All my life I've had something that is, for the sake of ease, referred to as social anxiety. I don't get that gut-level panic about social situations, it's just that when I go to speak, the words won't come out. It effects me deeply; I don't have friends.
For a long time, I insisted it wasn't social anxiety, because I don't feel anxious. But when I sat down to DIY CBT it, I asked myself what holds me back. I figured I was afraid if what people might think of I say the wrong thing, or say something weird or stupid. And if that's not social anxiety, I don't know what is. I accepted it was social anxiety after that, but I still didn't understand why the term "social anxiety" still just didn't feel like it fit.
A few weeks ago I switched to a higher dose of my meds. While I was in that transition phase, my wife and I were on our way to see friends at a restaurant (my wife has friends) we were running late, so I went into the restaurant while she parked the car. I said hi to them, they said hi to me, they asked me how I was, and I told them. A conversation happened. That was just something that never happens.
I noticed the change in small ways too. Like I no longer found it hard to say hi to people om the street.
That stuff I am afraid of, saying something weird or stupid, it's like being afraid of sharks or climate change. The fear is there, it's real,it just doesn't stop me from getting on with life.
it's promising and dispiriting at the same time. On the one hand, this big problem might be resolved; on the other, I feel powerless, like self-improvement is just about finding the right pills, nothing more. No manifesting and self-actualizing a better you, just pills.
I see a lot of posts on here about social anxiety (I've responded to a lot too) . So I am convinced there's a correlation between social anxiety and ADHD, but I've never understood the relationship. If ADHD treatments treat social anxiety (or at.least my variety of it), then could it be that ADHD *causes* social anxiety? Has anyone else experienced this? Or have any thoughts about the relationship between ADHD and social anxiety?
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I get the gut panic personally. I'm 1000% with you on how you feel about self development. Are pills really the only answer for everything? What kind of life is that. It's not much of one if you ask me. Knowing your chances of having better communication skills are tied to pills.. I'm still trying to cope with my own ADHD. I've gone through denial and acceptance, denial and acceptance over and over.
It feels like today's society is soley crutched on constant innovation and technological advancements and that doesn't give much wiggle room for the mistakes made by those that suffer from adhd.
I do think there's room there for a more positive view of meds.
Sometimes were just not in the right place to be receptive to self-improvement, or other forms of non-medication based therapies. If you know anxiety, you're probably familiar with SSRIs. SSRIs are heavy stuff, with serious side effects, but the most important thing about them is that they literally save lives, by preventing suicide. The expectation is that once the meds have alleviated the crisis, then you can be receptive to non-medication based therapies and self-improvement.
(Took me a long time to realise that, as they kinda just give 'em to you, and leave you be. But that's not how it should be).
Ideally stimulants would be the same. If you can't concentrate on anything long enough to address your issues, meds can help you sit down and get it together. They wouldn't do all the work, just help you get to the first step.
Difference is that stimulant meds for ADHD are like glasses. We also might need them to do basic stuff in our every day lives. They're not a temporary crisis measure, like SSRIs. One of the hardest things about being diagnosed is the realization that you'll be reliant on meds for the rest of your life. But in reality, you wouldn't judge a person wearing glasses for being reliant on their glasses. Meds are just a tool that you can use, as you wish, to make life easier.
You shared that you're teaching yourself CBT. That is doing it yourself. That's not the pills. Good job, and keep it up. Identifying the root causes for ourselves makes room for growth. I also have social anxiety, but it manifests differently. Medication has not helped, but reflection and introspection and working with therapists has helped me identify some things to work, on as well as adjusting my goals.
After 60 grinding years of undiagnosed ADHD and social catastrophe my medication, along with CBT, came as a blessing. This is my story ...
Today I accept that I overlook stuff, that doing tasks requires more effort than others, that organising my thoughts requires greater persistence, that planning in advance is my hedge against anxiety and that medication helps prevent social slip ups!
Socially speaking without medication I'm prone to gabble - a lot. Medication gives me pause - a moment to reflect about my interlocutor and take on their views. Pause to be charitable even when I strongly disagree. Pause so as not to take myself too seriously. In short, medication helps me to be true to myself and consequently more self assured. I'd love to be me without the medication, but that's the hand I've been dealt. It took several difficult years to come to terms with this state of affairs.
