Author

freudandfashion

I'm a newly graduated psychiatrist who believes it's stylish to talk about mental health. Welcome to my diary, Freud & Fashion, created in 2010 to document my life as a psychiatrist-in-training and share knowledge and psychotherapy pearls that I learned along the way.

Psychiatry therapy

Termination Point

written by freudandfashion

Saying “goodbye” can stir a variety of emotions including sadness, anger, and relief. The whole experience can feel quite uncomfortable, so is it better to say “goodbye” or to say nothing at all? Clearly, the more thoughtful and courteous action would be to leave with at least some type of acknowledgement (a wave, a handshake, the verbalization of “goodbye,” etc), though it might be less anxiety-provoking to slip away unnoticed.

In the context of terminating treatment in Psychiatry, there are various reasons why treatment between the psychiatrist and a patient may end:

a patient wishes/chooses to end treatment
the psychiatrist gets a new job, retires, or leaves the practice
the patient changes insurance plans
the patient moves
the psychiatrist passes away

For the sake of this post, I will focus on what I’m currently experiencing — saying goodbye to patients due to a new job. In this situation, the ending of treatment is not the patient’s choice, which can stir a combination of emotions such as abandonment, sadness, loss, betrayal, anger. Though some psychiatrists may feel that sending a letter or written notice informing of their leave will suffice (I won’t get into the complex legal aspects here), effort should be made to ensure that the patient does not feel at fault for the termination of treatment (ie, a patient may feel that the doctor is ending treatment because the doctor doesn’t like them, etc). Which is exactly the reason a termination phase (or at the very least, a final session) is crucial to help process emotions that may come up, allot a decent amount of time to coordinate transfer/continuity of care, and most importantly, to provide closure (for both the patient and psychiatrist).

In the last few days, I’ve experienced random moments of feeling sad and numb. Some of my followers on Snapchat may have noticed my absence of posts for over one week (I usually post on a daily basis). My videos are generally motivated by something exciting from my day or a psychiatric tidbit of knowledge that I wish to share, however I haven’t been as inspired lately. Even while writing this post, I’m interrupted by moments of abruptly staring into space and my mind wandering to more superficial thoughts such as shopping, what to make for dinner, and celebrity gossip.

With only a few weeks left until my final day in clinic, I fight the urge to flee and avoid the discussion of termination. But then I refocus and put my psychiatrist hat on and consider the potential impact that avoidance of the topic may have on my patient. However, the professional aspect of fulfilling my duty and ensuring proper transition to another provider for continuation of care is the easier part. The more difficult aspect is letting go of the strong connections that I’ve built with my patients, especially those who watched me grow from a newbie psychiatrist straight out of residency to one they grew to depend on and trust.

Despite the complex mixture of emotions, I know that I’m doing what’s best for me personally and professionally by taking this next step in my career. Yet, if I’m having a tough time, imagine how my patients must feel.

September 10, 2015 10 comments

Personal Psychiatry

Look You In The Eye

written by freudandfashion

Several friends have pointed out to me their observations of my interactions when in public places: that people strike up random conversations with me, ask for directions, of if I could take a couple’s picture at a touristy hot spot, etc. These types of interactions are becoming less awkward to me in the last few years, and I initially attributed my approachability to giving off a “psychiatrist” vibe, as if people can sense that I’m trained to listen to people’s issues. Or, perhaps, as one friend pointed out, I appear to be the antithesis of “bitchy resting face” syndrome.

Flashback to around twenty years ago when I was a loner preteen in the girls’ locker room, where my locker was located in the same aisle as the most popular girls at my school. As I stared at the floor too shy to make eye contact, I recall trying to muster the courage to say something to them…anything…in hope of some kind of acknowledgement, a wave, even a “hi” — anything to feel slightly less invisible than I already was. When I looked up directly towards them, words never left my mouth. All I had the courage to do was smile. A forced, awkward, and uncomfortable smile that caused my cheeks to fatigue.

