Anyone have Social Anxiety Disorder?

[Kuro]

Hey, I have been browsing this site for a while and thought I may post this. I am currently a junoir and applying to medical schools. I am not too worried about my stats and believe I can get in to a few schools. However, I am a bit concerned about my alleged SAD and how it may affect me in med school. I seem to get anxious in certain situations that a normal person may simply brush off. Even more, I have never really had much of a social life and fear that when doing rounds and presentations in medical school that my SAD may prevent me from living up to my potential. I believe that part of this disorder inhibits me from doing certain things. For example, the inability to ask a question to a professor in front of numerous other people. I just dont want this to become an ongoing problem and prevent me from doing my best in school. Does anyone else have any experiences with this disorder, and how it may have affected you in your undergrad or med school? I have been prescribed Prozac, but have refused to take it due to some negative things I have heard about it. Any advice would be appreciated. Thanks,

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[Hopeful_Doc]

I am generally found to be a quiet person, "introspective" and this is because of SAD. I am hesitant about getting to know people to a certain degree, in heavy social atmospheres i become extremely quiet and reserved outside of important comments or questions directed specifically at me. How will this affect me as a doctor? I am not sure. I know people find me to be a good listener and also a good advice giver when faced with tough decisions but on the other end if cornered verbally i am more likely to clam up. They (psychiatrist) prescribed me xanax and zoloft to attempt to correct this but I too refused treatment because it isnt really treating but masking the problem and I have found I can through some internal turmoil also mask my SAD and put on a facade of being personable that is not easily seen through....call it a poker face if you will. Try and find that poker face is my advice.

 

[Hard24Get]

I am generally found to be a quiet person, "introspective" and this is because of SAD. I am hesitant about getting to know people to a certain degree, in heavy social atmospheres i become extremely quiet and reserved outside of important comments or questions directed specifically at me. How will this affect me as a doctor? I am not sure. I know people find me to be a good listener and also a good advice giver when faced with tough decisions but on the other end if cornered verbally i am more likely to clam up. They (psychiatrist) prescribed me xanax and zoloft to attempt to correct this but I too refused treatment because it isnt really treating but masking the problem and I have found I can through some internal turmoil also mask my SAD and put on a facade of being personable that is not easily seen through....call it a poker face if you will. Try and find that poker face is my advice.

You two are planning to be docs and you are refusing treatment based on weak/misinformation? If the rare side effects are a problem, fine, but you need to accept as future medical professionals that psychiatric illnesses are real diseases with a physiological base, which is often serotonin deficiency. Thus, Selective Serotonin Reuptake Inhibitors ARE REALLY TREATING and NOT masking the problem. That being said, behavioral modification, such as joining toastmasters and other activities that force you to speak up can be just as great as meds, but if there is any comormid depression, a combo with medication may be the best way. Check out books like "The Shyness & Social Anxiety Workbook" by Antony & Swinson, and make an appointment with the counselors at your school to discuss these issues. I let SAD take away too many years of my life - don't make the same mistake!

P.S. Tom Cruise is an idiot

 

[kevster2001]

I see pathology in your future

 

[Hopeful_Doc]

You two are planning to be docs and you are refusing treatment based on weak/misinformation? If the rare side effects are a problem, fine, but you need to accept as future medical professionals that psychiatric illnesses are real diseases with a physiological base, which is often serotonin deficiency. Thus, Selective Serotonin Reuptake Inhibitors ARE REALLY TREATING and NOT masking the problem. That being said, behavioral modification, such as joining toastmasters and other activities that force you to speak up can be just as great as meds, but if there is any comormid depression, a combo with medication may be the best way. Check out books like "The Shyness & Social Anxiety Workbook" by Antony & Swinson, and make an appointment with the counselors at your school to discuss these issues. I let SAD take away too many years of my life - don't make the same mistake!

