Sunday, December 27, 2015

Give me liberty, or give me death - Part II: Demon Hunter

Let us recap some of the things I wrote about in this blog in the past, shall we? Yes, I was a severe alcoholic. Yes, I have struggled with major depression. Yes, a plethora of anxiety disorders, primarily social anxiety, panic disorder and obsessive-compulsive disorder. And you know what? Almost all of that is gone, and that which isn't is fading fast.

All this I have accomplished through hard work and an unwaving struggle. Any demon that follows you on your back, you gotta face it and stand up to it. Any fear that is strong and persistent enough to become a disorder, you have to face it and stand up to it every day and never let up, never give up. I made conscious decisions to tackle each and every issue and went through with it, not questioning for a second that I could succeed. Take a thing like obsessive-compulsive disorder, which to most people is a crippling illness. Is it? You suffer some of the worst fears a human mind can suffer, but the important thing about fear is not to give in to it but face it head-on, never hide, always confront it, every day. It isn't real, it's all in your head, which may seem like a silly thing to say, but that's how it is, and that's why you can beat it, because any mind that can come up with these fears can also come up with the will to triumph over them. Panic disorder? Mortal terror of certain death leaving the house or similar situations? Simple, leave the house every day, face the fear and live through it until you conquer it. I've done so every day for years, always at my limit of what I could take, but it didn't stop me, and you know what? It's all gone, out of my head. You gotta take on your fears and never give in to them and see that you can be the master of your own mind.

Yes, if you have a mental diagnosis, everybody will see you for the person you are not, not for the person you are. Everybody will tell you what you can't do, not what you can do. Everybody will say you are going to fail, that you always will be a failure. Especially people paid to "help" you. They'll tell you to take it slow, don't do too much because you're not capable, you're so ill, you need to be protected and pampered. You know what? You don't have the flu, you do not cure this with bed rest. You are on a battlefield with an army of shadows before you, and you do not sit down and wait for them to go away, you pick up your sword and take them down, one by one, with unwavering determination and all the strength of your soul, until there are none left. You think you can't do it because everybody tells you you can't? I'll let you in on a secret: "Everybody" is fucking stupid. If they think you are an invalid or a loser who can't do anything, don't even validate it by giving it a second thought, or even a first. It's YOUR life, and YOU gotta know what YOU can do. You are not ill, you are under siege from bad thoughts and bad feelings, and it is your job to break the siege. Fight every day, and don't let up, until you are free. If you can do that, you can lose all fear and reach for your dreams, because you have taken the warrior's road, and this will be in your soul for a lifetime.

No, I don't have anything to show for in the "real" world. I don't have a house, I don't have a car, I don't have a family. That is why people look down on me and claim I have accomplished nothing. But I have accomplished a bigger and harder feat than most people ever will. I have taken on the battle against the biggest enemy a man can face: My own shadows. And now? Give me death, give me devastation, give me famine, give me disease - I do not fear! This is why I can do anything in my life now. Most people would collapse facing what I have faced, but I have not given in and fought back, and now I am winning. If you can win this battle, you can win any battle, and your possibilities are limitless, because if you do not fear yourself anymore, you do not fear anything or anyone else. And if you see your own strength in what you accomplished, you know that no challenge can be too big for you. That is why you should ignore those who want to hold you back. They are nothing. They fear themselves and try to project it on others to alleviate their own fears. They are drains of energy that have no purpose in your life or their own. As long as you believe in yourself and know you can do anything, it does not matter what any of the small-minded people around you say.

You know what? In the beginning of your struggle there will be people who tell you to pull yourself together and move your butt. And you get so distressed with it and just want someone who understands you, what you are going through. And you will find these people, doctors, nurses, fellow sufferers. And it will feel good and comforting for a while. But in the end you will find that the people who told you to pull yourself together and move your butt were right all along. Because if you want to get out of a labyrinth, you do not wait for someone to show you the way or take down the walls. You take the challenge head-on. And master it.

