Understanding anxiety: How to shrink your fears and give your brain a breakby Sharon Stephenson
One in 10 people suffers from social anxiety – the kind that has you dreading end-of-year work functions, family gatherings, even the holiday disruption to normal routines. Sharon Stephenson investigates “the disorder of missed chances” and finds out how to manage your fears and give your brain a break.
It’s the date of the lavish Christmas party thrown by the Auckland accounting firm where Tim Braddon (not his real name) has worked for a dozen or so years. Although Braddon has bought a ticket for each of those Christmas parties, he’s never attended a single one.
“I’ve invented every reason possible to avoid them, from being sick and family funerals to making sure I’m out of the country on holiday,” says the 44-year-old. “But every year, I buy a ticket so my colleagues don’t think I’m tight or don’t like them, even though I have no intention of going.”
Braddon says he starts worrying about Christmas as early as September and spends many a sleepless night thinking up ways to get out of the annual event.
There’s a reason for this and it’s not the one you might think: “I’m not some ‘bah humbug’ Scrooge who hates Christmas – quite the contrary. The problem is I’m terrified of meeting people I don’t know and having everyone look at me. What if I say something stupid or embarrass myself in front of a stranger or, even worse, my colleagues?”
Instead of taking out his “twitching bundle of fears and neuroses”, Braddon prefers to stay at home (he almost missed his own wedding, so worried was he about people watching him walk down the aisle).
“Going to a party is like entering a war zone: my stomach is on a fast spin cycle and it feels as though someone has their boot on my windpipe. I also can’t stop blushing, which is mortifying.”
Braddon suffers from social anxiety disorder, also known as social phobia – a fear of being in social situations where there’s a chance of being judged, criticised or negatively evaluated by others. Sufferers have “a persistent, intense and chronic fear” of being judged or embarrassed by their own actions, says Auckland psychotherapist Kyle MacDonald. “People are social animals and have a strong desire to be part of a group and accepted by that group,” he says. “Social anxiety can occur when we fear that might not happen.”
Social anxiety is the most common of the anxiety phobias (which include agoraphobia, generalised anxiety disorder and panic disorder), with around one in 10 globally likely to be affected. It’s also one of the few disorders that affects men and women equally, and is typically believed to begin in childhood or early adolescence.
“Although no one really knows why social anxiety occurs, it can result from family experiences or because of a trauma such as bullying,” says MacDonald, who has witnessed such an uptick in patients suffering from the disorder over the past few years that he created New Zealand’s first web-based self-help programme, Overcoming Social Anxiety, which currently has about 500 users.
It’s believed that in social anxiety sufferers, the part of the brain that acts like a watchdog – the amygdala – senses danger even in safe situations. This can send the body into flight-or-flight mode, triggering physical symptoms such as sweating, dizziness, shaking and a racing heart. Social anxiety has also been associated with an increased risk of diabetes, heart disease, substance abuse and depression.
Commonly treated with cognitive behavioural therapy (i.e. teaching socially anxious individuals to identify and deal with negative thoughts), social anxiety can be limited to a single event, such as speaking at a conference, or it can occur in multiple situations or circumstances where people feel conspicuous.
There’s probably no time of the year that offers such an abundance of these situations as the end-of-year functions circuit, Christmas and New Year’s Eve, says MacDonald. This season can be difficult to negotiate at the best of times, with issues such as stretched finances, family dynamics and an endless merry-go-round of social obligations tugging at our sanity. Most of us get through it and, if not enjoy it, at least manage to laugh at the absurdity of it all. But layer a dollop of social anxiety on top and life can seem overwhelming.
Figures aren’t available in New Zealand, but research in the UK found one in four adults felt anxious about social gatherings during the festive period, with 6% telling mental health charity Mind that they take antidepressants to deal with the pressure. Nearly two-thirds of British office workers said they’d rather stay at home than go to the work Christmas party, while nearly a fifth pretend to be sick to get out of it. Of those who do make it to festive events, 22% admitted they pretend to enjoy themselves.
