Comorbid anxiety with depression

“Comorbid anxiety with depression predicts poor outcomes with a higher percentage of treatment resistance than either disorder occurring alone. Overlap of anxiety and depression complicates diagnosis and renders treatment challenging.”

Although depression is a common secondary disorder for people with long term social anxiety I am always surprised that in the vast array of online help I have read that depression is almost always ignored as if completely unimportant. I was first thinking of suicide in my teenage years and have had feelings of chronic misery and hopelessness regularly ever since so some kind of depression has always been there although it was mostly melancholy due to being always alone and society labelling me as a freak. Hardly surprising considering my lack of sex,relationships, friends and no job although i did do 20 years in a manual job I mostly hated which did not help my mental health or get me to be more social. My 20 years of work equates to about 4800 days or 38,000 hours and still it did nothing to rid me of anxiety. Must be all those avoidant strategies and safety behaviours I used otherwise known as being shy! The cure to shyness- stop being shy!

So expecting me to approach strangers and make pleasant conversation tomorrow is about as likely as expecting the neighbours pet Labrador to do so although obviously most dogs get on far better with strangers than me. Maybe I should become hairier and start licking people. Lack of motivation is hardly surprising as age really does matter and older people are much less likely to succeed as most people are ageist and opportunities are much less. They also seem to think that depression is only temporary because of a sudden lifestyle change or event and that you can go back to where you where before which was relatively happy if you just start doing stuff you used to enjoy. Of course I have never been relatively happy for long even as a child and never really did anything or went anywhere anyway as I had no friends. I cant seem to do anything while feeling this low and I feel this low as I see absolutely no hope for the future. As a result I am becoming even more avoidant and leaving the house far less than before.

I think I always knew it would end up this way even way back at school as the sad lonely boy who never spoke much in class although due to everyone being more optimistic and assuming I would just grow out of it I still imagined something good would just sort of happen. It didn’t. Then they blame you for not doing enough which only increases your guilt which makes you want to die even more.  At the same time they say you must learn to love yourself.


The “Passengers on the Bus” go round and round.



In acceptance and commitment therapy(ACT) they sometimes talk about the passenger on the bus metaphor and this role play supposedly illustrates how your negative thoughts influence your mind.etc etc.  Look at how enthusiastic every body is! Look at the positive comments on Youtube! Yet it makes me feel like vomiting and would certainly put me off doing this kind of therapy even if it was free and available tomorrow. Is this even any good for people with anxiety and especially social anxiety?

I cant imagine doing any role plays or exposures in my present state of mind.  I would just follow him around sort of mumbling and looking awkward as a passenger and giving no feedback whatsoever as I would not care or notice.  They might as well ask me to do a song and dance routine although considering some of the crap I have read about social mishaps I would not put that past them. Its as if in every one of these kind of videos the people say exactly what they want to hear instead of what would really happen as they are all hyper motivated. Would meds change my motivation? Perhaps a lobotomy would be better then at least I would not care any more.. I think this is why 9 out of 10 people with social anxiety dont go for help unless they are forced to and why they think CBT and other sorts of therapy are quite successful as only the motivated and enthusiastic people even do it. What therapy is there for negative, depressed and unmotivated people with social anxiety?


If you feel the way I feel

How self help sites and therapists seem to expect you to feel when looking for or doing things to fight your anxiety.

How you really feel.

“Oh I must go out and smile at total strangers on the street, engage in witty banter with shop assistants on the weather every single day without sounding mad or boring and approach attractive women and ask them out even though I have not worked in 28 years and make strange squeaking noises when I speak. That’ll cure me!”

Reality Check

“A common approach shy individuals will take to overcome their anxiousness is take on some big social challenge like going to a single’s bar or walking up to a model-esque woman and striking up a conversation. The problem with this approach is that if you fail to smoothly socialize, you just reinforce the narrative in your head that you’re shy and awkward, that you can’t change, that socializing is threatening, and that the only way to get rid of those threatening feelings is to avoid socializing altogether.”

Yes, now imagine getting that reaction when just trying to speak to a cashier at Tesco or even ordering food or a drink at a cafe and then hearing that these events are supposed to be the easy ones on a hierarchy list.  Thats why everything I do has reinforced my negativity and pessimism even more. I am still trying to find things that I would or could do that would be easy. Remember very shy people dont even get invited to parties so we dont get to choose. Shy, very shy or painfully shy? There seems to be a huge difference which is totally ignored. Then also add depression into the mix.  Perhaps they need different types of treatment for different levels of anxiety. Some hope.  The NHS often shoves people with different types of anxiety into the same group therapy regardless as its cheaper.