And all that effort and energy exerted for the end result of coming off as creepy: “That girl is smiling too much,” was all they said. From then on and for quite some time, I became known as “that weird smiley girl.” As if smiling was a negative thing. And, as one could imagine, I didn’t smile for months thereafter. Little did they know how much of a hit to my self-esteem that one incident would have. Putting yourself out there only to get rejected sucks and may hinder further attempts to connect with others in the future.

One may perceive me as a highly sensitive, socially anxious person, and I don’t deny possessing those traits. However, rather than being identified with a label or descriptor (ie, “That weird, smiley girl” or “Vania is anxious and highly sensitive”), I prefer that people acknowledge the different facets of my personality that make up who I am as an individual (ie, “Vania has social anxiety and can be sensitive”). The general tone changes depending on the wording and language used. In the former statement, being “anxious” and “highly sensitive” are inferred to be words that define me, whereas the latter refers to “anxious” and “highly sensitive” as traits.

For many years, I viewed myself as abnormal. That is, until the last few years where I grew to appreciate the qualities that make me who I am as a unique individual, which I attribute to surrounding myself with an amazing support system, including my therapist, who helped me realize it. As a result, I no longer stare downward nor feel afraid to smile and chat with others.

An issue that I have with how Psychiatry is perceived is the tendency to create labels. Many people have enough anxiety about seeking psychiatric help in the first place, and the fear of being labeled and stigmatized might sit at the top of one’s list of concerns. I’ve encountered several patients who told me they were diagnosed with a specific mental illness after one brief, initial 30-minute interview. “The doctor told me I’m Bipolar without barely getting to know me” is a statement of different variations that I’ve heard several times in my practice. I try to maintain an open mind about my colleagues, especially those who are only allotted 20-30 minutes to meet with a new patient (which is ridiculous in medicine, especially in psychiatry) because the ability to see a high volume of patients within a short time frame AND fully get to know each patient seems unrealistic and virtually impossible to maintain.

However, the last thing any person, including any medical provider, should do is make you feel like another label and essentially invisible or judged. Often when people muster up the courage to reach out and seek help are in times of desperation and in highly vulnerable states. The most therapeutic thing any person (or provider) can do is look you in the eye (even if you might be too afraid to look directly at them) and acknowledge you for who you are.

September 2, 2015 8 comments

Fashion Psychiatry

Schizophrenic Connection

written by freudandfashion

{Schizophrenic.NYC tank top}

As a psychiatrist, I treat nearly all mental health diagnoses, but among the patients that have been most memorable and have broken the most stereotypes in my mind are those diagnosed with schizophrenia. As an intern and resident physician, I allotted more time to talk with my patients with schizophrenia because they were generally the ones who spoke the least and typically given the least amount of time to interview during patient rounds on the inpatient psychiatric wards. I recall the shock on several staff members’ faces during the staff morning meetings when I’d discuss my schizophrenic patients, for I had a tendency to present unexpected, personal info such as a patient’s favorite food, previous hobbies, where they grew up, and more specifics regarding their background (brief patient case presentations typically consisted of logistical info pertaining to timeline of their involuntary holds, compliance with medications, reports of agitated behaviors/incidents, participation in group meetings, etc). They are human beings with stories of struggle trying to cope with their illness, and when stable, have the potential to live normal lives.

Unfortunately, many people diagnosed with schizophrenia lack support and access to the care they need, and many end up living homeless on the streets. The 2012 U.S. national survey by the Substance Abuse and Mental Health Services Administration reported that an estimated 46% of homeless adults staying in shelters live with severe mental illness and/or substance use disorders. Among the most vulnerable are those living with schizophrenia and bipolar disorder.

Given those alarming statistics, I was ecstatic to discover Schizophrenic.NYC, a clothing line whose founder, Michelle, was diagnosed with schizophrenia at age 22. Fueled by their vision to see less mentally ill people living on the streets of NYC, their goal is to donate and support organizations that support the struggle of the mentally ill homeless population. I had the wonderful opportunity to connect with Michelle and get more info about Schizophrenic.NYC and her thoughts on living with mental illness:

Being diagnosed with schizophrenia, what do you believe is the most common misconception of people who have schizophrenia?