Tuesday, October 6, 2015

Give me liberty, or give me death - Part I: A long road ahead

"Give me liberty, or give me death!", a famous quote by Patrick Henry, of course has very little to do with mental illness, and you may ask yourself why I use this particular quote in this particular context. What this new series will be about is a personal struggle for freedom, in my case a struggle for freedom from the indignity of being an unemployed person in Germany. It is not simply a matter of some personal pride, as you would expect being unemployed in a country so proud of its workforce and working life is, but it is something that goes far deeper, as there are more ways than one that being unemployed in this country makes you feel like less than a man (or woman). It is a state of existence as a subject, a thing, a number, and it is ultimately dehumanising. For me, the only option to survive is to break free from those chains, the only way to be proud again is to be a man again. And that is what this series will be about, the path from being no one to being someone again.

Starting from where I was, years of extreme depression and anxiety with long periods of alcohol abuse, there are of course two major obstacles for re-entering the normal life as a working and self-sufficient person. The first is, obviously, your health. As long as you are still in that state of extreme depression and anxiety, and worse, if the alcohol abuse is still happening, you are not in a position to think of rejoining the workforce. So these had to be my very first top priorities. I have made significant strides in both, but I will go into more detail about that field in the anxiety disorder series. The second is a real world issue, which is what this series will be about.

You see, usually, when you are unemployed in Germany for medical reasons for a longer period of time, you are sent to a government doctor at the Gesundheitsamt (health office), who will then examine you and determine if you are fit to work three or more hours a day or not. This was done with me in 2008, and since then I had been switched from unemployment benefits to social welfare. At the time I thought it was a good thing, because I definitely wasn't in a condition to do anything productive with my life. The problem is, once you have that "unfit to work" ("arbeitsunfähig") status, you are legally forbidden to work more than 3 hours a day. And since it is nearly impossible to find a job that offers work hours below three hours a day, it means in practice that you cannot legally work at all. So my first step after improvements in my medical condition was to start working on getting rid of that status.

It wouldn't be Germany if they didn't make a bureaucratic nightmare out of the simplest things. "Oh you feel better and wanna work? Sure, give us a recommendation from your doctor and get started!" That's how it doesn't work in Germany. It does start with the government agency for unemployment asking for a recommendation from your doctor, yes, but between that and the getting started they apparently want to make it as difficult as possible. I went to that agency today and submitted my application for being rehabilitated into the workforce, and basically, what they will do is give that application to their doctor, who will ask for every info about me from my doctor, then their doctor will talk to me, then after that doctor gives his or her recommendation to the government agency, I can get a preliminary approval or rejection. In case of the letter I will have to go to a clinic again, in case of the former I still won't be allowed to work, but will be allowed to start a three month job training of sorts that has no purpose other than to test my ability to work several different tasks and areas. After that I get another recommendation from that job training thing to, I think, either the government agency doctor, or the government agency itself, and then finally I can wait for a decision on whether I am allowed to work again or not.

The good thing is that I was told that I can make a good impression if I start an internship while I wait for the pre-approval process that would lead to that job training thing, so that's something I am definitely going to do.

The bad thing, the thing that really annoys me, is something I will go into detail about in the next post, that in Germany, it appears that the most commonly accepted and used treatment for depression is to depress people. No, not kidding, not even hyperbole, it really feels that way. Because whatever mental illness you have, and usually it is depression and/or anxiety since those are the most common, over 90% of what you'll ever hear from doctors, nurses, social workers and government officials is how terrible your life is and how you're unable to do anything and how difficult and impossible everything is for you. This is really the last thing I need. If I want to hear about how shitty my life is, I have plenty such opinions in the dark corners of my brain, I don't need to hear these kinds of things from people who are supposed to help me not see life as shit.

That was really what bothered me the most about the appointment today. A social worker who was supposed to help me came along to the appointment and apparently felt it necessary to keep talking about how difficult everything will be for me, how I'll likely fail and fall back into depression, how I shouldn't get my hopes up too much. Basically I am made to feel like a useless invalid when such helpful people talk to me about my future.

