Social Anxiety - My treatment journey

Sarah22nd February 202113 min

If you plan on being anything less than what you are capable of being, you will probably be unhappy all the days of your life - Abraham Maslow

Let me preface this by saying treatment for mental health problems is very subjective. There are lots of treatment options available and what works for one person might not work as well for another. If you try one and it doesn’t work, please don’t give up! Keep trying things until you find something that works for you. 

If you haven’t read about my social anxiety diagnosis you can do so here.


Medication

A Doctor prescribed me Sertraline, a selective serotonin reuptake inhibitor (SSRI) drug. I took one tablet a day for 6-12 months? I can’t actually remember how long I took it for (wow I’m so helpful). It can be normal to get side effects for a couple of weeks until your body is used to the medication & it’s also reportedly normal for your anxiety to get worse at first until your body adjusts. I don’t remember having any side effects. In fact, I don’t remember it doing much for me at all. It’s hard to tell the impact medicine had on me because I combined medication with therapy. I largely credit the therapy for helping me but I can’t rule that medicine didn’t help at all.

I decided to come off it when I’d finished therapy and thought medicine wasn’t making a big difference to my anxiety/life. My Doctor had already told me how to stop taking them safely, so I did this when I felt it was the right time. You can have side effects if you don’t come off them properly, so it’s best to speak to your doctor when you feel it’s time to reduce or stop your intake.

Referral to Therapy

My Doctor gave me the phone numbers of some local therapists to call and refer myself for Cognitive Behavioural Therapy (CBT). I found phone calls very difficult so I googled the places on the list to see if there were other ways to self-refer. When choosing a NHS therapist, I considered the method of referring and their location (eg. is it in walking distance - because I didn’t have a car, nor did I want to spend money on transport). It may also be worth considering their opening hours (eg if you need appointments to fit around your other commitments) and whether they have a limit on the amount of free appointments they can offer. If you have a preference on the gender, religion etc. of your therapist (eg if you are male and would prefer a male therapist), it could also be worth asking the clinic if they can accommodate your preferences.

Once I’d chosen my preferred clinic, I completed the self-referral form on their website. This was quite lengthy and included simple, quick to answer questions and some answers that would take longer and more thought to write. There were general questions about yourself eg. contact details, gender, if you have any disabilities, your first language. It also asked about why you want therapy/ what you want to get out of it, a brief explanation of your symptoms, medication, substance use and questions around self-harm. There were also tests for depression and anxiety. 

After I submitted my referral, within a week they phoned me to arrange my first assessment appointment (I think around a month in advance due to waiting lists) and sent me some details re their location and what to expect at my appointment in the post (you could choose how you wanted to be contacted - via phone, post, email..).

My CBT Experience

My overall experience of CBT was a positive one. I spent my first ‘assessment’ appointment giving the therapist a general overview of my symptoms and what I want to get out of therapy appointments. I cried for the majority of the appointment. She agreed that CBT could help in my situation and we agreed on an appointment schedule (I think it was an hour session, once every week or two). The clinic I went to offered limited appointments (I think 8-10 but I could be completely wrong) to facilitate them helping more people. There’s definitely cons to this, but I didn’t find it limited the quality of my sessions and I felt ready to end therapy when I did.

My therapist helped me challenge my thoughts and think about the situations I found hard in another way. She also taught me coping techniques and practiced them  with me in the appointments. The homework set was never anything that took loads of time and wasn’t a burden. My therapist also helped me come up with a plan for how I would complete the tasks.

At the start of every appointment, I was asked to fill in an anxiety/depression questionnaire. It was great to see my scores improving as the weeks went on - a visual reminder that the sessions were working for me and a reminder of how far I’d come in a short amount of time.

My final couple of sessions looked at relapse prevention and giving me the skills I would need when my anxiety inevitably returned. As there are a limited number of sessions, this feels like the predominant aim/overall achievement. Your mental health problem is most likely not going to be cured after a small number of sessions, you also may not have had the chance to fully get to the root cause of why you feel/act that way. What you will have is more knowledge and skills to deal with your mental health when you find it problematic. Someone compared this to ripping a plant out at the grass - it will grow back because you haven’t torn it out at the root. That being said, we don’t all have the luxury of having enough money to pay for private therapy and regular sessions over a number of years.

Final Thoughts 

At the end of my therapy I was more in control of my feelings and felt more in charge of my emotions. There were things I would still avoid doing, but there were also things I felt brave enough to do, that before therapy I wouldn’t have considered or would have struggled a lot more to do. As the years have gone on I’ve found my social anxiety less and less of a barrier. Fast forward 5-6 years to today and I’m not going to pretend that it’s never an issue, but I do have the skills to recognise when I’m avoiding doing something because of my anxiety and I’m more able to push myself to do those things. I’m not as held back by my anxiety and it doesn’t affect my daily life like it used to. I can’t imagine what would have happened if I’d not had CBT. My life would look a lotttt different and I’d have a lot more regrets.

If you’re weighing up your treatment options, do some research online and speak to your doctor about the pros, cons (and side effects) of medicine and the different kinds of therapies before making your decision. For more information on treatment options, see Mind’s information on drugs and treatments

Courage doesn’t happen when you have all the answers. It happens when you are ready to face the questions you have been avoiding your whole life - Shannon L. Alder

Sarah from Anxious Extrovert x

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