Have I developed general anxiety? Help please!

Mental health
1

Hi,

To provide a bit of background, I've had fear of public speaking probably from the age of about 14 or so, and am currently 20 years old. I've had good and bad experiences with public speaking since then.

Recently I started a year long work placement at a bank. The main symptom I suffered from during public speaking to date has been dry mouth and shortness of breath, although there were other symptoms such as increased heart rate, slight shakiness (though they were not as bad as the dry mouth). It didn't used to be extreme though, it was bareable - until about a year ago, where this began to get increasingly worse. Today, it's come to the point where I have difficulty speaking - my voice becomes croaky and sounds funny, sometimes I feel like I need to swallow before even completing a word.

In the not too distant past, although I experienced these symptoms I generally was able to speak fairly clearly and make sense. Also, with time, I sort of got used to/learned to overcome the rapid heart rate and the shakiness, but the dry mouth and shortness of breath feeling seems to have gotten increasingly worse in the last year or so. I always take water to these sorts of situations with me, however I can't really sip away water after every single word I say, but I've gotten to a point with this where I feel like I need to.

I'm wondering if I've started to develop a more general form of anxiety now rather than public speaking anxiety itself, as I now not only have these feelings in public speaking situations, but in a variety of situations, even on one-on-one meetings/chats where I feel nervous/uncomfortable or feel like I'm being judged or am worried about what the other person might think about me or say in response to my questions/comments.

After reading a lot of stuff online and trying a few different approaches (paul mckenna's confidence program, janet esposito's public speaking book etc) and medication (tried lemon balm, st john's wort etc), although I've had some good experiences as earlier mentioned, today I feel I am at a low point, thus I finally decided to go to a GP who then got referred to a psychologist who I will be meeting next week.

In the past, although I found public speaking to be a phobia, for the most part I tried not to avoid the situation and did my best. However, today I got to a low point and basically said no to a team presentation which I could've participated in next week as I want to speak to the psychologist and really get on top of this problem before I do something like that again. Next week I also have an important meeting with my manager, his manager and two of my teammates to talk about one of our projects, and as I was the lead on the project, I will need to talk about my work and show them what I've done, and we will need approval for the next stage of the project. Even in this sort of situation I feel quite nervous and get the dry mouth and difficulty speaking problem, thus I'm worried about that meeting too, as I want it to go well and am worried that I'll look really foolish in front of a senior person, my manager and my teammates.

I feel like I'm a rare case as I haven't really heard of a case where someone got dry mouth/shorntess of breath to the point where they had difficulty talking and sounded so croaky in such simple situations, even informal chats with certain people or casual rehearsals for presentations with some of my friends at work. I just sound croaky and indistinct, and have difficulty completing sentences. A sip of water is very helpful but only for a few moments, and then it starts again!

Note that I don't really have this problem in more informal/casual situations or with people I am more comfortable around, it's mainly when I feel in the spotlight, or feel like I'm being judged, evaluated or questioned etc, so I don't think it's a social anxiety sort of thing. I don't want to have this problem pull me back in my career or my relationships with people. I don't know if this is general anxiety, speaking anxiety or something else.. I feel like I'm the only one who has this sort of a problem.. I'm not sure how to approach this. This has gotten to a stage where it's occupying about 80% of my thoughts, and it feels like if I can get over this, I can get over anything in life.. Any opinions, thoughts, recommendations would be greatly appreciated!

2

rather than generalized anxiety disorder this sounds more like social anxiety disorder go to your doctor and they can talk you through your options x

3

Hi Invictus,

I have felt exactly, and I mean exactly, like you have. And I am here to tell you, that you do not need to worry, or think that you are doomed in your career.

My problem became vey evident from my career, whereby I too have to give presentations or talk in meeting, getting evaluated etc. I found myself burning up and going bright red, even just in meetings with my manager. It made me start shying away from situations that made me feel uncomfortable and pre-empting such situations and coming up with lies before they had even happened. It's that feeling of self-consciousness when you know people are looking at you and reading into what you are saying - it can be really overwhelming

I eventually started taking sertraline to overcome these fears, and for me, I found that although I didn't think I had these problems outside of my work, it has helped me in situations where I would usually get moody, or where I struggle to sleep at night with worry about my career, how I am comparing to others my age etc.

For me, sertraline has given me some space to be able to work these problems out for myself, to develop into the person that I know I can be, and to gradually reduce my dosage once my actions reflect my abilities. Basically a bit of self-fulfilling prophecy going on. My ability to perform at work has risen to such a level that within 3 dys - 2 weeks of taking it, I felt like the person I want to be, I haven't blushed once, and I am able to effectively speak in front of people. Even if I make a mess of something, I can quickly get out of it because my brain is allowing me to think rationally, it's so strange and such a good tool to learn from. And better still it is all in your head and totally controllable. I know that alot of people don't agree with medication but for me I needed a quick fix and so far it has been one of the best decisions of my life.

It sounds as though you have had a bit of a confidence crush and you really need to start believing in yourself again. You might not need what I did, but it is certainly worth considering. I'm not aware of any other effective methods to overcome self-esteem issues, but  maybe others on here will be able to help.

I Hope you feel better soon with whatever you decide, and start to be the person that you want and know you are. Do private message me if you want to discuss further. Hope this helps xx

 

4

Do you think that's the case even though I don't really have these sorts of issues in informal/casual situations where I'm just hanging out with people or chatting away? Thanks for reading through and for the response!