“At least once a day I want you to do something on purpose that is just outside your comfort zone. Things that count as being just outside your comfort zone are usually things like: saying one “small talk” sentence to a cashier, calling a relative, inviting a friend to a movie, putting a status update up on Facebook, saying the word “hello” as you walk by a stranger on the street.”

You see here we go again. Speaking to a cashier is 10/10 for avoidance for me. They also always ignore etiquette as if it is obvious what to say when speaking to different people such as male or female, young or older and what is appropriate to say to each may not be the same to the other.  And the most obvious one of all. If I am nervous I COME ACROSS AS A TOTAL MORON. People often dont understand me, I say inappropriate things or  my voice is so weak they cant hear me. All common for shy people and yet all ignored totally on self help sites.

I also dont have any relatives I know at all, my one and only friend lives in another city, I dont use Facebook as I have no friends and would not want people I used to know from work to contact me as I have been unemployed for many years and saying hello to strangers on the street I still find absolutely ridiculous as strangers dont speak in city centres.

Humiliation Guaranteed

After several days of waking up early I relented and took a sleeping tablet again. It worked as I did not get up until 10.30 but of course it made me feel groggy all day. I wonder if they also affect my moods as I have quite an overwhelming urge to self harm again although that could be as I was looking at self help sites on social anxiety and they always make me far more depressed as they never ever offer any hope or way out without a long painful struggle with humiliation guaranteed. YOU MUST DO THE HARD WORK OR YOU ARE A COWARDLY CISSY WHO DESERVES TO SUFFER!  I could do hard work after 20 years in the same manual job easily. However hard work is not acting shy and being ridiculed endlessly in the hope of getting used to it. Did people who were beaten ever get used to it?

I come across things all the while. Like the advice of making conversation with a co worker on Monday and telling them about what you did at the weekend.  I spent virtually every weekend for 20 years watching TV and maybe later doing some gardening. I never did anything or went anywhere as very shy people dont have any friends or do anything. There’s lots of advice like this and even though you have social anxiety and its so bad you have gone for therapy still assumes you have friends and go out and do things like normals all the time.Makes me think again if therapy is really for people with moderate shyness and anxiety and that they still have no idea of what very shy is really like.

However I really want to find out how they treat social anxiety and depression combined which I think is quite common. If they make no account for a depressed state of mind although I have no motivation and still expect you to do normal CBT exposures for social anxiety then I think they really have no idea and no one has even bothered to do any research into it yet. Considering some British doctors have not even heard of social anxiety and have to look it up on Wikipedia then nothing would surprise me.


So here is a video from the private therapy clinic in London on social anxiety I saw on YouTube. I know its on about avoidance strategies but I think its interesting that at one point she brings in another person and says “Talk for 2 minutes!”  Of course she does fine and that’s the point but it also begs the question that do some therapists and so called experts have any understanding of crippling social anxiety at all?

I say this because I have seen videos on group therapy and they just expect people to speak on random subject for so long or for homework approach strangers and make random conversation as supposedly easy tasks. As said previously perhaps only motivated people who have recovered to a certain point are even able to go to therapy and in which case why would I go to the doctor for help if the therapy demands a certain level of recovery before you are even able to try doing it.

You see, just bringing in a stranger and demanding conversion on a random subject may even now have me completely struck dumb and my brain freeze up entirely. This often then creates the classic nightmare of blushing and sweating and a full on anxiety attack.  The thing is I am better now than I used to be. When I was in my twenties I blushed, stammered and had anxiety attacks almost uncontrollably and especially around attractive girls so even the most basics of simple conversation were excruciatingly awkward and any coherent sentences close to impossible due to the physical manifestations of shyness. Speaking to a girl I liked and assuming I would really be OK or that no one would notice(IF ONLY THAT WERE TRUE!)was not even close to my reality.

Of course I was F**king avoidant! The humiliation was so intense I was contemplating suicide and punching myself in the head while sitting in the toilets! Can you imagine the embarrassment of acting like that in front of girls and other people ridiculing me which as I was in a crap manual job full of blokey ignorant young men was a common event for anyone even slightly different. What the flying F**K is is about intense humiliation that therapist dont get? Is it just because they have never experienced it themselves? You would do ABSOLUTELY ANYTHING to avoid it.  So the idea you go to a therapist and deliberately make a list of your most anxiety inducing situations and then agree to go and do them is not even a remote possibility for many people.