I would have to say that the most common misconception about schizophrenia is that people believe that schizophrenic people cannot live normal lives. Most people’s experience with schizophrenics are the homeless people on the streets who are yelling, screaming, or just plain talking to themselves. It’s hard to understand that there are people living with this illness who live normal lives and can thrive in society (with medication of course). The problem is that these functioning schizophrenic people keep their illness a secret. If everyone would share their story it would make people more aware that mental illness is extremely common and can afflict anyone. Just because you have a mental illness does not mean that you’re “crazy.”

2. Research shows that early identification and assertive intervention of a person’s 1st psychotic episode can improve longterm outcomes. What advice would you give to the youth who might be struggling with early symptoms of schizophrenia, but are too afraid or unsure how to navigate ways to seek help?

It is very hard for a youth with schizophrenia to get help. People with schizophrenia often believe that the people around them are trying to hurt them and are plotting against them. Early identification can only happen if the person has the self-reflection to understand that they are having a problem. Teens need to learn in school about the signs and symptoms so they can understand if they are having a problem. I would advise anyone who thinks they are having symptoms of mental illness to try to talk to someone they trust. Admitting that they see a problem is just the first step…and it’s the hardest one of all.

3. What organizations/people/resources have been most integral in your ability to manage your symptoms?

I am lucky enough to have a great support system. I have my friends, family and doctor that I rely on. My best friends, who are my former roommates, know all of my struggles and without them I would have never made it through college. My family has always supported me and has never treated me differently. My doctor is a great person to talk to and of course provides me with the medication I need to control my illness.

4. How has Schizophrenic.NYC impacted the mental illness community thus far?

Schizophrenic.NYC is growing everyday. I love to tell people about my mission to help the mentally ill homeless by donating to organizations in NYC that help them. I am trying to start a movement and people like that idea. It’s all about raising awareness. The more people who are aware the faster changes can be made.

5. What can we expect from Schizophrenic.NYC in the future?

I wish I knew the answer to that question! Who knows what the future will bring. As of right now, we are getting more shirts, tanks and accessories made. We will continue to spread our mission and work to make a difference. Stay tuned!

{Rorschach inkblot test design}

Photo credit: Alex M (@fitgodzilla) and Schizophrenic.NYC (middle photo)

August 25, 2015 13 comments

Lifestyle Medicine

Thankful Thursdays

written by freudandfashion

{Venice Beach, California}

For this week’s Thankful Thursdays, I would say that I am very thankful for one of my best friends from medical school, who flew into town for a quick visit. My resolution for the remainder of the year (mentioned in my previous post) included being spontaneous and free to explore. Surprisingly, in all my years living in southern California, I have never experienced biking along the beaches of Santa Monica and Venice, nor have I ever gone shopping on Abbott Kinney (a well-known boulevard located in Venice lined with trendy/urban shops, earthy/cool restaurants, and more). We had a wonderful time catching up, eating delicious food, and discovering new fixtures in the area that we’d never noticed before. I figure that Los Angeles still has a LOT to explore, therefore, to kick off my resolution, I might as well begin locally!

Thought of the Day: What are you thankful for from this week?

For background information of the reasoning behind my Thankful Thursdays posts, check out my 1st post of the series here! (And subsequent posts here, here, and here).