“Today I accept that I overlook stuff, that doing tasks requires more effort than others, that organising my thoughts requires greater persistence, that planning in advance is my hedge against anxiety and that medication helps prevent social slip ups!”
I love how you do eloquently put this. It’s a great affirmation and I’m totally going to start using it.
This was totally my experience starting meds, too. I knew I didn’t have trad social anxiety (fear of going out), I often was very excited to go out and socialize. But when I got around people I would clam up or get super self conscious or say something inappropriate and feel lots of shame after. This happened like 5% of the time in my early 20’s and 99% of the time in my early 30’s. At first I thought this was related to drinking, but then I noticed the same anxiety “hangover” from being out even on nights I didn’t drink.
I understand two things about my situation now: (1) meds help immensely because focus and anxiety are inversely proportional—when you can’t focus (like unmedicated in a highly stimulating environment like a restaurant, party or bar), your anxiety shoots up. When you can focus and filter out background noise and thoughts, anxiety diminishes and even disappears. Making conversations more relaxed bc you (and the people you’re talking to) feel calmer.
(2) The other thing for me was realizing at 35 that I’m autistic. So in social situations I would either feel intense pressure to mask (like a nonstop loop in your head of “act normal, please just act normal”), or would feel relaxed enough to “unmask” in public and be my weirdo self, only to wake up the next morning and think “WHAT HAVE I DONE.” That’s because until knowing more about autism, I didn’t recognize myself unmasked and/or being my authentic self felt very, very dangerous.
There’s tons of overlap in autism & adhd—if that resonates, look into it! Self-diagnosis for low support needs is widely accepted in the community. It’s been very freeing.
*lil note on this: I’ve been in CBT for years and recommend it to almost everyone. However, this is an area where CBT has almost no effect on anxiety. I could analyze the crap out of myself but it didn’t change my anxiety. That’s bc CBT tries to reason with “irrational” fears & anxiety and is mostly ineffective against the ongoing trauma of being an undiagnosed autist or adhder in a neurotypical world. If CBT isn’t getting you where you want to be, it’s often helpful to take that as evidence something else is going on.
I kinda forgot about this post, because ADHD, but I made it a point to come back and say what a good reply this was. That thing about being excited about seeing people - I get that. It's hard to call it social anxiety when you enjoy social situations, but it's hard to call it anything else when you have these issues.
My wife has ADHD too, and we're pretty sure she's on the spectrum as well. So, looking at her, I can say that I don't think I am on the spectrum. It's the sensory overload issues that she has, that I just don't get. And that "hangover" you mentioned, she gets that; I never have. But understanding the relationship between ADHD and Autism made a lot of things make sense to me, but I think that's just symptoms common to both, rather than having both. But I have noticed that it's hard to process a conversation when there's another conversation happening nearby. That's very much a factor.
I don't think I have to be on the spectrum to have anxiety related to undiagnosed neurodivergency. Before my diagnosis, I just thought I was really bad at everything. I've traced a lot of anxiety to that, but I've also found it to be really positive how quickly that anxiety melts away when you can understand what's going on, and start to fix it. So I totally get what you mean about the limitations of CBT, but then that's kind of positive too; if neurodivergency, and the anxiety caused by it is the issue, not these deep-seated negative thought patterns, then that's going to be easier to treat. Everyone has bad, negative, irrational thought patterns, sometimes those just aren't the things that are holding us back.
I found so many different ways of saying "I am afraid of saying something stupid, and looking stupid", and bringing that out into the light didn't help.
That feeling of regret everytime you let your freak flag fly sounds really familiar too. You're right that it's a fear of your authentic self, I never realised that until you said it! Though we need to remember that our authentic self can be cringey and embarassing, but that's okay. Maybe I have real reason to be embarassed by the unmasked me, but embracing that embarassment is important to self-acceptance.
I’m with Alphageekboy, I really like your description of the struggles with ADHD. I too have gone from acceptance to denial several times, and I’ve gone on and off meds in trying to find the combination that works best for me. I’ve had social anxiety for years and have been on an SSRI for years. It helps, but doesn’t do anything for anxiety sometimes. I was diagnosed ADHD a couple years ago at 52 and put on stimulants. The results were almost instant. My mood was better and I could engage people with confidence. Many people struggle with anxiety and depression and ADHD is the cause, but often overlooked. Now I rarely have to use my rescue panic med (Valium) for extreme anxiety. I’m also in therapy and have found the combination with meds to help a lot. All the best.