You know, because of a conversation with a friend I recently remembered the one teacher I met in my time in school that ever really encouraged me. He was a sports teacher, our term for physical education. And he basically said that sports isn't about how well you do, but about how hard you try. It actually improved my grade a lot that year, from pretty bad (German 4, equivalent to American D) to pretty good (German 2, eq. to American B), because I knew I could work hard and with passion and get a good grade even without the talent for being a sports ace. I wish this message had carried over into the rest of my life, but I am recently starting to remember it and thinking how true it really is for my current life situation. I'm not in it to be the future CEO of Volkswagen - though at the current rate every German will have had the job once by 2050 - but to give my best and show the world and myself what I can do. And I feel I could use a little encouragement from those who are supposed to help me, rather than paintings of a gloomy picture of a hopeless future.

I have taken the first step, and I will fight for each further step I make until I feel I am somewhere. And I know I can do it. It may be difficult a lot of times, but I can do it. If someone with the athletic virtues of a Steve Urkel can get a 2/B in sports/physical education with hard work and passion, I can use the same will to work hard and passionately to succeed in life.

Saturday, September 26, 2015

Life with an anxiety disorder - Part IX: Anxiety and depression

You know, I may have dropped a hint here and there, but I never really talked about depression past anything but a hint in this blog. Yet, while I don't know the statistics, from my personal observations I have been under the impression that everyone who is diagnosed with an anxiety also seems to be diagnosed with depression, and vice versa. So in a series about life with an anxiety disorder it is a subject that seems unavoidable.

Depression, of course, is the most diagnosed mental disorder on the planet, and I reckon everyone who reads this either has this diagnosis him- or herself or knows someone who does. Probably more than one someone. And what do you know? It's been on my list of diagnoses for a long time, as well. My latest one is "recurrent depressive disorder, current episode moderate", from when I was in therapy a few months ago. So apparently that means I have ups and downs in life. Everyone kind of does, but I have it on paper. And could get antidepressants for it if I was interested in those.

Personally of course I have never really seen myself as a person who suffers from depression per se. For me, the symptoms that lead to the diagnosis are all directly related to my anxiety disorder, specifically the social anxiety and the agoraphobia with panic disorder things, because if you don't leave the house and don't talk to people, life does get kind of bleak. And on the other hand, the more time I spend outside and among people, the less I feel any sorts of symptoms that could indicated a depressive disorder. So it really is more of a side-effect that any sort of illness I have. People who actually do suffer from depression do so no matter how much time they spend outside the house or with other people. They're just depressed. The bleak mood I get when I spend too much time alone in my four walls is not something I would classify as such.

I've met a lot of people who just seem to be miserable no matter what they do, and don't find any enjoyment in anything. I do not really know what causes this, and from what I've learned doctors really are clueless, too. For those people, from the other side of the spectrum, it seems that anxiety always comes as a side-effect. As they grow more and more detached from life, they become more and more scared by even the smallest things. Like I wouldn't consider myself as someone suffering from a depressive disorder, I wouldn't consider these people as suffering from an anxiety disorder, for them, the anxiety symptoms are a side-effect of their depression as the depressive symptoms are a side-effect of my anxiety. But through these side-effects, these two issues always seem to be linked. The ethics of doctors turning the side-effects into a full-on separate diagnosis of course are questionable, but generally symptoms seem to be related.

What I do know about treatment is that anxiety is always the best starting point because it is very straight-forward to treat. Face your fears and learn to live with them. That of course is ideal for me as someone with mainly anxiety issues who only gets depressive symptoms on the side, but I think it is also a good starting point for those who mainly suffer from a depressive disorder and only get the anxiety symptoms on the side. Get rid of the latter, even if your depression might be unaffected. There's actually a good chance that it will be affected. Positively. Anyone with anything in the anxiety spectrum, whether it be the main thing or a side-effect of something other, should always work on that first, because it's the most effectively treated when backed up with the will to do so. Lesson one: Learn to not be scared. Everything else you can deal with afterwards, and will be a lot easier to deal with at that point.

Monday, September 14, 2015

She has a great personality - Part II: Avoidant personality disorder

Avoidant personality disorder, also called anxious personality disorder, and referred to as something like "self-insecure" personality disorder in German, is that second partial diagnosis I got in therapy. I was never quite sure if I recognised myself in it very much, a lot of it is just completely unlike me. The thing is that it has a lot of overlap with social anxiety disorder, to the point that some scientists debate they are really two different names for the same thing. Which is probably the thought behind the diagnosis.