P.S. Tom Cruise is an idiot

There is no basis for a serotonin deficiency in my case, I am not depressed and therefore do not require an SSRI though one was prescribed to me. Why? "Because it will help" were the exact words used by the psych with no explaination of the benefit even when asked to explain. Xanax while good for taking the edge off makes me feel somewhat out of it and beside myself ....this feeling is not something I find to be curing a problem but instead masking and generating other issues like appearing wasted.. I hate tom cruise....the crazed pipsqueek.

 

[Carmenita79]

I had a roommate in college that had SAD and depression and he was super withdrawn, then started taking Paxil and his entire personality changed... he became really confident and talkative, etc. SAD is a biochemical problem, so if you want to get past it, take the medication. I mean, if you found out you had diabetes you would take insulin to feel better, wouldn't you?

 

[AmoryBlaine]

Hey, I have been browsing this site for a while and thought I may post this. I am currently a junoir and applying to medical schools. I am not too worried about my stats and believe I can get in to a few schools. However, I am a bit concerned about my alleged SAD and how it may affect me in med school. I seem to get anxious in certain situations that a normal person may simply brush off. Even more, I have never really had much of a social life and fear that when doing rounds and presentations in medical school that my SAD may prevent me from living up to my potential. I believe that part of this disorder inhibits me from doing certain things. For example, the inability to ask a question to a professor in front of numerous other people. I just dont want this to become an ongoing problem and prevent me from doing my best in school. Does anyone else have any experiences with this disorder, and how it may have affected you in your undergrad or med school? I have been prescribed Prozac, but have refused to take it due to some negative things I have heard about it. Any advice would be appreciated. Thanks,

Interesting situation. I wish I could tell you that it won't affect you in med school at all but that would be a lie. Even over the course of our first two years there were several times when we were required to give presentations, occasionally in front of large groups. On a more day-to-day basis, med school is becoming increasingly oriented towards group learning so if you have problems in that setting there might be some trouble.

Third year, well, I am starting soon so most of what I have to say is based on talking to my friends. I will say that I think it's going to be quite difficult for people who have a real social anxiety. Basically every day you are called upon to present your patients to teams that include other students right up to big-shot attendings. Also, many of our rotations have required presentations.

SDN Pre-Allo is a great forum, but it is one where you are much more likely to attract a cheering section of "you can do it!" than be given any real honest answers. If I were you I would look harder into treatment options, maybe even things like situational treatment (i.e. beta-blockers) for when you HAVE to give a presentation. I don't blame you for being wary of starting down the road of psychotropic meds, but I also think that you should work very hard to get this issue as much under control as possible before you start medical school.

Good luck however it turns out. There are plenty of shy people out there that turn out to be great docs.

 

[DropkickMurphy]

I see pathology in your future

Beat me to it.

 

[Hopeful_Doc]

I see pathology in your future

haha and ive taken an interest in it

 

[UICpremed]

Get bloodwork done to see for chemical imbalances. You can use anti depressants and benzodiazepines as a crutch while you also go through CBT (cognitive behavioral therapy) with a trained and experienced professional, a psychologist. You will probably be lead thru exposure therapy to face your fears from least to greatest.

Diaphragmatic breathing helps. It triggers the parasympathetic nervous system which does exactly the opposite of when you get anxious. Changing your thought patters is key.... since everything originates from your thoughts.

You don't have to change your entire career line just because you have SAD. If you learn to manage it/beat it before medical school, then you will have more choices and lead a happier life thru and after med school.

 

[anon-y-mouse]

I'm sure the only long term fix for you is going to be increased exposure to people... expand your friends circle, practice smalltalk with people (i.e. come up with a list of 5-10 questions / topics you can talk about with anyone and ask them)... people in general love talking about themselves, so if you're with a professor, you can ask about his/her research, aspirations, etc. and always keep them talking -- while you seem interested and engaged. The 5-10 questions thing can work well with patients - you can talk to them about their work, children, hobbies, sports, current events, tv, etc. Practice that in any situation you get into. If you're buying something from a store, and it's relatively free, you could ask the clerk when s/he's working until, whether it's been busy that day, etc.