August 20, 2015 8 comments

Personal

Explore

written by freudandfashion

{Bubblegum Alley, San Luis Obispo, California}

I know that the end of year 2015 is fast approaching, but I’m declaring a resolution for the remaining months: to be spontaneous and feel free to explore. The restrictive years of medical education, training, and work, can be so draining. Some of you may know that I work in clinic part-time (a career decision that I will explain in a future post), however, the majority of the time, I utilize my days off to recover from work. Though I take absolute pride in my work as a psychiatrist, my profession is only a part of my identity and I refuse to let it dominate my life. I’d much rather spend my time exploring new places, trying new activities, and doing whatever I can to make up for lost time spent with my head buried in books and research articles. So, if you ever see me outside of clinic, please don’t call me “Doctor” (unless you don’t know what else to call me, or by chance are a patient of mine). My name is Vania, and I enjoy spending time outdoors, trying a variety of sports activities, poking fun at myself while educating followers on Snapchat, getting carded at any alcohol-serving establishment, and I find beauty in even the ickiest of things (like a gum wall…how cool is that?!).

Have an exploratory weekend!

August 15, 2015 21 comments

Medicine Psychiatry

The Other Side

written by freudandfashion

Written on August 11, 2015

My psychotherapy supervisor taught me a tip during residency — to pay close attention to the very first thing a patient says, and more importantly, the last topic they bring up towards the end of session (because it’s likely that the subject weighing most heavily on their mind is too uncomfortable to discuss at the very beginning). I struggled to come up with a topic to discuss on my blog today. At first, I uploaded chipper, smiley pictures taken from a recent spontaneous trip to the coast, but there was something about my grin and carefree expressions that didn’t seem quite appropriate to post today. I try my best to ensure that my blogposts are reflective of my current state of mind, and my current mood is actually quite solemn.

I know that today marks the one-year death anniversary of Robin Williams, yet avoided news articles, tweets, and Instagram posts that paid tribute to the iconic, inspirational actor. While sitting on the couch and staring blankly at the television screen, a short reel of Robin Williams popped up on entertainment news. Not content with the mainstream, flowery piece which strung together brief clips of some of his finest, Oscar-winning work followed by a quick moment of silence in remembrance, I picked up my phone. While scrolling through Instagram, I focused on a long, detailed post written by a young man in which he describes his own personal battle with depression and multiple, near fatal suicide attempts. Robin Williams’ lost battle to mental illness motivated this man to share his story rather than isolate in shame and silence. The words authentically describe the powerless experience of succumbing to the disease. The depression takes exclusive command and overrides any attempt at rationalization. And I know the story to be true because the writer is a dear friend of mine who miraculously survived.

Several of my patients have described similar experiences. Several people living with mental illness whom I follow on social media share similar stories. Every morning that I arrive in clinic, I log on to my electronic medical records and pray not to see a message from the coroner’s office. As a psychiatrist, getting that dreaded phone call from the medical examiner is probably my equivalent to the oncologist receiving a call from a family member or hospice staff. As a young teen, I vividly recall accompanying my family for routine, frequent visits to my grandparents’ apartment, where my grandfather passed away, rid of the suffering he endured from colon cancer. A few years later, my grandmother peacefully died from multiple myeloma. Her last words to me before she passed was that she wished for the opportunity to pay for my education and witness me become a doctor. My other grandfather, as he approached the end stages of his battle with cancer, fulfilled his wish to fly back to the Philippines, where he comfortably spent his final days in his homeland with our large, extended family by his side. When the medical examiner’s call ends, my immediate response is to shut the door and sit alone in silence.

Finally recognizing the mixture of emotions that I suppressed the entire day, I could no longer hold in my tears. Rather than isolating (as clinicians tend to do when it comes to coping with patient loss), I attempted to share my thoughts and emotions on social media, with the goal to make others aware of the difficult emotions that we, as mental health practitioners, face when dealing with patient suicide. The loss not only permanently impacts us professionally in our practice, but also as human beings. I left the post on my feed for 20 seconds, then immediately deleted it. Shame, embarrassment, and fear of judgment overrode my hope to break the norm of silence and connect with others too afraid to open up about their own experiences losing a patient to suicide.

As you can see, I waited a few days to publish this post after much contemplation. The truth is that the fear of losing a patient to suicide weighs heavily on my mind almost every day.