“When the invites start rolling in, I have to fight the urge to lock myself in my bedroom and not come out until late January,” says Lucy Elliott, a former Shortland Street actor turned children’s book illustrator.
The 23-year-old daughter of veteran Kiwi actor Peter Elliott says sweat stipples her fingers at the very thought of end-of-year functions. “I get really anxious when I have to walk into a room with people I don’t know. I worry that I won’t know what to say, so I plan out what I’m going to say in my head,” says Elliott, who admits she wrote a list of talking points before our interview. “When I’m prepared, I have a sense of control.”
But if the conversation takes a different tack, Elliott says she often flounders. “That can really throw me and I’ve been known to run away from a party because of it.”
The post-mortem the next day can be even more brutal. “I’ll go over every conversation in my head, thinking, ‘Why did I say that? I’m so stupid’ and generally beating myself up about it.”
Elliott reckons she’s suffered from social anxiety since she was at Auckland’s Western Springs College and was effectively locked out of a friendship group. “Dealing with people one-on-one is fine, but put me in a group and I get heart palpitations and want to throw up.”
It’s ironic, then, that Elliott – whose father and two siblings have also suffered from some form of social anxiety – picked a career in the public gaze.
“For someone who hates being stared at to then go and be on Shortland Street for four years is a bit crazy! But acting let me become someone else, and having lines written for me gave me that certainty about what to say and when.”
Being recognised by fans did challenge her boundaries, but Elliott got around that by wearing wigs and hats whenever she went out in public. And seeing a psychologist helped.
“I’ve learned to be aware of the triggers and to deal with my anxiety a little better. Before I used to make excuses and tell little white lies about not attending parties, but now I’ll be honest and I say, ‘I’m sorry but I feel a bit anxious and I don’t want to go.’”
When Elliott does accept an invitation, she tries to stay as long as she can. “It’s about finding that balance between family and social obligations and feeling comfortable.”
MacDonald agrees, saying Christmas is a good time to reassess long-standing obligations.
“Ask yourself, “Am I going to the family Christmas dinner at my brother’s house because that’s the way it’s always been done, even though I get anxious and don’t enjoy it?’ Think about how you really want to spend this season and then be honest about it. It might cause some short-term tension, but in the long term you have to do what’s right for you.”
“I’m introverted by nature and sometimes find it hard to be in a social setting with people I don’t know very well,” admits Drewery, who calls herself the “queen of excuses”.
“I’m really good at getting out of invites. But if I do go, I spend the whole time thinking, ‘How can I get out of here?’ If I’m feeling particularly insular, I’ll show my face and then leave as soon as possible.”
Her disorder often drops anchor at Christmas, when the pressure of social obligations can get out of hand. “Family Christmases in Christchurch have always been difficult because I’m the black sheep of the family who left home early, and had an unconventional career,” she says.
“I’m not married with kids and I don’t own a home, so I can get a bit of a hard time from my family. Usually, I’ll only go to family Christmases if my sister and her kids are going. Otherwise I’ll try to spend as little time with my family as possible, which makes me feel guilty. But if I don’t limit that time, then anxiety will creep back in.”
Drewery can’t remember a time she didn’t suffer from social anxiety and blames it not only for a breakdown but also for suicidal thoughts. The 33-year-old, who juggles studying for her master’s degree in social work with working for the New Zealand Prostitutes Collective, Barnados and as an extra in the film industry, says that thanks to medication and therapy, she’s a long way from the person who once spent her days dreaming up ways to kill herself. “I’m now more aware of the warning signs and how to manage the anxiety.”
That anxiety “ranges across the spectrum”, starting with the separation anxiety she suffered as a child to schoolyard bullying that made her unable to get out of bed. “I hated school and felt as though everyone was looking at me. My heart would beat so fast I’d have to run away.”
