Untangling Mental Health, Part 4: Social Anxiety

Part 1: Depression and Anxiety
Part 2: ADD
Part 3: Apathy

I’m a hardcore introvert. I also worry far too much about what other people think of me. I’m socially awkward to start with and I’m not good at picking up on social cues. Except for some very close friends, every social interaction comes with the stress that I'm going to get it wrong. That I'm going to be judged.

This includes things that you might not consider to be social interactions. Such as calling or emailing a professional service (e.g. doctor’s appointments, asking my landlord a question, etc.). Or sending out a CV.

That last one is terrifying.

When we were dealing with infertility, we went with IVF over adoption. There were multiple reasons, but one was because adoption would mean filling out an application form and letting unknown individuals judge my worth. With IVF, I only had to worry about dozens of people seeing me naked and shoving medical equipment up my vagina. So much easier.

There’s no way around the Panel Of Judgment for a job though. I do have to send out my CV, and I have to psyche myself up to it each and every time. There’s an episode of Friends where Rachel sends out something like 100 CVs in a day. Do normal people actually do that? I’m doing well if I get out three, and then I need to go and do something else to take my mind off it.

At the start of summer, I tried signing up for LinkedIn, but that was even worse. I was filling out a career profile for everybody to see: not just strangers, but people I knew. Acquaintances. I lasted a few hours before I attempted to switch my profile to private. Three months later, I'm still getting daily emails telling me how many profile views I've had and asking if X, Y or Z (who I emailed once) is a contact.

LinkedIn has become a very personal nightmare, and I've not had the nerve to go back to the site since July. I'm pretty sure an inactive profile is worse than no profile, and I should probably just delete my account, but that would mean facing back up to it, and I don't want to. Procrastination and inertia again.

(You might wonder how I can be so panicky about being judged and yet be so candid on a public blog. This blog was partly built as a way of facing up to that fear, but it's also a freeform expression where I can explain myself as fully as I need to. Besides, I'm well aware that my explanations lead to a Too Long; Didn't Read reaction and that's a shield in itself.)

On the whole, I don't actually mind what strangers think of me. And I have faith that most of my friends know and love me enough to deal with my flaws. The difficult part is the swathe between friends and strangers. The acquaintances... from the Mums in the school yard, to our vets, to the people I'm reaching out to with my CV. The ones where I don't know if they like me but I do have to interact with them.

Problem: Isolation

The stereotype of the introvert is that they prefer being alone, but that's false. I like some solitary time, particularly when "my head's full" as I describe it, but I also thrive on company. Humans are evolved to be social creatures and I'm no exception. It's more accurate to say that as an introvert, I don't want the spotlight and I can get tired out trying to sustain a conversation, but I'm often happier watching other people than I am being alone. Living alone has always been a recipe for depression.

Since having the kids, I've craved adult company, or more accurately, social interactions that I don't have to be switched on for. Social interactions where I can let somebody else be the driving force and just go along for the ride. One of my biggest regrets from my marriage is how often I told my husband that he should go out while I sat at home to save the cost of a babysitter. It made me more depressed while convincing my husband that I preferred staying at home to doing the things he enjoyed... to doing things with him.

Once my husband left and I could no longer fool myself that he was filling that social gap for me, I became more conscientious about going out regularly if not frequently. I built up my own support network of friends who were happy to take the social lead. Going out with them built up new self-images for me: I like doing this; I am somebody who does that.

I lost that support network once I left the States. My old insecurities have started hitting hard again, and I find myself spending too much time in my own head.

Solution: Make friends.

The problem I have with building up a new support group is my inability (or insecurity over my ability) to read social situations. That and my social anxiety makes me reluctant to open up to people. How do I know if I'm over-sharing? How do I know if they care or are just being polite? How do you transition from acquaintance to friend?

This has a heavy influence on how I use social media as I often find it easier to broadcast rather than address a specific person. I make a comment or ask a question on Facebook, and only people who are interested will respond. I can pour my heart out in this blog, and anybody who doesn't want to deal with my navel-gazing can ignore it—yet sometimes it resonates with people who I wouldn't have expected to be interested in my ramblings.

