The Fall Within - More About My Anxiety Story Part III

As my generalized anxiety disorder became more severe, it also became more focused as social anxiety. It is very hard to explain this phenomenon to someone who has never suffered from it in the same way it is impossible for me to understand what an anorexic or a cutter thinks or does. It’s also like trying to “explain” the Grand Canyon to someone who has never seen it or even seen a picture of it. You can talk about it dimensionally, as in feet deep, miles across . . . but you just can’t explain it.

Social anxiety is, as Jamie said a long time ago, an irrational fear. You can not explicate it rationally. It is wired deeply within the brain and is very primal. In social anxiety it is the illogical and intense fear of being judged. But worse than that, it is an absurd fear that that judgment carries infinite weight. It is not just someone’s opinion that you are a bad person but their “opinion” actually declares you to be a bad person. I still may not be conveying the depth and the width of this fear. When social (or any) anxiety is at its prime, it is worse than a fear of death. This is why it is hard for someone who doesn’t suffer from it to understand. They would just think, “I don’t care what the hell they think about me.” In the same why I would ask an anorexic person, who is near death . . . but really wants to live . . . “Just eat, damn-it EAT!” I can’t grasp why they can’t.

I mentioned once before that four years ago I was sleeping in a pup-tent alone, beside the road in Northwest Pakistan. It was a tense time (as it always is there) where the anti-Islamic Dutch cartoons had just been published and George W. Bush was visiting Pakistan the following week. The day before a crowd had been circling our encampment shouting, in English btw, “Death to the Americans!”

After I had been sleeping for a while, one of the team’s Pakistani body guards awaken me and said, almost in a shout, “You’re going to die sleeping here! These Taliban are going to come in here while you’re asleep and cut your throat from ear to ear and there is nothing my men or I can do about it.”

I was sleeping alone because the rest of our team was sleeping in a shipping container under the watch of the guards. I could not sleep lying side by side, like sardines in a tin can, with a bunch of snoring doctors and medics.

But even after that warning, I was calm enough to go back to sleep . . . waiting until the next day to move my tent to a safer place.

However, the night before I have to do a public speaking event, I don’t sleep at all but lie in a pool of cold sweat. That is social anxiety and that is how the fear is worse than the fear of death itself. It is totally irrational.

After my acute anxiety experience twelve or so years ago, I started this pattern of having panic attacks in virtually every social situation (parties, seeing patients, Sunday school classes). I continued to do public speaking but it was extremely hard. I actually had a panic attack once when I was suddenly asked to read scripture in front of our church over several hundred people. My voice was shaking so hard that people couldn’t understand me.

I want to say something about panic attacks before I close this posting. I will also say in summary that while my horrible anxiety improved over the subsequent years, it has never returned to the mild level of 15 years ago. In my next posting (and last I hope) I will describe my experiences seeking help from two different Christian psychologists and one secular.

The Panic Attack:

A panic attack is very physical. For the specifics, go back to two posts ago and click on the title. It takes you to a very detailed description of what goes on in the brain, adrenals and heart during anxiety and panic.

But in simpler terms, it is initiated subconsciously. So you don’t have a panic attack on purpose or by “talking yourself into it,” as someone might say who has never had one. Once it starts (in my case) it takes off automatically. Eventually, a large dose of adrenalin is dumped into your bloodstream. Adrenalin (and the other complex processes) speed up the heart rate to about 150, start a hypoxia (starving of air) response, create generalized shaking and often causes the muscles to literally lock up.

These responses in themselves have a very healthy purpose, and originally were good and designed by God. To have a dose of adrenalin helps you to escape real danger. You can outrun a robber if you have this effect. Even the freezing up has a purpose, like that of an opossum (by avoiding attracting attention to yourself when you lie very still).

But in the social context of having anxiety and then a panic attack, this physiological response can seem devastating and unstoppable. The problem is that panic attacks associated with anxiety disorders are self-perpetuating. For example, if you have an irrational fear of being judged (as being bad, loopy or stupid) then you have a fear of a panic attack because if you do have one, then you will (at least in your mind) convince people that you really are nuts.

It goes like this. You are terrified if you speak in front of a group that they might think you are goofy. So you get up in front of the people, then you lock up or start shaking so badly you actually DO look goofy. Then the next time you will be more afraid.

I know beyond a shadow of a doubt that my biggest anxiety is anxiety itself and panic attacks. If I already have social phobias, then my greatest phobia is that I will have a panic attack and thus prove that I am stupid . . . or a nutcase, or unspiritual.

Panic attacks do not make me feel like I’m sick or dying (because I work in medicine and I know better), however, for many sufferers it does. Some people with anxiety disorders have a fear of being sick (heart attacks, MS, seizures, dementia, etc). So when they get the adrenalin rush, it convinces them they are having one of those diseases.

It takes a huge amount of energy to physical fight anxiety and to keep a panic attack from coming.

A Final Statement

Guilt is a big part of social anxiety (and depression and a host of other metal ailments). If your fear is being judged, and that judgment (like the judgment of God) carries eternal weight, then you feel perpetually guilty. This is where people with anxiety disorders can be manipulated by the Christians (pastors, Christian psychologists, etc) who have other mental health issues (narcissistic) or personality disorders. They will say things like, “Why weren’t you at the meeting? I was really counting on your.” The meeting was usually some waste of time to boost that Christian's ego, but he or she wraps it up in the “Jesus blanket” so they can use guilt manipulation to make you come.

It is also, in my opinion, why we need to hear about, meditate on and experience the Grace of God, the mercy of Christ, the total redemption and absolute justification that comes via the cross. It is counterproductive, in my opinion, to preach to us about discipline, being in the hands of an “angry God,” etc . . . because we have this constant feeling of being in the sweaty, trembling, angry hands of God almighty. That is one reason I think nut cases who practice Nouthic counseling will have to answer to God someday for the damage they have done (okay, they have the mercy too, but it is my emotions speaking).

I will end next time with my experiences, good and bad, of trying to get better.