Drewery managed to put her anxiety back in the box long enough to graduate with a degree in circus and physical theatre before moving to Wellington, where she taught circus skills and performed as an acrobat and burlesque dancer.
But after a traumatic relationship break-up in 2014, she hit rock bottom.
“I stopped working and I couldn’t leave the house. I felt distanced from everyone and suicide seemed the only way out.”
After several weeks of drifting around in a haze of anxiety, confusion and anti-depressants, Drewery finally found a psychiatrist who helped her find a way out of the funk. That included signing up for her master’s degree and ending her performing career. “I thought I’d feel like a failure if I gave it up, but I honestly don’t miss the pressure.”
Yet while she’s managed to keep a lid on her social anxiety recently, she’s come to accept those feelings will never go away. “You don’t outgrow anxiety or snap out of it,” she says. “I always know when mine is coming back because I want to hide out in my safe space – my bedroom – to stop my brain from racing. I also hide by sleeping: I can sleep for 10 hours and then roll over and sleep the rest of the day.
“Social anxiety is part of who I am and every day is about managing it so it doesn’t ruin my life.”
“I’d gone with my family to an Orphan’s Christmas in the Coromandel about three years ago,” says Jacobs, 23. “I knew there were going to be all these people I hadn’t met, but when we arrived I was so anxious I couldn’t physically move.”
Instead, Jacobs spent two hours sobbing, trying to will herself to join the 20 or so guests who tried to coax her out of the vehicle. “After two hours, I did feel safe enough to get out of the car and of course the rest of the day was great, but that’s what social anxiety does to you.”
It probably doesn’t help that Jacobs spends most of her time working from home, as part of the five-person The Candle Wasters film collective, which produces feminist web series.
“Most of us have some kind of anxiety, which we realised we were giving to our characters,” laughs Jacobs.
Her anxiety is triggered by “every-thing”, from being worried she’s going to have a car accident (“I spend the whole time repeating this mantra: ‘I hope we don’t crash, I hope we don’t crash...’”) to attending social events.
“It’s so random because sometimes I’ll be fine and other times my face will go red, I can’t speak and I have to go home. I’m 100% a flight person, so fleeing a party is my get-out-of-jail card.”
Last year, Jacobs overcame a major hurdle to speak in front of 300 people at the Screen Production and Development Association (SPADA) annual conference in Wellington.
“When they asked me, my initial reaction was, naturally, to say no. But thanks to counselling and my incredibly supportive partner, Henry, I was able to talk myself down from the ledge. The key was making sure I was prepared, which reduces the possibility of anything bad happening. In the end, it didn’t go too badly at all.”
Nadine Isler knows how Jacobs feels. The Auckland psychologist, who works for the Anxiety New Zealand Trust, has suffered from social anxiety herself in the past. “It was pretty bad for about six years during university but, partly because of my psychology training, I was able to manage it,” says Isler, 32.
It certainly helps her relate to her patients. “I know how they’re feeling and how tempting it is, particularly at this time of the year, to turn down every invitation because it’s natural to try and protect yourself. But the more you steer clear of something, the more frightening it becomes. And safety behaviours such as avoidance actually do the opposite of what you want. Yes, you reinforce the fact that you’re safer at home, but you also don’t learn that it would have been fine if you’d attended.”
Instead, Isler suggests that sufferers RSVP to as many invitations as possible – and stay at each function for as long as they can.
“I’d advise people to try and stay until their anxiety levels drop, so their body learns that going to an event isn’t as fraught as they think. Even if you can only manage half an hour and you talk to two people, that’s still a great achievement.”
She also cautions against using alcohol or drugs (“anti-anxiety juice” as Jacobs calls it) as a balm.
“Alcohol can be a crutch for anxious people because it helps to calm them down. But it doesn’t help in the long term and can also lead to issues such as substance abuse.”
“I had a major panic attack and I couldn’t breathe,” recalls Craig, 46. “It felt like someone was choking me.”