That doesn't help me figure out what's appropriate to dump on the neighbours or the Mums in the school yard though--especially when I know they don't need me as a friend. They have friends and commitments already. They don't need to take a depressed person on board. That's my insecurity talking, but it's not false either.

Oddly enough, I find it much easier to get a date. The beauty of online dating apps is that the intention (if not the finer details) is pre-set. We matched because we are interested in each other and we're talking because we're looking for a date. I'm less concerned about asking questions or bringing more complex subjects up, since a date pre-supposes that we want to get to know each other and our respective values. I can be less afraid of causing offence.

Solution 2: Get a hobby. And make friends.

This is something else I've been procrastinating on, partly because it would involve researching some sort of club ahead of time and making contact. I'll keep on saying "I must look into that," but in practice, it probably won't happen until I've cleared up a lot of the career research and contacting.

Full disclosure, I will make friends eventually. I know all the neighbours to some extent, and there are a couple of Mums who also often walk down my route to the school. One of those Mums, in particular, I feel like I'm clicking with. It's just going to take me some time to get a proper social circle again. Until then, all my social engagements will be with my parents, my children or a date.


And that effectively concludes this series on my personal mental health situation. I could go on, I could cover a dozen of the idiosyncrasies that make me my dizzy, impractical self, but Depression, Anxiety, ADD, Apathy and Social Anxiety are the broad strokes of why, almost four months after I moved, I still don't have a job or friends.

All of this is an explanation. It's not an excuse. I'm not trying to get out of doing this. I'm not asking for somebody else to do it for me. (Though if you do have a magic wand solution, I'm all ears.) I will get there, I'm working on it... but this is why it's going to take so much time.

Untangling Mental Health, Part 3: Apathy

I swear I didn't plan to wait three days before posting the blog about procrastination. That was not deliberate! But appropriate, nonetheless.

Part 1: Depression and Anxiety

Part 2: ADD

Apathy is the most tangible and poorly justified of depression symptoms. There's a lot of stuff I haven't done simply because I don't want to. I need to do it. But I can't bring myself to do it. It's procrastination on a chronic level.

• A fraction of this is simple procrastination. I'd rather be doing something else, so I do something else. This is totally normal (and this is why the blog is three days late.)
• Lack of motivation is also a minor factor. What's the point in doing something? This is the classic not-getting-dressed symptom of depression.

Neither of these are the real culprits in my situation. The second one sometimes affects self-care tasks, like meals or showers, but most of the things on my to-do list have a very obvious point, for the children if nothing else. 

• "Planning how to do things is as good as doing them." This is an absurd bit of illogic, but I was in my mid-thirties before I realised that this is exactly how I operate. I work out the hows and whats of a particular project and get a sense of accomplishment that mentally ticks off that task. I have to be really careful to make sure that it doesn't then go onto the backburner indefinitely.

This may be an ADD thing. It's certainly an ongoing issue for me, and a significant problem. But it's still not the main contributor to my apathy...

• Every task has inertia: the bigger (more important) the task, the harder it is to get started. The longer I put it off, the more self-loathing I have for not doing it. The more self-loathing I have, the bigger deal it becomes. The bigger a deal it is, the more afraid I am to tackle it. Ad infinitum.

This is a classic way for my anxiety to manifest. Almost twenty years ago, I had a nervous breakdown while attempting a high school teaching career. In theory, every evening, I would mark work, plan lessons, etc; in practice, I would spend up to two hours staring at my folders and weeping before I could bring myself to start work for the evening. Unsurprisingly, I failed to keep up with the workload.

Thankfully, I'm not in that state now, but because I've been so overwhelmed by the workload this summer, I've focused on the house and put off the job and friends part of the to-do list.

The job in particular has now been blown totally out of proportion in my mind. On the one hand, it feels like such a grotesque privilege to not have to get a job immediately; on the other there's a social stigma attached to not working, particularly an unemployed woman who is having a man provide for her. Oh, and that man is the kid's father and we've already covered the issues surrounding him. 

Being unemployed is an ever-increasing blow to my self-respect, to the point where it's almost impossible for me to address it because of the associated anxiety.