August 13, 2015 16 comments

Personal

Find The Light

written by freudandfashion

{San Luis Obispo, California}

Sometimes in the darkest moments, it’s hard to imagine that there’s light at the end of the tunnel. Friends, family, or therapists may try and provide reassurance that life gets better, things get better, fate will lead you to something better, and that you deserve better. Such thoughts sound so passive in nature, as if we have to wait and rely on fate or other external factors, rather than rely on ourselves, in order to see any change and progress. I’ve become more proactive lately and in some ways feel as if I’m cleansing myself of any major factors in my life that have suppressed me in any way because, frankly, I’m tired of living a life filled with constraints. However, more often the restraints we have are those placed upon ourselves. I know my writing in this post may sound vague, but the ultimate point I’m trying to make is that only you can set yourself free of anything in life that makes you feel trapped. The imperative tool needed is the courage to advocate for yourself and take action instead of being a passive bystander in your own life. Have a wonderful weekend.

“I learned this, at least, by my experiment: that if one advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours.”
― Henry David Thoreau, Walden

August 8, 2015 11 comments

Psychiatry

Summertime Sadness

written by freudandfashion

{Santa Monica, California}

I’ve been intermittently unmotivated lately and am trying to analyze the reason why. Then I realize how hot, humid, and sweaty I feel as I scroll Facebook and view photos of my friends’ fabulous summer vacation trips as I sit at my desk all by my lonesome. Perhaps my current mood is triggered by the summer season? If you have a tendency to feel lazy, unmotivated, or depressed during the summer season, you’re not alone. There are several reasons that the summer months may bring about a drop in mood. The good news is that there’s ways to overcome these feelings and bring some pep to your mood this time of year.

What are some potential reasons for the shift in mood?

1. Changes to your regular schedule. Basically, anything that throws off one’s routine can contribute to a change in mood and motivation. The kids are out of school, which means increased responsibilities monitoring them and taking them out on activities to keep them occupied throughout the day (this also means decreased “alone/me” time). And although summer vacations are usually planned and much-needed, it takes time to adjust back to your regular routine upon return. Many also travel to different time zones, which contributes to even more difficulty to readjust.

2. Expectations to have a fabulous summer. Several of us continue to work, attend summer classes, or stay home during the summer months (due to budget, other responsibilities, etc) and with modern life dominated by social media, we are bound to come across our friends’ seemingly exciting vacation photos. Not spending a few weeks in Hawaii or the Hamptons? That’s okay, but one can’t help but feel the pressure and envy to be on vacation especially when it appears that everyone else is jet-setting away.

3. Increased pressures to have the ideal swimsuit body. I used to hate summers in so-cal as there’s nothing that made me more self-conscious than being surrounded by model’esque women in bikinis. I vividly recall skipping out on pool parties as a teen (partially because I didn’t know how to swim) because I was body-conscious and oblivious on how to choose a flattering swimsuit.

4. Summer seasonal depression. Seasonal Affective Disorder (SAD) is a recurrent depression that is experienced only during a specific season, but is NOT experienced during the rest of the year. Though the prevalence of SAD during the winter time is much higher compared to summer, studies have shown a correlation between summer seasonal affective disorder and higher, hotter temperatures.

5. Losing a sense of purpose during the summer months. People who have time-off during the summer months (ie, teachers, school employees, etc) may have difficulty shifting their priorities from work to something else around this time of year. It’s well-known that utilizing skill and having a career that strengthens and contributes to a person’s sense of identity tends to improve mood. When a sense of purpose is taken away (even if for a few months), one’s mood may decline.

6. Weather change. Some people just don’t like basking in the sun or going out when temperatures are high. Period. But the distaste for heat can lead to social isolation and difficulty leaving the comfort of an air-conditioned home, which can contribute to a decline in mood and lack of motivation. Also, the heat and longer days can cause insomnia, which may cause a decline in energy levels as well.

