Episode #278 - Battling Social Anxiety

One of the more common sides of mental and emotional illness that often goes undiagnosed is Social Anxiety.  It can be paralyzing to anyone who suffers but more especially to a church member who is required by commandment to be actively engaged.

Transcript

Welcome to Episode #278 – Battling Social Anxiety. In today’s podcast I wanted to highlight an illness that often goes unnoticed, undetected and too often relegated to the shadows of the mental illness community.  But is just as problematic and difficult as clinical depression or bipolar.

A group of mental illnesses often related and connected to depression and bipolar are referred to as anxiety disorders.  Anxiety is actually a broader term for a set of illnesses that all revolve around extreme worry, concern and fear, the fight or flight kind.  This can be I’m nervous to speak in sacrament type of anxiety and a more consistent broader and deeper feeling of fear and worry that paralyzes someone physically, mentally, socially and spiritually.  As in the case of most mental illness there exists a genetic, traumatic event and random component to the illness.  You are more likely to have it with a family history but then again you can have it without any known family link.  It is not likely to come upon you suddenly but it the case of traumatic events it can move from a little worry to cloistered in your bedroom in a matter of a short period of time.  Most people who deal with the illness do not see it as a mental illness simply because it does not always manifest itself in a manner that would be recognizable and everyone gets nervous and so it is often disregarded as nervousness.  And in our society we deal with anxiety and nervousness more often with a jump into the deep end of the pool learning approach. While the jump in approach often works with typical nervousness, it can be problematic and even detrimental to someone who has a social anxiety disorder.  Many people with the illness do not always have symptoms that they would associate with social anxiety.  Symptoms such as rashes, ulcers, loss of hair, loss of appetite, additional appetite and so forth can actually be anxiety rather than a physical illness.  

As far as spiritual matters it can be debilitating in any number of ways including simply anxious fears about guilt, callings, speaking, teaching, serving and even going to activities.  Often individuals who do not know they have the illness will simply walk away from church activity because it reduces their symptoms.  I know that it might sound strange but it isn’t the gospel or the teachings that are causing any issues. It is the administration of the outward gospel with its social activities, teaching, service that causes such a deep paralyzing effect.  It is not a doctrinal issue but a procedural and administrative one.  And one that can be remedied given a diagnosis and just a little help.

Most often you find anxiety as a mental illness discussed in connection with long term clinical depression. This doesn’t mean that anxiety doesn’t exist on it own because it does and it can be just as debilitating as any other mental illness.  Anxiety can even lead to depression. 

However, I believe sometimes that these lesser known disorders and so many others are relegated to the outskirts of the mental health community.  Depression and Bipolar have such a tendency to take over community governance due to their frequent occurrence within the overall community and simply because more individuals popular in culture have come forth to education others about the illness.  This does not make anxiety disorders any less problematic or any less real but probably more hidden.  

I have found that in many cases, perhaps because of lack of education, they have become less believable than depression and bipolar.  It is difficult to understand why someone all the sudden has to stand up and leave the church building and not return.  How can something just come upon someone without their consent or ability to control it at a moment’s notice.  It is difficult to imagine for someone who has not experienced it.  The only thing that I could even relate to it would be seeing a snake, spider or mouse when you have a phobia.  You’ll lose control.  However, in the case of these mental illnesses the feelings can and often come without necessarily a cause and last for much longer periods of time.  

I have heard this illness described as simply someone who can’t control their worry, a worry wart.  But having had this one, sometimes there isn’t even anything causing it.  You just feel deeply anxious and you ask yourself why and you say to yourself, I don’t know but the feeling is still there.  Anxiety is debilitating on many levels.  Exhaustion, fear, sleeplessness, sometimes nightmares, all form a terrible vortex that simply consumes life.  I have heard someone say why don’t you just snap out of it.  If individuals who have this illness could simply snap out of it, I would think that they would do it.  The problem is not often thinking patterns but a matter of chemistry that creates the thinking patterns that are reinforced by the chemistry and time.  It is a terrible compounding illness.  Good men, women and youth become almost confined to their home and rooms because of it.  This type of illness is incredibly susceptible to self-medication and drugs which have a more calming affect upon the body.  Having experienced this problem on a smaller scale during both depression and mania, I could not even imagine a more developed illness.  