Basically, what we have here is "social anxiety plus", with all the symptoms of social anxiety but going a step further. The core idea behind avoidant personality disorder is that the afflicted always needs his or her "safe place" and feels anxious outside of it. For most people that would be their own four walls, and as soon as they're out of them, it becomes impossible for them to deal with all the new situations outside life presents and they display all the symptoms of social anxiety disorder. Inside their home or other safe place they are fine, happy, sociable people, but outside their zone of comfort they get in a terrible state of mind and all their social skills are gone. This is the first part where I really don't see myself in, because I am not dependent on my home, and my personality - or how I display it - in any place I am. So already at the core issue I begin to doubt my diagnosis.

From what I've learned, their are two ways the issues with social skills are displayed when those who suffer from avoidant personality disorder leave their safe place. One of them is a cold and distant personality that does not really participate in social interaction, appears to ignore people and minds his or her business exclusively. Guess that applies to me in some way, but that is also a common social anxiety thing. The other one is something I was majorly offended by the therapist even suggesting it, a type of personality that agrees to everything somebody says and never speaks up for him- or herself in fear of negative consequences. You know, "do you want to go for a coffee?", and you don't want to at all, but you say "yes" because you are scared of the person asking being mad at you. That really isn't me at all. I mean, yes, I have agreed to doing things I didn't feel like to be nice, but everyone has. Never to the degree of a "disorder", or any sort of personality that would do this regularly and forego being independent and standing up for him- or herself.

Another core issue is of course what it says in the name, the tendency, or compulsion, to avoid. Any situation that may cause discomfort must be avoided in this disorder. This goes hand in hand with the safe place thing, of course, where leaving said place is avoided entirely. And there seem to be many stories out there of people who do just that. Situations in which fear might arise are avoided to such an extent and safe havens clung to with such obsession that normal life becomes impossible. It's also where the overlaps with social anxiety come in, in that being situations which are being avoided entirely. It's what Germans call "self-insecure" (I just don't know how to translate "selbstunsicher", it's such an odd word), such a strong barrier of self-doubt that avoiding situations which could go wrong socially becomes a must. Again, this is something that goes too far to properly describe me, so I continue to have serious doubts about the diagnosis, even if it is only a partial one.

The things I did recognise myself in were indeed the overlaps with social anxiety disorder, of course, such as fear of being judged or rejected. But since nothing of the other symptoms applies it seems to make more sense to simply leave social anxiety disorder as a diagnosis and not make up anything else.

There are of course people out there who are aptly described by the outlines of this disorder, and I don't envy them. Luckily, there is treatment, and it's actually fairly simple, as it's the same as for social anxiety disorder: Get out, go out, meet people, interact. Takes a load of practice, but it works. And reaffirm your self-esteem, because you might not think so, but you're actually pretty cool. At least I am, hey, I'm the middle of treatment (self-treatment at the moment, no therapist), starting to think I really am pretty cool. And anyone can. And I'm having fun meeting people. And anyone can do that, too. So if you're reading this, and you're diagnosed with avoidant personality disorder, and it actually describes you well, be sure to have some fun and feel good about yourself, even if it is actually no fun at all at first, and you actually feel crappy about yourself at first. If I can do it, anyone cool enough to read my blog can do it, too.

Thursday, August 6, 2015

She has a great personality - Part I: Obsessive-compulsive personality disorder

When I was looking into ideas for a new series there were several directions I wanted to explore, but eventually I decided I wanted to write a few posts on personality disorders because I have two partial diagnoses myself and am closely acquainted with people who have other diagnoses in that field. Both of mine, obsessive-compulsive personality disorder and avoidant personality disorder, are ones I didn't get a "high score" for in the various forms of testing I had done with me, but I was a close enough match for both for them to end up in my list of diagnoses. I actually recognise myself a fair bit in both of them, which is why the first two posts of this series will focus on them, starting today with obsessive-compulsive personality disorder (OCPD).