Solution 1: Keep calm and carry on.

I don't need to feel guilt over having financial provision. 

1. The wisdom is not to count on a spouse to support you forever, in practice, it's difficult to prepare for both eventualities: the failed partnership and the successful one. In supporting my husband's career and caring for our family, I effectively reduced my income capacity. It is entirely fair for my husband to provide for me as I make the transition to being the primary earner for my household. to our changed circumstances.
2. I'm earning my keep. I'm raising the children full-time, and that means I'm still reducing my income-capacity for the sake of my family. Put very cynically, I have freed their father from all the impacts children have on your lifestyle, but I continue to enable his relationship with them. (Obviously, this was not his intent and certainly not his wish, but it is a result of our circumstances.)

I also don't need to feel unreasonable guilt over procrastinating here:

• As I have a form of income, the greater priority is to establish a home for my children and get them set up at school.
• I haven't totally procrastinated. I signed up with a recruitment agency and sent my CV to a handful of local nurseries in the hopes of getting lucky without having to invest a lot of effort and time that I didn't have. I did not get lucky.

I've been telling myself that for a month, with limited effect. 

Solution 2: Finish everything else first.
 

Last week, I ran out of relocation Things To Do. Oh, there's still a few odds and ends to finish up, but I suddenly realized that there wasn’t anything hanging over me and causing stress. That stupefied me for a day or two, then on Thursday, I woke up and decided to sit down and look into the job. And I did.

In other words, once I eliminated other stress factors, I felt prepared to tackle this mammoth source of anxiety. Simple solution... but there were over two months of "procrastination" before I could put that solution into effect, and I'm lucky that in this instance there was a natural endpoint to the other stress factors.
 

I've got a multi-year career track to figure out and that's going to take me a lot of time and research, so the job is a work in progress, but it is in progress now. I’ve got some momentum going. I just have to be aware of the hurdles still ahead.

Coming soon... Social Anxiety.

Untangling Mental Health, Part 2: Attention Deficit Disorder

Part 2 of a series of blogs breaking down my mental health issues. 
Click here for Part 1: Depression and Anxiety.

Attention Deficit Disorder is something I've known I had since my teens at least, but I wasn't officially diagnosed until last year when I started therapy. Until then, I'd been in denial about just how much it impacted my life.

 Poor attention span is what we think of with ADD, but it's a lot more than simple inability to focus. (I can focus sometimes... It's involuntary, but I can get wholly absorbed in some things to the point that I don't register what else is going on around me.)

• Difficulties focusing make me slower at a given  task than most people.
• The effort of focusing is tiring, which means my productive periods are short.
• Distractions mean that I leave a lot of things half-done and forget to go back to them—an inability to keep the house tidy is a sign you might have ADD.

Then there are the short-term memory issues. Again, I have a fantastic memory in many ways, but with day to day activities, it's as if my brain sometimes stops filing things away.

• I regularly lose things that I had had in my hand just moments before. (I'm pretty intense about having specific places for things and building up a habit for leaving them there.)
• I'll walk into a room or open a cupboard and be unable to remember why. Sometimes, my brain sort of hangs up at that point, and I'm just standing for minutes at a time, trying to figure out what I'm supposed to be doing. Those are the times it’s not just frustrating, it’s scary.

Solution 1: Mitigate the Aggravating Factors

There are ways to live a more ADD friendly lifestyle… But they’re very much of the easier said than done variety.

• Get enough sleep: I have always had sleep issues and being tired doesn’t help my focus. Power naps resolve the midday drowsiness, but stress triggers the insomnia. The cats also disrupt my sleep overnight, but I do go through phases where I sleep well. Those are awesome.
• Fresh air and exercise: Natural light is always good for your brain function, and thankfully we do get a lot of light in the living room and kitchen. Actually getting outside is even better. It's a ten-minute walk to the kids' school, and we do that every morning and afternoon, even in the rain. Thank god they haven't protested, because it's probably doing a lot to keep me sane.
• Remove extra distractions: I like having company, but if somebody is doing something else, I struggle to stay productive. It doesn't matter if they're not engaging me, and it doesn't matter if I'm not interested in what they're doing... my brain is staying aware of them. Managing things so the children can help rather than hinder me is a parenting skill I'm trying hard to acquire.
• Keep things uncluttered: it's both a lot easier to see what's out of place and it's easier on the over-stimulated mind. This was a big part of why August was so horrific… boxes everywhere and I didn’t know where to put or find anything. I did eventually clear all the boxes, but I still have children, so clutter is a rollercoaster-style issue.
• (I know tidy kids exist. I don't have tidy children because they don't have a tidy mother because she has ADD.)