5

The problem is that often these problems start out in certain situations like just being extremely anxious in presentations etc but the more anxious you start to feel, the more you doubt yourself and the more you stress about it, people with often withdraw from that activity and then become more withdrawn from other types of social interaction. the reason its not generalised anxiety is that its confined to a certain type of activity, within the social realm, if it is infact not social anxiety disorder and doesn't worsen at all, it may well be that you're suffering from phobic disorder than anything, the specific phobia being fear of public speaking. talk to your doctor, if you want to go down medication route for when you have to do this sort of activity, they can prescibe something like diazepam for when you need it. Breathing excercises may help to, in through the nose out through the mouth, but also the way in which phobias are generally treated is through gradually exposing yourself to the fear step by step, and the more exposure and confidence you build in each step could lead to you being more comfortable in these situations.

6

I still think youve got social anxiety not GAD.

Also love your name, I hope its in reference to Ernest Hemingway & Nelson Mandela.

Anyway, I don't think you've got GAD, your anxiety seems to be related to communicating with people. Even if you dont have it in informal situations/people you know, its still a 'social' issue. 

According to metacognitive therapy (which i use as the bible) you should think of your feared situations ie what scares you about public speaking - stumbling over words, going red? ect. And actually do it on purpose and see people's reactions, I am sure theyre not what you think they will be. This will help you to see that there's nothing to be frightened of.

The more you avoid these situations, the more scary they will become. 

I dont think medication is the way forward (but thats just my opinion)

A therapist, probably CBT, will work well for you.

The book I have is metacognitive therapy for anxiety and depression, got it from Amazon

You are going to be fine! X  

7

There are several types of anxiety disorders including panic disorder, social anxiety disorder, specific phobias, and generalized anxiety disorder.

Anxiety is a normal human emotion that everyone experiences at times. Many people feel anxious, or nervous, when faced with a problem at work, before taking a test, or making an important decision. Anxiety disorders, however, are different. They can cause such distress that it interferes with a person's ability to lead a normal life.....But I think You anxiety problem is different(social anxiety). You must have to consult with your doctor...Don't worry. You will be allright.

8

Thanks klaire, sorry for the late reply, I've been thinking about the issue and I've sort of realised that although I had always discarded social anxiety as being a possibility, I am now almost certain it's that. Thinking about the past year or two, I've realised that a lot of my behaviour and thoughts match the behaviour and thoughts that a socially anxious person might have. For example, when I'm with people I don't know too well or feel uncomfortable around, I tend to be very quiet. Since I've started this work placement, I've often gone to lunch by myself instead of going with the rest of the interns, I thought this was because I liked being alone but I'm realising that maybe it's because I am quite quiet around them and can't seem to really form much of a connection. There are other examples I can give as well. This was just hard to accept and surprising to me because I've always felt very sociable, I've always enjoyed going out with friends etc, but this seems to be more the case with people I've known for a while or certain types of people who I feel more comfortable around etc. So, I suppose I have social anxiety but it is limited to certain settings..

Anyway, I spoke to a therapist on Monday, she suggested a book by Gillian Butler which I've started reading (Overcoming Social Anxiety and Shyness) and mentioned the obvious - that I need to face the fears, own the anxiety and do whatever it is I fear anyway. She also mentioned mindfulness meditation which I've also started looking into and said that if I find that these don't help much, we could consider beta blockers but they're probably not the best idea because they don't solve the problem, they just mask it and once I stop using them it is likely to come back. I agree with her that beta blockers at this stage probably isn't the best approach, I think I can overcome this naturally.

I do however have a big meeting tomorrow with a very senior person, my manager and two teammates which I'm quite anxious about as I will be showing my work and I will need to talk about what I've done and give a demo as well. I don't feel 100% ready at the moment.. I've tried preparing myself mentally but I still do get the occasional thoughts which just tell me I'm going to screw up. Any suggestions/tips for tomorrow would be great.. Thanks!

9

Thanks sarah, sorry for the late reply, I've been thinking about the issue and I've sort of realised that although I had always discarded social anxiety as being a possibility, I am now almost certain it's that. Thinking about the past year or two, I've realised that a lot of my behaviour and thoughts match the behaviour and thoughts that a socially anxious person might have. For example, when I'm with people I don't know too well or feel uncomfortable around, I tend to be very quiet. Since I've started this work placement, I've often gone to lunch by myself instead of going with the rest of the interns, I thought this was because I liked being alone but I'm realising that maybe it's because I am quite quiet around them and can't seem to really form much of a connection. There are other examples I can give as well. This was just hard to accept and surprising to me because I've always felt very sociable, I've always enjoyed going out with friends etc, but this seems to be more the case with people I've known for a while or certain types of people who I feel more comfortable around etc. So, I suppose I have social anxiety but it is limited to certain settings..

Anyway, I spoke to a therapist on Monday, she suggested a book by Gillian Butler which I've started reading (Overcoming Social Anxiety and Shyness) and mentioned the obvious - that I need to face the fears, own the anxiety and do whatever it is I fear anyway. She also mentioned mindfulness meditation which I've also started looking into and said that if I find that these don't help much, we could consider beta blockers but they're probably not the best idea because they don't solve the problem, they just mask it and once I stop using them it is likely to come back. I agree with her that beta blockers at this stage probably isn't the best approach, I think I can overcome this naturally.

I do however have a big meeting tomorrow with a very senior person, my manager and two teammates which I'm quite anxious about as I will be showing my work and I will need to talk about what I've done and give a demo as well. I don't feel 100% ready at the moment.. I've tried preparing myself mentally but I still do get the occasional thoughts which just tell me I'm going to screw up. Any suggestions/tips for tomorrow would be great.. Thanks!