The Wellington playwright says her anxiety stems from a fear that something bad is going to happen. “I can’t cope with change and I’m scared of failing. I also worry what people will think of me,” she says, ticking off the triggers for the disorder that has stalked her since she was six.
“I don’t do crowds, I hate being looked at, I hate being in open spaces and I especially don’t like meeting new people,” says Craig, who admits she almost turned the car around before this interview.
“I always ask myself, ‘Why am I putting myself through this?’ and most of the time the urge to flee is strong.”
Craig, who began seeing a psychologist when she was 13, says it took until she was 30 to be diagnosed. “I thought I was just depressed, but it makes me sad that I haven’t been able to do things like go on an OE. Anxiety has robbed me of a lot.”
No surprises, then, that some therapists refer to social anxiety as “the disorder of missed chances”.
It’s also affected her health, punching a hole in her immune system and putting her on the sickness benefit for 10 years. So for Craig, whose mother and older sister also suffer from anxiety, Christmas isn’t the season to be jolly.
“I spend the hours before a function hating myself for saying yes and the hours I’m there wishing I was at home. Most of the time, though, I can’t make myself go and then I feel like I’m missing out, that I’m a failure. Generally the higher the expectation, the worse it is.”
One of the most difficult parts of the summer holiday season is the lack of routine: work is over, many places are closed and friends are away.
“It makes me anxious when my routines are disrupted,” she says. “Plus there’s too much expectation around Christmas, New Year, holidays and summer in general. I prefer to spend Christmas Day at the Wellington SPCA, where I’ve volunteered for four years. Animals are great for anxiety and depression – it’s hard to feel anxious when you’re cuddling a kitten or puppy.”
Craig, who manages her anxiety with a combination of therapy, medication and acupuncture, says life is a little less terrifying these days.
“I wrote my first play, which was performed for the Young and Hungry season last year, and I’ve been getting some paid script-writing work. I was also able to move out of my parents’ house and into a shared flat.
“I’m still anxious, though, and I think I always will be to some extent. But I’m learning to let go and fully embrace being a weirdo!”
Managing Festive Anxiety
Holiday gatherings offer numerous reasons to be stressed and anxious. Here are some ways to get through:
• “Mindful meditation helps to turn down the anxiety thermostat,” says psychotherapist Kyle MacDonald. “Training our minds to focus on what we want to pay attention to, moment by moment, won’t solve social anxiety on its own but will help to keep it in check.”
• Anxiety sufferers often have rich, vivid imaginations, says psychologist Nadine Isler. “But instead of imagining the worst, think about how you’d like the evening to go. Be realistic but also positive in your imagining.”
• “After the event, you’ll be tempted to go over every interaction, making sure that what you did and said was okay,” Isler adds. “Try and resist it – this replay and evaluation is likely to be much more critical than it needs to be, and can be toxic.”
• Realising you’re not alone can also help, says Isler. “Just remember that roughly one in 10 people suffers from social anxiety and they are going through the same thing as you.”
• Gradual exposure can help sufferers get used to the idea of socialising. “Start small and give yourself a chance to acclimate to a party,” advises MacDonald. “And set reliable limits – say, I’m going to stay for half an hour and I’ll have one drink and talk to two people and then if I’m still not feeling comfortable, I can go home.”
• Have a toolkit of distractions if you need them. “If you’re standing there on your own and you start to feel uncomfortable, go to the toilet or for a walk outside, or use your phone to distract yourself,” says MacDonald. “Sometimes you just need a few minutes to gather yourself.”
• Ask people questions. People generally love talking about themselves, says Isler. “And focus your attention on the person who’s speaking or the person who’s standing by themselves. Go and talk to them, rather than focusing on yourself.”
• Be kind to yourself. During the holiday season, you’re probably eating badly, sleeping less and drinking more. Feeling at the mercy of your relatives or social obligations can add to the pressure. “Have a hot bath, go for a run or do whatever you need to look after yourself,” says Isler.
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