for money might help her get over her social anxiety.  She admitted to barfing a few times while working but she fought through it- for the money. By the time she was 16 she had $4k in the bank.

Three years later she is a manager of a different store while going to college.  Hasn't barfed for the old reasons in a long time.

There is hope.

I worked retail in high-school and college.  Seeing everyone in Clemson forced me to open up a bit.

This may sound crazy, but try taking him to some strip clubs.  

In reply to Steve_Jones :

When Jodi worked at the rehab facility they were affiliated with a small therapy farm. It seems like it works pretty well.