WAYS TO BREEZE THROUGH THE SUMMER MONTHS

1. Seek help from a professional. If you feel that the summer season is causing impairment in your daily life, then seek help from a professional (physician or therapist). Medications, such as antidepressants, might be an option to help you get through the season. Also, therapy (particularly cognitive behavioral therapy) has been shown to help seasonal depression.

2. Stay active. As I wrote in a previous post, exercise has been shown to be just as effective as antidepressants for the treatment of depression. While on vacation, try to maintain an exercise routine as much as possible. Many people understandably avoid outdoor exercise due to the heat, so consider exercising later at night, early in the morning, or join a nicely air-conditioned gym for a few months.

3. Get some rest! Our circadian rhythm plays a large role in the maintenance mood. Despite the temptation to stay up late, try your best to maintain a regular sleep schedule as variations (especially lack of sleep) contribute to irritability, increased anxiety, and depression. Also, if you’re tired after a busy or stressful day, allow yourself to get some rest instead of overexerting yourself.

3. Keep your environment cool. I’m admittedly cheap at times and avoid turning on the air conditioner unless absolutely necessary, but if the heat makes you moody, then your wellbeing will hopefully prevail as the utmost priority over cost.

4. Don’t let social media bring you down. Keep an open mind and remember that pictures on social media generally display near perfect appearances. Get annoyed by the person in your group who obsessively snaps away trying to obtain the perfect photo instead of engaging in the activity at hand? I get irritated and would love to throw their phone in the toilet, but I exercise restraint. I’d like to think I’ve learned to maintain good boundaries by allotting only a few minutes to take pictures per each activity (if any of my friends or family think otherwise, please let me know). I found this article, which explains the concept of perfection in social media, quite interesting.

5. Carve out time for yourself. I emphasize the concept of self-care so much in my blog that no further explanation is needed, but if so, please refer to my entire blog 🙂

August 5, 2015 10 comments

Personal

Finding Your Way

written by freudandfashion

{Yountville, California}

I woke up yesterday morning with a sense of dread and struggled to get out of bed, yet ended the day feeling energetic and liberated. Lately, I’ve been making conscious efforts to prioritize myself for the sake of maintaining my sanity. As a result, my mood and anxiety levels have improved almost instantaneously after making a crucial decision regarding my work schedule and the next step to take in my career. If you have any important decisions to make, I strongly recommend holding off on any impulsive, irrational decisions unless you’ve had time to relax and get in the right state of mind. So often our minds get bombarded by all the stressors in our lives that we lack any reserve to think clearly. So take a break, talk it out with others, weigh your options, and trust that your instincts will take you down the right path.

August 1, 2015 6 comments

Psychiatry

Overcoming Social Anxiety

written by freudandfashion

{Claremont, California}

To continue my series on conquering our fears (see Part 1 here), Part 2 consists of one of the more common phobias: Social Phobia. I struggled with social anxiety since childhood (as I discussed in a previous post) and often felt uncomfortable in any situation that involved interacting with people. It wasn’t until six years ago during my psychiatry residency training that I finally gained control of my symptoms. Some of the common thoughts that would race through my mind:

– “Are people judging my appearance?”

– “What should I say so that I don’t sound stupid?”

– “Hurry up and say something so that people don’t think I’m shy and quiet”

– “What I said was so stupid, they must think I’m an idiot”

– “What excuse can I give to avoid going to the event?”

My social anxiety dominated a huge part of my daily life.

If you also struggle with social anxiety, the following are some steps you can take to work towards overcoming your fear:

1. Avoid Avoidance

One of my supervisors always emphasized “avoiding avoidance” in application to overcoming all forms of anxiety, and the statement definitely applies to social situations. The more you avoid, the more you reinforce your anxiety symptoms. Sure, it might be far less anxiety-provoking in the moment to stay at home, but how will you cope with anxiety-provoking situations in the long run? Social anxiety impacts all facets of daily life, from something as common as participating in a regular conversation or going to the grocery store to giving a talk at work.