How do these illnesses affect members of the church?

As members of the church, we expect to feel the Spirit as a voice of calm, peace, love and in a still small way.  Anxiety at its core is just the opposite of these feelings.  It can make it nearly impossible to feel the Spirit and to receive personal revelation which is so critical to our conversion and our daily travels through this life.  The doubt, concern and constant pressure to think about things out of our control is overwhelming to soul and body.  Sometimes it is not even about things out of our control as it is a feeling of dread or fear that is inescapable.  

All of us get nervous when we have to do things that are new and difficult but when you are already overburdened with deeply anxious feelings and then are asked to give a talk in sacrament meeting you can actually get very ill, physically.  Your physical body deals with mental illness in unique ways and one of the ways that it effectively self-medicates is that it makes you physically sick. The physical sickness caused by chemicals in the brain is actually just a response to the difficulties associated with the new environmental incursion.  But it is a subconscious uncontrolled response and so the person actually feels sick and experiences symptoms of a physical ailment where none exists.

In the church we are taught that we don’t decline invitations, callings or counsel from our leaders.  This is good advice for those who are little tentative and need a little push of confidence to do things that are difficult.  So the teaching is good for the majority of the church where most are just nervous, maybe really nervous about what others will think of us, or that we won’t be as good as someone else, we might get embarrassed and so forth.  Sometimes this nervousness is very real and can take some time to overcome but it is manageable with time and some encouragement.  Social anxiety as an illness is not something that just needs a little push of confidence or even some guidance. It is a chemistry that just isn’t right.  It may be extreme or more moderate but it is not something that can be controlled like a bad mood.  Yes part of the treatment is to work through counseling with the illness and temper some of the symptoms but most individuals need at least some type of help through medications or other sources.

So while the Nike advice, just do it, is good for most people, it can be a body blow to those suffering with anxiety.  Often you will find that those who suffer, don’t enter Sunday school or priesthood meetings until the prayer is already said.  They avoid leadership who might ask them to do something.  They are likely to stay home if they think that they might be asked.  If they think that there is even a slight chance that they might be called to give a testimony they will leave the meeting.  They won’t attend interviews if they think that they might be asked to be in a calling.  They are frequently sick and even avoid activities, meetings and other places where their anxiety might get to the fight or flight mode.  They often seem nervous, anxious, sometimes evasive, shy and so forth.  However, my experience with these individuals is that they are often spiritual and have strong testimonies because they have to work at it.  They have to really work to feel the Spirit, to receive revelation, to understand the gospel.  They have a tendency to read a great deal and so they are often full of knowledge that they simply can’t teach others because their body won’t allow it.  When they let someone into their close circle, it takes a great deal of time and effort on both parts of the relationship.  It is not that they don’t trust people, it is a natural reaction of the illness.  This may make them seem standoffish, sometimes snobbish, perfectionist, elitist and so forth.  The reality is far from what you see on the outside.

You will find that these individuals will take hours choosing clothing, makeup, shoes, and anything that presents them to the outward world.  Small mistakes are very large in their eyes.  What we may not ever see they can magnify into a mountain.  If they are noticed, they worry that it was because of a mistake and if they aren’t noticed their body tells them that no one cares and they worry as to why they weren’t noticed.  Sometimes they get up take hours to get ready and then can’t leave the house.  I guess what I am saying is that it is a miserable illness.  However, what I am also saying is that these individuals are compassionate, knowledgeable, often very funny, loving, thoughtful, devoted and conscientious about others.  They notice simply things and even the smallest of things.  If they can they give generous praise and are empathetic.

Now regular chronic anxiety affects about 2.7% of the population. So in a hundred members of the church you are likely to find 3-5 individuals that have the illness.  However, within the church you will find it at a little higher rate.  You will also find that it affects women at twice the rate of men.  Although men do have the illness.  You will find that each of the sexes deals differently with the illness but you will also find that it is similarly debilitating.

Now you say well what can I do about it.  I suppose that they are similar to most mental illnesses and disorders.  You have to understand and recognize they exist and are debilitating especially within the structure of the church.  Not that there is anything wrong with the structure of the church.  It is just that the disorders seem to affect certain aspects of church activity.

