As I currently have the motivation of a dead rabbit I have switched attention away from treatment for social anxiety to depression. I read that 9 out of 10 people with social anxiety never even go for treatment and when they do its often because of a secondary factor with depression the most common especially in older people. Thats basically me in a nutshell and its my depression that has really kicked in and made me even more avoidant and feeling hopeless almost daily.
“The first step of behavioural activation is to identify several activities that are both easy and rewarding. These will serve as replacements for unhealthy behaviours that may have taken over during a depressive episode. It’s important to be sure that their chosen activities rank highly in both of these categories (ease and reward) to increase the likelihood that clients will be successful.”
Behavioural activation tries to encourage the person to start doing pleasurable things again so they dont sink further into the abyss of despair. They ask what you used to do and enjoyed doing before you became depressed and try to make you start doing them again to improve your mood.
Unfortunately as I had no friends and never left the house to socialise for the last 35 years apart from work due to severe social anxiety my list of activities is very very limited. Most of these therapy techniques assume so many variables. They assume depressed people have a family and support network available, They assume insomnia is in your head and nothing to do with living next to neighbours who slam doors at 2AM and let their dog bark all day. Social anxiety and depression constantly fight against each other in one giant paradox of despair. What? Too dramatic?
If you are depressed they say you should go out and socialise. However if you have chronic social anxiety you have no friends to socialise with and so get more depressed (and alone). Treatments for both ignore the other condition and are not taken into account. Strange considering one in 3 people with lifelong social anxiety get depression.
Apart from going for a walk and sometimes photography while out walking I have pretty much no former enjoyable activities at all to put on a list. Reading? Watching TV, sometimes even gardening are the sort of things i have been doing for many years anyway and I have come to utterly despise walking as I live in a city with ABSOLUTELY SHIT walks available. I am about to go a walk soon. Guess where I am going? Exactly the same place I went on Saturday as there are virtually no other walks I enjoy at all in this city. And its May day holiday in the UK so everywhere is crowded.
The next stage is trying to find if there is a particularly method of treating people who have depression due to lifelong social anxiety. If there is not then as I have said all along there is pretty much no help available unless you already have the motivation and drive to do exposure therapy and I dont. Every time I go to the supermarket now I imagine trying to make small talk to the cashier and them looking at me like I was a strange weirdo or with contempt like some people did at work. I would then have to go to another supermarket entirely and become even more avoidant. Yes, that the reality of social anxiety when paranoid and mad. Exposure only works for me if it succeeds and boosts my confidence, not if it makes people laugh at me because I act like a fool. Not feeling physical pain is not a positive motivation so the flight or flight response and assumption that once your brain realises its not going to get hurt if it stays in the same situation does not work at all. Perhaps some therapists should learn this.