An example of avoiding avoidance: one of my patients rarely left her home during the day (and would run errands only at night to avoid the crowds) due to social phobia, except to attend her appointments with me. Therefore, in order to encourage avoiding avoidance during the day, I made sure she scheduled weekly, daytime appointments with me in order to challenge her fears of running into people during the day.

2. Climb the social anxiety “ladder”

If you don’t have too much difficulty with shyness and feel motivated enough to expose yourself to a series of social situations, then create a list of approximately 10 situations and rank them in terms of level of anxiety (1 = lowest anxiety situation, 10 = highest anxiety situation). Start with #1 and work your way up. And be sure not to skip because you run the risk of getting too overwhelmed and exacerbating your anxiety, which could lead to increased discouragement, self-doubt, and feelings of failure.

For example, my hierarchy would look something like this:

1 = speak to the cashier at the grocery store

2 = go to the bank after work when it’s busy

3 = attend a new exercise class at the gym

(I’m skipping #4 – 9 for the sake of brevity)

10 = Give a talk/lecture to a large group of people (#10 should be a goal to work towards)

3. Get a self-help manual, workbook, or internet-based self help program for social anxiety

Cognitive behavioral therapy (CBT) is one treatment modality shown to be effective for social anxiety disorder. One study found that an internet-based self-help program helped university students with social phobia and public-speaking fears. CBT examines the engrained, negative patterns of thinking (for example, “everyone at the party is judging me” or “anything I say is going to sound stupid”) in order to modify and challenge these irrational thoughts/beliefs. CBTrequires commitment, a lot of homework, and practice of the techniques in order to be successful. After all, the origins of such distorted ways of thinking have likely been engrained since childhood.

The following is a list of recommended resources (if you are currently seeing a therapist, please be sure to run the resources by them before using):

The Shyness & Social Anxiety Workbook

In The Spotlight, Overcome Your Fear of Public Speaking & Performing (for public speaking anxiety)

Overcoming Social Anxiety: Step By Step (Audio/Video Series)

3. Work on self-acceptance and feeling comfortable with being less than perfect

This is something I definitely struggle with, especially since much of our social anxiety centers around our fears of being judged and wanting to maintain a “close to perfect” image, yet at the sacrifice of openly being ourselves. How many times have you been at a meeting or lecture and are hesitant to ask a question or verbalize an opinion, but then someone else speaks up and says the exact same thought before you (this has happened to me numerous times)? Or maybe you have a fear of doing something embarrassing in front of a group of people? Recognize that your opinion is just as valuable as others and that as a human, something clumsy or embarrassing is bound to happen from time to time (even celebrities have major televised fail moments).

4. Seek help from a competent mental health professional

Seeking support from a professional who specializes in anxiety disorders is always an excellent option especially if your social anxiety is preventing you from enjoying and/or moving forward in life.

So, how did I overcome my social anxiety? Well, I went into a field that forced me to learn more about myself, started seeing a psychotherapist, participated in group therapy with my co-residents (a requirement in my residency program, which I believe should be mandated in all programs), exposed myself to situations that challenged and forced me to learn to cope with being in uncomfortable group and public settings (becoming chief resident was among the more challenging roles, yet provided the most growth), among other things. Not to say you have to do ALL these exact same steps to conquer your fear, but that’s the process I underwent in order to feel confident and comfortable being myself in social settings. And yet I STILL have to put in work on a regular basis to prevent my anxiety from getting the best of me (one of the reasons I’m in a weekly psychotherapy group). I took a one year break from therapy after graduating from residency and noticed that my ability to work through my anxiety didn’t come as easily, which motivated me to restart group psychotherapy last year.

Medications can help alleviate your symptoms, but fully gaining control and overcoming the anxiety for the long term requires work, so you have to be willing to expose yourself to uncomfortable situations, willing to keep learning, and willing to face and challenge your fears on a regular basis.

If you also struggle with social anxiety, would love to know which techniques you find most helpful to cope with social situations.

Photo by Marlon Santos

July 30, 2015 11 comments

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