When reading about obsessive-compulsive disorder (OCD) in the past, my web sources, mainly Wikipedia, were always adamant about it not being confused with OCPD because, they say, that's often done, and it's some sort of really bad thing to do (judging by the tone of the "do not confuse"-warnings) because they are completely different things. Well, I made sure I never confused them and steered clear of reading about OCPD because of how unrelated I was told it was to what I have. In the end, I now, since recently, have both diagnoses. Unrelated they may be, but I guess it's not impossible for you to have both. So I had to begin reading up on OCPD anyway, after being told for so long that I shouldn't bother with it. Also, what's with that extremely similar naming if people are so worried about the two diagnoses being confused with each other? Just saying, though. What you read in this post has nothing to do with OCD, even though I have that diagnosis, too, and wrote a post on it in the past.

My partial diagnosis of OCPD came together rather simply and quickly. I was in treatment for - among other things - depression, and one of the most common things people with depression have bothering them is that they have a lot of principles in their heads that go "I must..." I must perform well, I must satisfy this or that need of others, et cetera. When my therapist asked me to write down a few sentences like that that apply to myself, I filled an entire page. About fifty or so sentences of things I thought I must do in order to consider myself a valuable human being. And the list wasn't nearly complete.That's OCPD in a nutshell, everything has to be done to perfection according to a rigid set of rules, and if you don't live up to them, you suck. You put immense pressure on yourself to run every aspect of your life by these ideas written in stone and measure yourself by your success at fulfilling them every day. You obsess over them and you have the compulsion to follow them, hence the name of the disorder.

If I were to make a list of examples from my life this post wouldn't be done before next year. I'll just pick one I think is the weirdest and most useless to illustrate how invasive this disorder is in living one's life normally. I bet many of you have heard of that site You install a software on your computer and it "scrobbles" the music you are listening to with your media player of choice, and the scrobbles are then made into a set of lists including charts of what you listen to the most. I've been using it since late 2006. At one point a few years ago my taste in music drastically changed, and I wanted my charts to reflect my changed taste in music, but I did not want to delete anything because I didn't want to lose the data for historical value, and I also would consider it cheating. So I started to constantly listen to the music I'm into nowadays. Must have been around 2011. You know how hard it is to get a lot of new stuff past an entire top 500 of music that had been established for five years? So I constantly watch my charts, see what needs to go up, look what needs to go down and what can go past it, listen to things I like on repeat ad nauseam, all day every day. Just think of the maths in this. If you have an artist in, say, seventh place at a thousand plays, and you want to get it out of the top 50, you'll have to get forty-four artists above a thousand plays. It sucks the life out of you. But music is one of the most important things in my life and I identify myself by what music I like, so I feel it is necessary to do this to properly represent what kind of person I am.

Sound ridiculous? It is. And for years I have been trying to identify what it is inside me that causes me to spend so much time on that ritual. For the longest time I assumed it was a form of net addiction, until one day I read up on OCPD after the therapist at the clinic gave me that partial diagnosis, and then it dawned on me. A rigid set of rules linked directly to my self-worth. Obsession and compulsion are a constant given. And the difference between OCD and OCPD shows here. If it was the former, I'd feel strong symptoms of anxiety after non-fulfillment of the ritual, with the latter it is not about how I feel at that moment, it affects how well I think of myself as a person. Mind you, the above is just an example of many, I do not determine my intrinsic value by some charts no one will probably ever look at alone. It's this huge list of things I need to do perfectly, a list so long it is humanly impossible to get everything right. The perception of oneself suffers by the nature of the thing, because you simply cannot live up to every rule you burden yourself with.

I think the reason I only got a partial diagnosis and not a full diagnosis is that I can often "unhinge" my daily life from my suffocating rules. It's like when I play/record music. I want everything to be perfect, but I can quickly reach the point at which I say "ah, fuck it" and just do as well as I can and be happy with it. It's something that plays a major role in my life, but there's a healthy side of me that can just as well take over. No, not as in multiple personality, it's still me, it's just that mental illness can vary in severity depending on how you feel at any given moment. It's less true for personality disorders which in many cases tend to be always there, but it's not uncommon, either. Sometimes it dominates my thinking, sometimes it doesn't even cross my mind. Hence the partial diagnosis.

