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.

What Is Paruresis or Shy Bladder Syndrome?

“Paruresis is the inability to use public restrooms without any medical cause. Paruresis may also be known as urophobia, shy kidney, shy bladder, or bashful bladder syndrome (BBS). Paruresis is found in both women and men of all ages and when severe and untreated can lead to medical complications. “

I am not sure if this is worse in men than women as men often have to stand next to other men at urinals if there are no cubicles free. On the plus side when out and about men can pee in bushes and behind trees. I can use cubicles virtually anywhere but as men’s toilets often only have 1 or 2 and often they are out of use then going to the toilet can be a real problem and create more anxiety. I have never been able to pee standing up next to other men. Occasionally if the toilets are empty I can pee before anyone comes in but if there are other people around then I find it impossible.

The worst paruresis experience I ever had was when I went to a Bruce Springsteen concert a long time ago with a family member. First we went on a coach which took 2 hours. Then as the concert was at a football ground the toilets were absolutely full and the one, yes one cubicle was being used with yet more people waiting.  The concert then lasted over 4 hours and then a 2 hour journey home again. I desperately tried to wet myself as I stood in the crowd to relieve my discomfort but could not. I dont remember a thing about the concert as my bladder was my primary concern. Although I survived this put me off going to such an event ever again. I cant see any cure as they dont make any allowance for standing up next to other men pissing compared to being in a cubicle which I can do anywhere.

A Sunny Friday Afternoon Indoors

I took another sleeping tablet last night and did not get up until about midday. I still feel groggy and have  been having head pains and feelings of slight unreality again as if I am about to have another dizzy experience at any time. I can see my isolation getting worse in many ways but I honestly dont know how to deal with depression and hopelessness. If I go to the doctor then they might give me some meds. However as said before there is a 18 month to two year waiting list for therapy on the NHS and it mostly tries to get you to just go out and do stuff again assuming that you did stuff before. See above video. Immediate solutions as mentioned by Katie above have no long term benefits without a solution to other problems such as chromic social anxiety and long term unemployment. Having social anxiety means I never went out and did anything in the first place anyway so I have no hobbies to return to.

It unusually warm and sunny on the UK today for May and its over 80 degrees and yet the idea of walking the streets of my home city are about as appealing as being kicked in the nuts. I dont like getting hot and sweaty and everywhere is crowded. So the above advise is shit and does not work. Just getting out and promising it will make you feel better is a complete lie. It would require a complete overhaul of my entire life and making friends with good like minded people. Yet of course if there is something wrong with you the vast array of normal people dont want anything to do with you anyway. I have an idea than most therapists would give up on me and tell me to go away as its too late now.

Just Smile!

I walked down the street the other day wearing dark glasses and a peaked baseball style cap as normal. It was at least sunny and warm. As I live in a busy city there were lots of people coming my way, many making their way home from work or studies as there is a university not far away and it was past 4PM.

All I could kept thinking about was is it normal to make eye contact with strangers or even smile at them on the street? I say this because its yet another of the so called simple exposure tasks for social anxiety I have read about online. What is the etiquette considering I am single man in my forties?  There was absolutely no explanation about the rules of engagement. Some men are aggressive and in gangs and would see eye contact as a challenge.  Smiling at young people sounds a bit creepy to me like you are after something or fancy them especially younger women.  Do strangers really smile at other people on the street in a busy city at all and why the F**k would I want to. How many would smile back or even think I was insane?

Its yet another moronically stupid peace of advice for anxiety which would claim to be quite a normal thing to do and see me as highly negative or irrational for daring to object and yet in reality could get me attacked, abused or thought of as being even stranger than I am already. Perhaps the therapists who invent this crap all live in peaceful idyllic towns in fantasy land where everyone is friendly and kind. Perhaps they think everyone with anxiety is 23 and attractive also.

To make me feel even more negative I also read this on a forum from someone with social anxiety this morning on CBT therapy.

Professionals often set a very high bar for you, then really do lay into you when you can’t reach it – blaming you for everything and then in the next breath genuinely wonder why you lack confidence.

It sounds staggering doesn’t it? Kind and supportive environment my arse! There are just so many people online who claim to have had terrible experiences with NHS therapists and also their doctors who appear to think its their God given right to get annoyed and irritated with patients who dont recover with therapy or dare to go back for more help. Someone only last week said their doctor was looking up social anxiety on Wikipedia as they had never even heard of it.  Yet every single website and doctor on TV tells you to see your GP immediately as if there is fantastic help available and almost immediately.  Don’t suffer alone! Go to your GP and get told off like you are a small child!