I wouldn't say I have social anxiety. I'm capable of talking to people. I just don't like to. I don't really like making small talk with strangers and having to pretend that what they're saying is interesting. I realized at a certain point that most of my friends are people I've known since childhood. And I don't know, I just don't have any interest in creating a new social circle. I'd rather be left alone most of the time.
Wow, you have talked yourself into a downside of being able to say hello to people.
Let's flip this. Your taking a pill for help, but first ... "pill" is pejorative, horribly so. Do you say "pill" to diabetics or people with heart problems who take meds?
But let's flip this. In fact, the pill has helped you function at the minimal level. I don't mean that as an insult. It's just that when we have severe problems, any improvement is huge.
Here's thing. Those people who have great social skills. They INHERITED a pill ... inherited certain brain biology and chemistry and family relationships and parenting and all of that. They did NOTHING to earn their social skills. Would you be dismissive of them? You think they're walking around feeling like their inheritance of certain biology and brain chemistry and hormones and personality traits, and their good fortune to be raised by people who nurtured them in a way that helped their skills--do you think they're feeling inadequate about having inherited all of that?
Your job is to now build on the medication to make friends, to attend gatherings, to go to groups, to host parties, to interact better with people at work. To be a better marriage partner and parent (if you are) and on and on. The "pill" just gets you to the minimum. It confers no deep advantage.
Thank the medication and now build on it. Basically you went from severe social anxiety to less severe. Feel guilty about the medication--wait til after you've made five close friends and feel comfortable at social gatherings.
When you feel comfortable to host and sponsor social gatherings, come back and write to us then about feeling guilty.
BTW: the logic you're using is the logic I used when I was depressed. Depressed people find a way to make everything bad. Have you been treated for depression. Sorry DIY doesn't work. We have too many blind spots.
Hang on, having mixed feelings is not the same as talking a positive into a negative. And despite my word choice, I do have a positive view of meds, no guilt there. I am just a little worried that if meds did something that I couldn't do by myself, then building on what they did by myself feels hopeless.
It's a bit like if you had failed several times to climb Mt Everest, so you got yourself airlifted up half way, now you're staring up at the other half of the climb, wondering how you'll ever make it, if you weren't able to make the first half of the climb yourself.
But I have a positive outlook. I am happy to be where the meds have put me, even if there are challenges ahead. I agree that DIY doesn't work, and about how you always find a way to be negaive. I agree because I owe that positive outlook to meds.
More accurate to say you have been airlifted to a quarter of a mile to Everest. What happens next is all on you. All those people who didn't need the pill have bodies and brains that allow them to FAR MORE EASILY get to half way up Everest.
You're defining minimum function (saying hello to people and having a conversation) as if it's some overwhelming advantage. The pill has given you a help to a rock-bottom minimum! You're still way below people who were born with better brain biology. And yes, these people born with better brain biology can get airlifted to half way up Everest--by virtue of the internal pills they've been born with.
Let's scale this
-10 ...... 0 ...... + 10
This happens all the time.
You've gone from -7 to about + 2 on the social comfort scale.
Most people are born with a +5 or +6. I can converse with all kinds of people with ease with almost no social anxiety. Yep, my entire family had this skill except for my sister. Sorry, I didn't work for it or earn this.
You're still way way behind. When you have a dozen reasonably close friends and feel comfortable throwing parties, then start feeling guilty. But the meds won't take you to a dozen good friends. They get us to a minimum and we have to do the rest.
Anxiety, including social anxiety is one of the many comorbid disorders found in those of us with ADHD. Please visit one of the educational ADHD sites to learn more about this. Studies show SSRIs & SSNRIs work to reshape neurotransmitters and allow for more sertonin to be present where it is needed. This causes us to be more flexible/open to others & learning. Good for you for working on this!
Hello, this recorded webinar may be helpful to you. It teases apart the fact that sometimes adhd creates anxiety and sometimes anxiety is just comorbid with adhd. It explains how to tell the difference.
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