To close my first post on personality disorders, you'll already be getting the idea that almost all of them are united by the idea that you are your own harshest critic, that somehow you always fuck up. Maybe not narcissists, more on those friendly fellows later, but in most personality disorders you'll always catch a person if you ask them about the last time they did really great at something. Or generally something they're really great at. With OCPD it shouldn't surprise you that I think every single post in my blog sucks. You know, they don't live up to some outlandish idea of perfect writing. But we live in a time in which these disorders can be identified and treated, so I'm optimistic about the future. Mine and that of everyone else suffering from a personality disorder.

Alcoholism: A love story - Part IX: Self-harm and suicidal ideation

The previous post in the alcoholism-series was about the liberating feeling of sobriety. Since then I have broken my inofficial vow of abstinence on a small number of occasions. What happened was the same thing that always happens when I get drunk by myself in recent months: I get suicidal ideation and start cutting myself with a carpet knife. That's no fucking good. In December (last year), January and April it ended in me having an emergency admission (in the middle of the night, all three times) to the crappy local psychiatric hospital and staying there for a few days. I completely freak myself and everyone else out. So, hey, that sounds kind of serious, so what is happening here?

The obvious first. I am really unhappy with my life, and I suppress it very well. When you suppress something and get drunk, chances are what you suppress comes boiling up with a vengeance. I don't like to whine, but there are a lot of things wrong with how my life has been going in the past, well, thirty-three years or so. If it wasn't for my awesome dog and a few hobbies I can still get excited about - like writing this stuff - I'd pretty much be unhappy with every single thing that my life consists of. No, I'm not going to post a picture of my dog, stay focused. It's not just that I am unhappy, I also see no feasible way of changing it because the environment I live in is so suffocating. I'd have to get far away from this place, but where? Are other places better? And I need better friends, but how? There's no mailorder for those. And wherever I go I have these mental disorders in my head that I like to write about in this blog. And I need to do something productive, something I can be proud of, but what? I don't think of myself as particularly good at anything. I'd also like to be with someone again, but I promised not to whine.

Of course I can't talk about this to anyone when I'm sober, partly because "don't whine" is a strict rule of mine that was shoved down my throat by family my entire life, and partly because my social anxiety tells me no one wants to hear it anyway. Can't even hint. So I suppress. And try to look like nothing's bothering me. Then I get drunk, feel great while I'm mildly to moderately intoxicated, and then it explodes out of me. Basically I am The Inverted Hulk. I turn green and become a superhero of self-destruction. It literally builds up in the space of a minute, from a great mood to completely messed up. Start talking about suicide to friends and family, something which I hate, and start cutting up my arms. All the while living through a feeling of misery the word "depression" can't quite live up to.

But how did I arrive there? I used to not do that when I was drunk. Even though I've been unhappy with my life and bottling it up for as long as I can think back. Got whiny or annoying sometimes, but nothing to anywhere near that level of dysfunction. At one point I turned from a normal obnoxious drunk to The Inverted Hulk. And I think it has its roots in little over a year ago when someone close to me started making frequent, very dramatic and very convincing suicide threats to me. I was never one who could in any way live with the idea of the death of someone close to me, so it hit me hard. And it happened more and more, until it was all the time. What made the whole thing infinitely worse was that I was always given the feeling that it would be my fault, that I would be responsible for that person's death, which was a burden that exceeded what I could carry by a factor of a million. I'm not particularly good at carrying any of the burdens I have in life (as we all do), but that one was like putting a Himalayan mountain on the back of an ant and expecting it to keep going about its life normally as if nothing was there. Far lighter things have been known to flatten an ant (fuck off, PETA), so don't expect it to live very long with the weight of Mount Everest on its shoulders.

So I started breaking and falling apart. It wasn't that suicide threat thing that caused it, that was the general unhappiness with everything else with my life. But it brought me to the point of being unable to deal with everything. While I continued to bottle things up while sober, the drunk stage now got infinitely worse. My faith in life was shattered, and my tortured brain knew only one way to live it out. The way that person taught me so thoroughly.