As for pharmacological interventions, you could try clonazepam (klonopin) or a beta blocker like propranolol before critical events (like speeches, etc.) to reduce anxiety. Obviously you shouldn't depend on them, but use them if you really need them. One of the major problems with prozac is that it can take 3-4 weeks to build up an effective amount in your system, and a similar amount of time to get off the drug. Something fast acting like a benzodiazepine or a beta blocker could be good in a pinch, but this is something that you're going to have to work on (naturally).

 

[MossPoh]

I was diagnosed with depression and SAD...put on the drugs and what not. All it did was make me feel very as I call "static". I wasn't really happy, but I wasn't sad either. Also, I just kind of lost my ability for any decent writing. I didn't like how it made me feel overall..maybe it was all in my head but I just stopped taking it. I am weird in that I practically have a panic attack ordering food in German or something, but I have no problem playing drums and acting like a crazy jackass in front of thousands of people...but I can't get the will to do a presentation in front of 30 peers. I have learned to just suck it up sometimes and push through. Everyone has their own way have handling stuff. My face gets the brightest red humanly possible, heart feels like it is going to burst out of my chest but I just suck it up and ask the question or go up and try not to skip entire sentences when speaking. It is slowly becoming easier...keyword being slowly. I found books and crap worthless because in the end most of the stuff is pretty obvious what you need to do...it is just a matter of sucking it up and doing it.....won't kill you but it will be really painful at first. Those points you just need to take a deep breath, maybe squeeze a ball or something and have at it!

 

[cardsurgguy]

If the couple of you in this thread have felt uncomfortable with the psych meds which are indicated for SAD, then maybe you could ask your doc for a beta blocker such as propanolol.

I knew a person who got really nervous (to the point of shaking a little bit and sweating and tachycardia) in presentations in front of any remotely large size of people.

He was put on propanolol and he said it helped. It relieves the physical symptoms of tachycardia, tremors, and what not, which in turn helps anxiety.

And it works for your concerns, since it's not a psych med and won't change your mental status. It just slows your heart rate and breathing rate, etc...



This is anectodal evidence, so I looked on Emedicine to check up on this.

And under the page for Social Phobia (SAD), it was there as an option for pharmacologic management. Here is what it said...

Propranolol: Beta-blockers have been used to block the autonomic response in persons with social phobia. Preventing symptoms such as tremor and increased heart rate may lead to successful performance in social situations despite anxiety.

The link to the page is here.....http://www.emedicine.com/med/topic3121.htm

 

[Law2Doc]

I see pathology in your future

Even to be a pathologist, you are going to need to get through med school, rotations, residency. This is going to involve presentations in front of the class, various class participation, speaking with patients (with and without an audience) and presenting the case to a team, and other various social interaction. You will need to work with people (students, physicians, nurses) and have them like you; you will need superiors to give you good recomendations, not say you shied away from things. And you won't go too far in your career in pathology just by sitting alone at a bench - while it is perhaps the least (whole) patient intensive field, for career advancement you will still need to meet with groups of other physicians, give talks, lectures and the like throughout your career. Figure out how to get a handle on it, with or without the meds, or this career choice will be a difficult one.

 

[anon-y-mouse]

propanolol

Propranolol. I think you have had too much orgo...

 

[Sublux7]

Hey, I have been browsing this site for a while and thought I may post this. I am currently a junoir and applying to medical schools. I am not too worried about my stats and believe I can get in to a few schools. However, I am a bit concerned about my alleged SAD and how it may affect me in med school. I seem to get anxious in certain situations that a normal person may simply brush off. Even more, I have never really had much of a social life and fear that when doing rounds and presentations in medical school that my SAD may prevent me from living up to my potential. I believe that part of this disorder inhibits me from doing certain things. For example, the inability to ask a question to a professor in front of numerous other people. I just dont want this to become an ongoing problem and prevent me from doing my best in school. Does anyone else have any experiences with this disorder, and how it may have affected you in your undergrad or med school? I have been prescribed Prozac, but have refused to take it due to some negative things I have heard about it. Any advice would be appreciated. Thanks,

Try Paxil CR or Pexeva; I have had a lot of experience with this during the course of my career. PM me if you like.