Solution 2: treatment / medication
After getting diagnosed, I tried a couple of different medications before settling on a low dose of Adderall. It's not a miracle cure (there isn't one), but it made a world of difference to my productivity. It also largely solved my sleep issues—insomnia at night and intense drowsiness in the middle of the day—I'm not sure if they're a result of ADD or if the stimulant properties of Adderall effectively regulated my sleep pattern.
 
Problem 1: Adderall is illegal in the UK. (Bringing in a few months' supply for personal use isn't a problem, but a doctor can't prescribe it.) So I'll have to find a different medication which will require a period of trial and error. I have yet to start that because of...

Problem 2: My diagnosis in the US isn't recognised here. In the States, I could be diagnosed via a self-assessment form, but that wouldn't be acceptable in the UK. I need to be referred to a psychiatrist. I tried to start this process in June, but I never heard back about the referral. I've since changed GPs, and I have another appt next week to again ask for a referral.

These sorts of administrative setbacks put the onus on us patients to self-advocate and keep pushing for diagnosis and treatment. Unfortunately, mental health issues tend to make us bad at that. I'm ADD, so I'm getting distracted by the sea of other things I have to do with The Move. Depression / anxiety issues make me fear that the doctors don't believe me, that they're judging me, so I dread having to explain myself and put off making that call, making that appointment....

Oh, look, we've reached procrastination....

I'll talk about that tomorrow.

Untangling Mental Health, Part 1: Depression and Anxiety.

It's World Mental Health day, and my own mental health has been a big issue ever since the breakdown of my marriage. Over the past two years, I've seen firsthand how mental health issues feed into each other and how the obvious solutions are never as straightforward as they seem.

I wanted to write a post unpicking my own mental health... the issues I face, the factors that contribute to them, and the effects they have. But that very quickly ran insanely long, World Mental Health Day is almost over, and I'm not going to help my own mental health by burning the midnight oil to get this completed.

So I'm going to run this over a few days instead. I'll start with the one that needs the least explanation:

GRIEF

Everything relating to my children's father continues to be one massive fallout zone of depression and anxiety. It's been almost two years since he left me, and the half-life of these emotions remains unknown. Fortunately, the panic attacks are much reduced, but the anxiety still triggers other issues, such as insomnia and ADD. I have bouts of crying, almost at random, but the more insidious effect of depression is on my self-esteem.

Solution 1: Avoidance
I've put figurative biohazard tape around the entire area of the kids' dad. I don't talk to him more than I can help, I don't ask about him, I don't talk to other people about him.

... Except my children. I kind of have to, even if they're emotionally intelligent enough to avoid the subject. And, obviously, they have to continue seeing their father. They Facetime him every night before they go to bed. He and I have to coordinate about things relating to them, including him visiting.

Inevitably, he's going to remain an ongoing presence in my life, so I still have to deal with the results of those emotions. 


Solution 2: Get on with my life
As devastating as the failed marriage is, there are many other aspects to my life. If I invest in these, they should flourish and overwhelm the negative emotions associated with the kids' father.

Our particular situation was the problem here: we were living in a country where I didn't have a work permit and would lose my visa in the event of a divorce. (Our plan had always been to return to the UK and raise the kids there.) I couldn't just get on with my life because I had to scrap it and start over: no marriage; no home; no job; no friends.

The last three have been my to-do list since The Move in June. I thought I'd be able to have them well under way by the end of summer. I wasn't even close.

In part, I underestimated how much needed to be done once we reached the UK; In part, I underestimated how much my ADD would slow me down. I'll save the elaborations on that for Part 2.