For now that means drinking is absolutely out of the question. And there are a lot of areas in my life I need to work at very hard. I am soon going to be admitted to a day clinic to continue the therapy started at that clinic I've been to from mid-May to mid-July, and while I'm there I have a lot to build for myself, a life, something to have faith in and a future to look forward to. Something far away from what has been suffocating me all those years. Figuratively far away, not intending to move to Australia. Huge spiders. I have some big decisions and changes to make, and it won't be easy. But I need to have something. Anything resembling happiness. And you can bet your life on it that I will do everything in my power to try to accomplish that. I have no intention of ending my life as a fuck-up. Like nobody should.

Saturday, July 25, 2015

Life with an anxiety disorder - Part VIII: Social anxiety, part two

Having been in the clinic for eight weeks being treated mainly for social anxiety I have learned quite a bit about it to add to the previous post on the subject. Most of it are minor adjustments to what I already knew about it, one major revelation occured as well, though. Overall my first post on the subject was pretty accurate, but yeah, it can use some minor tweaks. And a single large one.

I was pretty spot-on on how common it is, I learned it afflicts as many as one in ten people. To various degrees of course, but that's still quite a lot of people. And my idea of this intense fear of doing something ridiculous, inappropriate, laughable, awkward, etc. is a common symptom to all people suffering from social anxiety, which I didn't know before. So I indeed described it correctly, yet did not realise how these are the same issues millions of people with social anxiety suffer from. That was quite interesting to hear, especially in the social anxiety group when people talked about their problems and they talked about things I have experienced or could experience the exact same way. That's the first minor adjustment, I figured my symptoms were pretty unique to myself, or to a small number of people, but they're symptoms a huge number of people suffer from in that exact same way.

The second minor adjustment I have to make is to my connection between social anxiety and panic attacks. It is not entirely uncommon for panic attacks to be caused by social anxiety, but for most people, the anxiety symptoms of social anxiety are not as extreme as those of a panic attack. Not that they feel great in any way, but the intense panic usually isn't there, just a very broad and unsettling anxiety that is hard to describe, like a weight on your chest. But because I do suffer from panic attacks, and there have been occurances of panic attacks in social situations, then why do I now say I was inaccurate in connecting them? Well, in my case it was always a coincidence when social anxiety and a panic attack occured at the same time, because I have discovered that they have two entirely different triggers and two entirely difference sets of symptoms, and one isn't connected to the other. They can occur simultanously because you can have trigggers for both in one place, and you get confused about what causes what, but from what I have learned now, I do not get panic attacks from social situations. That's a different issue I still need to work on.

I learned a bit about escape and avoidance behaviours, the German term we used for it translates to safety or security behaviours ("Sicherheitsverhalten"), which is something I hadn't known about before but did feel able to relate to when it was discussed. Stuff like playing with your cellphone in social situations, playing with your keys, crossing your arms, playing with your beard if you've got a cool one like mine, having drinks of water and always having the water bottle handy. Anything those suffering from social anxiety think will distract themselves and others from their insecurity. It helps a little in the short term, but we learned that it really only makes you more insecure in the long run because you become dependent on your little rituals and end up completely lost without them, or screw up even more if you put more thought into playing with your cellphone than into the conversation or presentation or whatever you are doing that scares you. 

The key to any social interaction of course is to pay attention to the other person(s) involved rather than to yourself, and that is the key people with social anxiety have lost, because they feel they - we - are so socially awkward that we need to constantly watch out for what terrible things we are doing. The major revelation for myself at the clinic was that it actually turned out I'm not perceived as socially awkward by others in any way. It's all, entirely, in my head. I've had many social exercises where I did small talk, held presentations, moderated groups, did all sorts of stuff with people, and I was always told I am perfectly charming and seem very secure and self-confident, by people who have no stake in lying to me. That was really what hit me the most, that the perception of others I am so worried about is so different from what I worry so much that it might be. 

All this stuff I will have to take with me on my continuing path to recovery. The bit in the first social anxiety post about practice being the key to beating this thing is still valid. Lots and lots of practice. But the additional things I have learned since the first post on the subject helps me reach my goal a lot better and more confidently.