 

[Apparition]

Even to be a pathologist, you are going to need to get through med school, rotations, residency. This is going to involve presentations in front of the class, various class participation, speaking with patients (with and without an audience) and presenting the case to a team, and other various social interaction. You will need to work with people (students, physicians, nurses) and have them like you; you will need superiors to give you good recomendations, not say you shied away from things. And you won't go too far in your career in pathology just by sitting alone at a bench - while it is perhaps the least (whole) patient intensive field, for career advancement you will still need to meet with groups of other physicians, give talks, lectures and the like throughout your career. Figure out how to get a handle on it, with or without the meds, or this career choice will be a difficult one.

SAD should not be a deciding factor for OP to go into medicine. Every career requires interaction with people. To get a job, you still need to go through interviews, which may be harder than med school interviews because there are no MCAT scores on your side and GPA doesn't really matter either. Succeeding in the corporate world very often depends more on your social skills and the ability to build at least seemingly great relationships with people than on your actual knowledge and skills. There are meetings at which you have to speak and constant interactaction with coworkers/clients. There's a lot of acting and pretending in regular jobs because most people aren't genuinly passionate about them. At least if you love medicine, that will be a driving force to overcome SAD.

 

[WantsThisBad]

Hey, I have been browsing this site for a while and thought I may post this. I am currently a junoir and applying to medical schools. I am not too worried about my stats and believe I can get in to a few schools. However, I am a bit concerned about my alleged SAD and how it may affect me in med school. I seem to get anxious in certain situations that a normal person may simply brush off. Even more, I have never really had much of a social life and fear that when doing rounds and presentations in medical school that my SAD may prevent me from living up to my potential. I believe that part of this disorder inhibits me from doing certain things. For example, the inability to ask a question to a professor in front of numerous other people. I just dont want this to become an ongoing problem and prevent me from doing my best in school. Does anyone else have any experiences with this disorder, and how it may have affected you in your undergrad or med school? I have been prescribed Prozac, but have refused to take it due to some negative things I have heard about it. Any advice would be appreciated. Thanks,

It sounds to me like you have a good idea of what’s going on within you. A lot of people that have these types of problems are unable to see them in the same light that it appears that you have. I think that your decision to not take medication is one that you certainly have the right to make. If you think that medication is not what you need then it is probably far less likely to work for you in a situation like this. I commend your decision to not take it. I have seen a lot of people spend many years trying to find that "Good Combination" of mental meds for their problem. It often results in a lot of years of dry mouths, headaches, constipation, mood swings, suicidal thoughts, and no help with their original problem. If you think you can fix this problem on your own then do it!!!! If you can avoid taking drugs that alter your brain chemistry, then why not? I think your best bet is to put yourself out there...make yourself uncomfortable!!!! The best way to deal with anxiety sometimes is to make your self anxious. Go do some things you normally wouldn’t. If you avoid them then you will never get used to them. This may end up being something you have to live with for most or all of your life, but you can learn how to deal with. As far as being a doc goes, I have no idea what advice to give you since I am not doc, but I would imagine that this could have a negative effect on your career, but I guess that all depends on what kind of work you do on your self between now and when you're wearing the white coat! Good Luck, I think you should battle your SAD! - Nick

 

[Law2Doc]

SAD should not be a deciding factor for OP to go into medicine. Every career requires interaction with people. To get a job, you still need to go through interviews, which may be harder than med school interviews because there are no MCAT scores on your side and GPA doesn't really matter either. Succeeding in the corporate world very often depends more on your social skills and the ability to build at least seemingly great relationships with people than on your actual knowledge and skills. There are meetings at which you have to speak and constant interactaction with coworkers/clients. There's a lot of acting and pretending in regular jobs because most people aren't genuinly passionate about them. At least if you love medicine, that will be a driving force to overcome SAD.