It is important to be observant.  Most people with anxiety disorder are going to be reserved, shy, often avoiding interactions that might lead to callings and invitations.  If they know that you aren’t going to ask or push them to do things that elevate their anxiety they can be more open to conversation and friendship.  If you are willing to listen without judgment, notice small things, honestly compliment them you can be a help in tremendous ways.  They most often just need someone in their life on which they can lean and feel comfortable.  If that person is always at church and is beside them, church and activities can become bearable.  So a spouse or companion is often the person one which they lean.  If they are young, single, divorced, or isolated in some way then they are going to need a good friend that can be a help and what I might refer to as a shield.  If you know them well and you know that they really can’t give a talk, teach a lesson, or take a calling then you can be their buffer.  This type of buffer can be the most valuable thing anyone dealing with this illness can have and can make life bearable.

There is something important to note about individuals with anxiety.  Anxiety can be triggered by traumatic events within ones life such as abuse, accidents, death, suicide and other types of events one would consider traumatic.  The anxiety may show up right away or not for years.  It can be a frightening illness to someone who has never experienced mental illness.  It can shut them down almost completely emotionally, physically and spiritually.  They need professional help and that in and of itself is going to create even greater anxiety most of the time.  With time professional help can make a huge difference but getting to the point of help may be just as difficult, especially with someone who has never experienced mental illness.

Anxiety comes in many forms, shapes and sizes and in differing variations.  Yes our current society creates a more difficult experience at times.  I think that some of this is well documented.  Social media, public and private education experiences, social events, even being around people on a regular basis often causes anxious concerns.  However, society is not likely to change anytime soon, so helping someone with their illness is going to have to happen within the framework we have.  Yes we can alter the framework while children are young and help ease them into the cultural framework where they are going to be asked to work and serve.  I do believe that we should also work to change the problematic issues of society.  But we are going asked to live and interact physically in Babylon and while we live spiritually as though we are in Zion.  

This is going to mean that youth and adults with this illness are going to need help to adjust and to find treatment methods and coping mechanisms that allow them to function.  We need to do our part with professional help and also petition the Lord.  I know that there are many individuals who do not believe in or seek out professional help.  There are many reasons.  I am not here to convince anyone about what to believe or how to go about the process.  What I do say is to have an open mind.  That is all the Lord needs to work.  If we close out opportunities by excluding certain possibilities we limit what the Lord can do to treat and help others.  I am not asking you to walk outside of covenants or to try things that are on the fringes of treatment but simply keep your thoughts open to what the Lord might put there.

If you are a leader who has someone in your organization that struggles.  There are a few things you can do to help and they are quite easy and fall within what you should be doing anyway.  The first is to look for the signs and symptoms of the illness.  Youth are going to be naturally hesitant, nervous, anxious, afraid and so forth but if you find someone with an aversion that seems to be more severe or beyond what would be normally expected then you might consider them as though they might be suffering.  Often youth don’t know that they suffer from the illness and it causes all kinds of issues including inactivity.  If they feel as though they are going to have to pray, read aloud, or perform in any other manner and their mind quickly resorts to the fight or flight pretext then it is wise to make sure that you as the leader becomes the shield they need to belong. 

Instead of a sacrament talk, or even blessing the sacrament there might be other ways the young man or women could serve and still feel as a valuable member of the quorum or class.  Leadership for anyone who suffers is not going to be difficult.  They are going to have trouble fulfilling assignments and other callings.  Not out of lack of desire.  They are very desirous but the illness prevents them from moving forward.  They are generally going to need someone there occasionally to encourage and help.  This doesn’t mean that they can’t teach or do anything in quorum without someone by their side.  Their abilities will vary according to the illness and relationships they have developed.

Finally, the best thing you can do is to be a good friend who gets to know them on a personal level.  Notice those things they do well and their talents.  I have found these individuals often have great talents in music, art, spiritual matters, literature and so forth.  They are often knowledgeable about a variety of topics and if you hit the right topic you will find them very educational.  If you look for them, you will find them and the result will be wonderful.  You will be able to help them to use their talents and abilities.

May the Lord continue to bless you in your affliction and your service to those who are afflicted.  As always remember the Lord requires the fight and then ha can do his part.