Is CBT a scam?

‘Extensive evidence’ shows that two years on, depressed or anxious people who had CBT were no more likely to have recovered than those who had no treatment, said Oliver James, chartered psychologist.

After 5 to 20 sessions those with anxiety or depression appear to recover, 2 years later they are no different to those who had no treatment, he said. ‘As a treatment, rafts of studies have shown it to be ineffective in delivering long-term therapeutic benefits to patients with anxiety and depression.

So I am still trying to convince myself if going to the doctor would actually be a good idea. After all will it really help me find a job when I have so many other problems?  Putting yourself through up to 20(much less on the NHS) weeks of intensive exposure with resulting stress and then when you are on your own again it all goes out the window is not great to hear. I just read someone had to wait 18 months for CBT for depression on the NHS so it can take ages to even get started.

In the short-term, 40 per cent of those who complete a course of CBT, typically five to 20 sessions of up to an hour, are said to have recovered. CBT appeals to politicians and NICE because it is quick and cheap

Only 40%. I thought it was 75%.  Less than half is an appalling success rate. But dont forget some people say “There is loads of help out there, dont suffer alone!” There isn’t. Its a lie and in reality a tremendous struggle to even get the right help or find anyone. Time to start praying to God again.

Too Negative( Again?)

Many of my posts(probably my entire blog!) would just be dismissed as  being too negative and the ravings of a mad man but I admit to being depressed so of course I am negative. Being a 40+ long term unemployed virgin in the modern world sort of makes you negative strange as it may seem! Getting annoyed or even angry at this attitude as some people do surely shows a total ignorance or stupidity of mental health even by many professionals many of who have never experienced it themselves so have no idea of the anxiety and misery created. As an example I would quite literally choose death right now rather than do some social exposure situations I have read about.  You can’t bully positivity into someone just as me doing three positive affirmations every day doesn’t work at all. My mind knows its all a lie and not real.

The idea that I would willingly volunteer my most feared social situations and then choose to engage in them with humiliation almost guaranteed when in this mood is almost ridiculous and if it makes me feel that there really is no help then it must be true for many other people as well.  There must be so many people who look online for help and then see that CBT is not doable and so never see their doctor. Relaxation techniques and mindfulness would be about as useful in helping as being told I was going to be burnt alive the next day but if I did them I would get a nice nights sleep first!  Being told the only way out is to do all the things you fear the most is like having the last glimmer of hope extinguished.  They then try and make out you are a coward if you dont try while totally ignoring that your anxiety was caused by other people and that most normal people dont have to go through any of this and still get a decent job, a partner and have kids!  Humiliation is  a massive motivating factor in recovery and self esteem and just because I dont get physically attacked has no positive consequence whatsoever. In fact when I think back to many humiliating events in my life i would have much rather been punched in the face repeatedly than called a zombie and mental and laughed at behind my back as I was at work.


More thoughts on therapy

I am still confused about possible help for someone suffering depression caused by life long social anxiety. Treatment for anxiety centres around doing awkward social exposures and hoping the patient gets better through practice. Yet exposure therapy demands motivation, optimism and commitment. It ignores depression which creates hopelessness, negativity and absolutely no motivation or optimism and also the inability to make pleasant small talk or even care any more. For instance how the hell are you supposed to make small talk with a stranger about the weather or anything when you feel and talk like a zombie and see no hope for the future?

Treatment for mild to moderate depression seems to centre around making the patient more active and engage in previous social activities which ignores the fact the patient may be isolated, never goes out and has no friends as they have had long term socially anxiety. I simply dont see how they make the patient optimistic and then motivated enough to engage in exposure therapy without them transgressing into depression and negativity at the inevitable failures. Keep stating how much hard work is involved does not help in the slightest and is much more likely to result in non commitment or refusal to even enrol in therapy.

Despite so many people stating that age does not matter and that it is never too late I wonder if therapy is much more beneficial to people under a certain age and pretty much useless to older people and once feelings of suicide are starting to emerge. Also if living conditions are not especially good with sleeping problems and alcohol dependence then perhaps therapy is of minimal use. Exposure therapy is of no use whatsoever if the therapist can not convince the patient to even take part in the first place as it appears so overwhelming.