Medicine is a far more customer service oriented profession than many others. There are quite a few jobs out there, that have less intensive personal interaction, allow you to telecomute, work with your hands, are product, not service oriented etc. It is not true to say that every career requires significant personal interaction, but certainly the professions and high powered positions all do. And while many jobs have but one interview, as does med school (but then again at the residency and job levels), the requirement to perform in front of people does not ever end in medicine, as it might in certain other jobs. So if one can overcome SAD then fantastic, go for the stars. If you cannot, medicine is going to be one of the hardest roads, precisely because it is a service industry, and much of what you are marketing involves interpersonal relation.

 

[DownonthePharm]

I have SA, and I would say that I suffer from it greatly because it prevents me of doing a lot of things that I have wanted to do over the years. Mostly anything performance oriented is out of the question for me. I had my doctor prescribe beta-blockers to me but havent had a situation to use them yet. I took Effexor for depression for a while and gained a lot of weight, so I am afraid to use any other medications.

I am starting Pharmacy school this fall and I have been extremely worried about the process of meeting new people. Once I am comfortable with someone I dont have as big of a problem but there is still that inital impression that I am afraid of messing up.

I have gotten a lot better in the past few years, some things that have helped me have been the books: Diagonally Parked in a Parallel Universe, Feeling Good Handbook, Shyness & Social Anxiety Workbook and the website: www.socialanxietysupport.com. I also know of a free call in support group, if you want to know the information on it just PM me.

 

[MirrorTodd]

I thought I had SAD for a while, but it turns out that I was just bad at initiating the converstion with chicks.

 

[lilmissfickle]

I have social anxiety (as well as general anxiety), and have tried a couple SSRIs to no (or ill) effect. Antidepressants aren't really targeted for anxiety disorders, but they're such a crapshoot in terms of effects that in the opinion of most psychiatrists, it's worth it to try a couple anyway and see what happens.

I don't have the patience to try every drug under the sun, however, so I recently started a course of cognitive/behaviour therapy. So far it seems to be right on the mark. Basically, the clinical psychologist will teach you a whole bunch of 'strategies' to use in social situations, targeted specifically to your particular anxieties. Then you have to practice practice practice them and report back on your results. Sometimes there's role playing involved (which is really helpful if you want to prepare for something specific like an interview) and sometimes she makes me walk around the hospital and initiate conversations with people, then 'grades' my performance. Sounds kinda dopey, but if you've got the time and the money (or the insurance coverage), it's a worthwhile skill set to invest in.

 

[shuey123]

Hey there!!!

A lot of great posts in this thread...

I suffered from SA for about 7-8 years....through juior-high, and high-school.....it was hell ( my face felt as hot as hell ). I never even knew there was such a condition as SA....until I found a book in my local library called "Coping With: Social Anxiety" (great book for high-school`ers and the younger crowds). On te web I was glad to find www.socialanxietysupport.com (great site)..

One thing is certain: you MUST NOT allow SA to affect major decision making....such as choosing a profession......If you do, you will just end up doing crazy things such as staying at home all day and avoiding any contact with people.

To defeat SA, you need to persist, and to never give up!!!

