MN, M.D.: I’m Just Entering The Workforce But My Social Anxiety Leaves Me Physically Sick Before I’m Supposed To Arrive At The Office
Q: Do you have any advice for someone just entering the working world who suffers from social anxiety? I experience physical symptoms like headaches and nausea a few hours before I’m supposed to show up at work. I have a hard time feeling comfortable and confident when I finally get there. I absolutely hate being around others and meeting new people. I find myself going to the bathroom unnecessarily just to escape being around others. I reflect for hours on my interactions at work after I get home imagining how stupid I must have come off to people. Unfortunately, I cannot put off working any longer. I’m 19 and really need the experience and money. However, I just realized how hard my life is going to be if I cant figure this anxiety and work thing.
It seems like you have a severe case of social anxiety disorder (SAD). Don’t worry, you are not alone. It is one of the most common psychiatric conditions in the U.S. Anxiety disorders affect about 40 million American adults. You probably have a relative with a similar case of anxiety or you had a traumatizing experience in the past (eg, speaking in front of an audience or a history of childhood teasing). Either way, SAD causes an annoyance to daily living. People often report that the anxiety when they were in their teens, but some have noticed it as early as 5 years old. You probably were also quite shy when you were young. SAD often occurs when there is an anticipation of a new environment or experience (eg, job promotion that requires public speaking) and usually improves when the person gains experience in that area.
Here are a few tips to help you cope with daily living. Taking time for you is first and foremost. Try ways to take the stress off by practicing yoga, listening to music, mediating, or getting a massage. Find ways to relax and clear your head about anything that causes you to stress. Getting enough sleep, exercising daily, limiting alcohol and caffeine can all be used in reducing stress and ultimately removing anxiety. Stop aiming for perfection because it does not exist. Have a good attitude in everything. Lastly, try to look for local anxiety support groups that can help you in coping with this on a daily basis.
For me, when I come across a stressful situation, I always remind myself that it is only for a “season.” Whatever happens only happens for a moment of time. Even if it is going to be a recurring part of my life, I have to tell myself that it is something I am going through but it does not become me. I strive for the best, and if it does not turn out to be a success, I can leave that situation knowing that I did what I could do for that moment. Yes, I try to think about how I can do it better in the future, but I cannot let the past continue to be my present! It happened and I need to move on. Don’t waste time thinking about what others think about you. You may think they notice you are nervous, but keep this in mind: they are not thinking about you. They are busy trying to think about how they are coming across. You need to go into every situation “like a lion” and when the nervous feeling comes into play, always have a strategy on how to quickly resolve it (eg, prayer, taking deep breaths while inhaling and exhaling, counting to 10 slowly). And as I often tell people when dealing with a situation that is causing anxiety, “fake it ‘til you make it”! In other words, present yourself as a person of confidence until that experience becomes comfortable for you.
There are several medications that can help to curb this anxiety. Antidepressants are typically used to treat depression, but also are quite effective when it comes to anxiety disorders. Cognitive behavioral therapy is another therapy that is effective. It involves a psychologist or counselor talking with you about what you are experiencing. They will then help you change how you see your situation and how you react to it. The ultimate goal is to teach you how to cope better with your anxiety. Some people find it effective to take medications only, while others take medications and do therapy at the same time. It is very important to talk to your doctor about this because anxiety can lead to other conditions like depression, substance abuse, and even suicide.