And then if you do go and force yourself to speak to people they assume things are usually much better than you imagine is yet more absolute lies.  Avoidance may not be the answer but neither is extreme humiliation which traumatises you for years. When I watch all these experts and read the self help books they never seem to even consider that anxiety can be this bad and that exposure therapy is a straightforward task to recover from if you just practice hard enough. I wonder if they have ever even treated somebody who is really cripplingly shy.






A million to one he said

I actually got to the stage where I was about to visit my GP for the first time ever about my anxiety. This  apparently often happens  because of something else which in my case is depression which has meant that I have become so avoidant I am only leaving the house to shop at Tesco and have given up doing everything else. However I made the mistake of looking online at all the types of treatment available.  Sounds reasonable? However realistically many GP’s dont even offer therapy for older people with anxiety and depression and just hand you a leaflet. Great, that will cure me!  Then there is about a year, yes one year sometimes even 18 months to wait to get therapy on the NHS. And finally……….. I have read the UK anxiety forum and lots and lots of people who took therapy for social anxiety said their therapist was a complete moron and it actually made them worse or no different at best. Yes, there is loads of help for social anxiety! Online advice anyway, in real life its almost non existent.

Getting help for anxiety or depression in the UK reminds me of the Drake’s equation for the chances of finding intelligent life on another planet. Several million to one or more.There are just so many factors to be taken into account before anything gets done. The next problem is that I have read countless CBT manuals for anxiety online and self help books and they all pretty much say go out and EXPOSE yourself!  No not in a naked kind of way but expose yourself to fear inducing social situations so you get used to them and get better. Then do more harder ones for ever and ever and ever!

I cant even think of easy ones I feel I could try to start of with.

Beginning of the end

As I have been feeling worse than almost any point in my life over the last year I have serious considered going to the doctors. There are just so many self help sites, TV doctors and even people online who advise this for depression and anxiety as if its the first step to certain recovery. Yet with no motivation left at all is there really any point? Will meds make me feel motivated and if not what can? Torture? Shame? Guilt? No, they make me want to die.  I thought meds for anxiety or depression made you feel like a zombie anyway.  Some people even say if you go to the doctor that means you must still have some motivation left. No it doesn’t. It means that there is nothing left at all apart from death and you are deciding which is best. That’s also ignoring that over 50% of people who went to their doctor for mental health problems found the help poor or very poor.

CBT for social anxiety is completely pointless as I would not do exposure therapy under any circumstances as there are absolutely no easy situations. Smiling at strangers or making small talk is a shit idea and makes me vomit. I can just imagine the cringworthy conversations I would have about the weather with shop assistants and the looks of contempt.

Also shy people (usually men) often get looks of contempt from females when they try small talk. Its the law and lets you know that you can just F**k off as you are ugly and a loser so dont even try. Thats because  men making witty banter with women are often trying to chat them up as men know they will die a virgin unless they constantly go round looking for attractive females and initiating conversation.  By contrast if a woman likes a man they sometimes smile and if you are very lucky even say hello. Then they still expect you to chat them up and hate you if you dont. Thats why there are 10 times more male virgins than female.

Depression is also an overwhelming factor and my dire future(and past)is the reason so its not in any way overreacting. In fact many people with mental health problems are committing suicide in the UK right now because the government makes it hard to impossible to claim benefits and does not care if you end up homeless and I have not even tried to claim any benefit yet and am already this depressed. Therapy cant help me get a job can it as no one will employ someone this long unemployed and who cant do stand up manual work. If the job is shit then I wont be in a better situation or be happy anyway even if I can pay the bills.

I am beginning to see suicide as a logical and sensible solution just like the women that drown their own children and then killed themselves rather than let invading soldiers repeatedly rape them to death during WW2. Death is not good but its still better than prolonged torture first and then death anyway. Sometimes there is simply no way out and non existence becomes the best option. After reading extensively for help for anxiety and depression online I have not seen anything anywhere which has given me the slightest hope as it all assumes so much and ignores the obvious. People are almost all judgemental bastards. You have to be one of them in the first place to be accepted or they hate you. Just like using the SAUK anxiety forum.

I think that is why so many people who claim to have recovered (certainly from social anxiety)come across as bastards online as they have developed an aggressive, seize the day! and bullying mindset in order to succeed and then try to bully other people to feel this way which of course does not work with depressed people. Many people who succeed are indeed total wankers. Look at so many politicians and business leaders for proof that being a ruthless, selfish and nasty C**T does not impede your chances of success in life.

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