 

[Kuro]

Oh, by no means do I intend of altering my future career decisions. However I am a bit apprehensive of what medical school is like in terms of social situations. I get nervous in certain social situations when I am targeted, or asked a question in front of a group of people who I do not know. I have difficulty and basically no experiences in approaching an attractive girl. I significantly fear speaking or giving a presentation in front of an audience. I actually remember in high school, I would fear attending my English classes, becauses I was afraid the teacher may call on me to read whatever story it was we were reading. And I fear this anxiety may prevent me from succeding in med school, for example, asking a professor or another student for study advice or assistance. Around life long friends and family members I have no trouble being in the social spotlight. I just wish I could act like this around friends and people at school. And, I do not want this to be a problem in medical school. I feel that the only was to do this, I assume, is to push myself into situations I am not comfortable in. Whether this is asking a girl out or volunteering to present lab data to the class, this seems like the only solution. Again, I am not sold on medication like Prozac, because I am not at all depressed, and fear a medication like this may in fact increase my anxiety.

 

[yyd]

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[QuikClot]

A few thoughts:

* There has been little mention of the two most critical social tasks facing the would-be doctor: communicating with patients, and communicating with other healthcare workers. To be good at your job, you have to be good at these things; patients, especially, depend on their doctor to ask the right questions, provide emotional support, give clear guidance and discuss their options.

The good news is that there are lots of socially incompetent and/or uncaring doctors, and you need not stand out. But if you want to be really good at your job, you have to deal with this.

* Brain stuff is vastly more complicated than a chemical imbalance or two. Those chemicals are interacting with neural networks and each other in feedback loops and inhibitory responses that make the blood clotting cascade look like something out of "Ernst Goes to Camp." Anyone who tells you psychotropic drugs can correct an imbalance and leave you normal is misinformed.

* Both certain kinds of therapy, and certain drugs, have shown the ability to both eliminate symptoms and improve functioning, and to create permanent, measurable changes in brain functioning. Absent a horrific organic brain disease like schizophrenia, it is possible to "reprogram," even "rewire" your brain. In most cases, therapy and drugs work better in combination than they do separately.

* I know from my own history of depression that you can control the self-destructive parts of your nature without sacrificing your creativity or your uniqueness. You can transform things you may have thought were immutable parts of your personality, which can turn out to be no more than albatrosses around your neck.

Only you can decide want you want to change, but I would humbly suggest that we can get cozy with bad situations; bad jobs, abusive relationships, dysfunctional families, even hostages, one study found, can develop a sense of love and protectiveness towards their captors. So you can't always trust your feelings of losing something. If you are shy, and it's not a problem, and doesn't keep you from who you want to be, great. You can live with it. But don't succumb to Stockholm syndrome of the personality defect. You can ditch it, if you want to, without losing a piece of yourself in the process.

 

[locoindio]

Hey, I have been browsing this site for a while and thought I may post this. I am currently a junoir and applying to medical schools. I am not too worried about my stats and believe I can get in to a few schools. However, I am a bit concerned about my alleged SAD and how it may affect me in med school. I seem to get anxious in certain situations that a normal person may simply brush off. Even more, I have never really had much of a social life and fear that when doing rounds and presentations in medical school that my SAD may prevent me from living up to my potential. I believe that part of this disorder inhibits me from doing certain things. For example, the inability to ask a question to a professor in front of numerous other people. I just dont want this to become an ongoing problem and prevent me from doing my best in school. Does anyone else have any experiences with this disorder, and how it may have affected you in your undergrad or med school? I have been prescribed Prozac, but have refused to take it due to some negative things I have heard about it. Any advice would be appreciated. Thanks,

Hello,
I am an aspiring physician like so many of us on this message board and have been diagnosed with OCD, a disorder in the same spectrum as SAD, according to the DSM IV. My OCD has hurt me the most when I have been in a situation in which my confidence has been shaky. Over not that much time of exposure though, I've been able to handle it, and it's not so bad. The ket to tackling a lot of the anxiety disorders is repeated exposure and response to stimuli, both through exposure or cognitive behavioral therapy.....but everybody takes a different approach. I prefer to hit the problem head on, but that's me. If it's something really bugging you, you should try and be as forthcoming with yourself as you can and just take it head on, even if you're not as foolhardy as I have been on some occasions. Hope that helps....