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For many years throughout my teens and my twenties, I suffered from a condition known as social anxiety. This is apparently the second most common anxiety problem in the UK, which is recognised by symptoms including heart palpitations, increased sweating, blushing, dry mouth, shaking, extreme shyness and often cutting oneself off from other people. In this article, I will briefly explain my experience of the condition and its affect on my life, before explaining a bit more about it and what can be done to help those who are suffering.

My Experience

I have always been fairly shy and awkward in social situations. However, this did not progress into what I would call social anxiety until my teens. Looking back, it appears the main factors for me were my poor social skills (especially in small talk) combined with evasive behaviour, which only served to exacerbate the condition.

At school, this started by not going to the lunch hall and packing my own lunch instead. At Sixth Form College I got more of the symptoms of social anxiety. I started avoiding going to the busy cafeteria, as I couldn’t stand the noise around me; I also failed to turn up to lectures if I didn’t know anyone else going.

At university, things got progressively worse. I ended up avoiding most of my lectures because I didn’t know anyone there and would feel incredibly self-conscious. Of course, not attending lectures only made things worse, as I didn’t meet anyone new. I spent a lot of time inside, by myself, waking at strange hours and venturing out to the supermarket if I needed to buy more supplies. I also became more interested in hallucinogenic drugs than might be deemed healthy.

As my attendance suffered, so did my grades and my confidence. As a result, upon graduation I avoided the ceremony and found it difficult to get a job owing to my grades and lack of experience. The social anxiety eventually lead to depression.

For me, things started to improve when I got a job and I started to meet more people. Perhaps the best thing for my confidence was to attend a language course, which was not only something I was interested in, but also meant I would be forced to interact with others frequently.

My biggest hurdle was having to teach English as a foreign language to a class of Chinese students. This is something that I previously would never have been capable of doing and it gave me the courage to do what I wanted to do.

What can be done to help?

I visited a counsellor at university, who introduced me to Cognitive Behavioural Therapy (CBT). I was informed that my condition was basically because I was too on edge and nervous which caused adrenaline production, in turn leading to all the unpleasant side effects. A person suffering from social anxiety is dealing with the body’s ‘fight or flight’ response. It is apparently something that would have been beneficial in our humans’ ancestral environment.

The idea behind CBT is to recognise your problem and gradually make efforts to change your behaviour. For example, if I felt like an ‘attack’ was on its way, I was advised to sit down on a bench and relax (recognise the absurdity of my behaviour). I’m afraid I can’t spread much more knowledge on this technique because as like many of those who suffer from depression or associated illnesses, the motivation to attend the sessions was lacking…! [Follow the links for more info.]

My personal advice would be to try and become more sociable. Join some clubs which allows you to meet with new people (activities I enjoy include kayaking and kayaking) or learn another language (join a course or organise some language practice sessions). Anything that will get you talking and meeting more people is a bonus. I would also add that there is no rush. You do not have to suddenly become a social butterfly. Simply trying to gradually increase your social activities is beneficial. You may find the steps recommended for treating depression in ‘The Depression Cure’ to be useful.

My second piece of advice is to take some exercise. If you can combine the social component with the exercise component regularly you are on the way to a recovery. Exercise releases chemicals which improve your mood; furthermore, getting in shape gives you some form of control over your life.

For more information on Social Anxiety and how to treat it, take a look at some of the links below:

Useful Associations

http://www.leadinglight.org.uk – a London association to help people suffering with social anxiety and a couple of interviews with Ruby Wax, explaining what it is.

http://www.anxietycare.org.uk – information on anxiety in general, its different forms and how to treat it.

http://www.social-anxiety.org.uk/ – information on anxiety, including links and a forum.

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Having suffered from depression in my early twenties and having since found ways to fight it, I feel that the above book is well worth a read for its inventive use of evolutionary psychology to fight depression. Although it provides some very good advice, my main qualm is that it fails to provide much enough information on existential crises as a cause of depression. For this reason, although I think that the advice is sound, I would also combine it with theories brought to light in Frankl’s ‘Logotherapy’ or Camus’ The Myth of Sisyphus (providing that you also are seeking some sort of meaning to your life). I have outlined the main tenets of the book below, followed by a short critique.

 

What is depression?

Depression is a word bandied about a lot nowadays, and may be incorrectly used by someone who is just a bit down. In technical language, depression is called a ‘major depressive episode’. According to the criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) (apparently frequently used by those working in the mental health field), the diagnostic criteria are the following (excerpt taken from Iliardi’s book).

There are nine core diagnostic symptoms:

1. Depressed mood

2. Loss of interest or pleasure in all (or nearly all) activities

3. A large increase or decrease in appetite/weight

4. Insomnia or hypersomnia (greatly increased sleep)

5. Slowing of physical movements, or severe agitation

6. Intense fatigue

7. Excessive feelings of guilt or worthlessness

8. Difficulty concentrating or making decisions

9. Frequent thoughts of death, or suicidality

 

A diagnosis requires at least five of these hallmark symptoms to be present most of the day, nearly every day, for two weeks or more.

These core symptoms also have to cause functional impairment or severe distress.

 

What causes depression?

Ilardi blames much of depression today on our maladaptation to the modern environment. Humans adapted to be successful in the EEA (Environment of Evolutionary Adaptedness) and have not had time to evolve to fit the modern environment (the development of modern, settled societies happened relatively quickly when compared to a human evolutionary timescale).

According to Ilardi’s book, the human body was never designed for the post-modern industrial environment. This is demonstrated by cross-cultural studies that show an increased rate of depression in more ‘modern’ societies. Until about 12,000 years ago – when people invented farming and began domesticating livestock – everyone on the planet made their living by hunting and foraging for food. People lived as hunter-gatherers for the vast majority of human history.

An example of our maladaption to our modern environment is provided by the obesity epidemic. Our hunter-gatherer ancestors faced a fluctuating, seasonal food supply – with the prospect of hunger and starvation around the corner. It therefore made sense for them to crave sweets, starches and fatty foods, and to binge whenever those rare fatty foods were on hand. Now that high calorie foods have become available 24/7 it has caused no end of trouble. In addition, as we take less exercise than we once did, we tend to burn off fewer calories – hence lots of overweight people.

 

Ilardi’s Six Step Cure

Many of the features found in the EEA (the environment that humans evolved in) are not present in modern society. Iliad has identified a number of these features (which tend also to be found in modern day tribes who experience little depression) and suggests that we incorporate them into our lives as a preventative measure against depression.

The features are as follows:

  • Dietary omega-3 fatty acids
  • Engaging activity
  • Physical exercise
  • Sunlight exposure
  • Social support
  • Sleep

Fat molecules play an essential role in the construction of brain cells and the insulation of nerve fibres. However, whilst the body can make of many these fat molecules that it needs, it is unable to make some that it requires, and we must therefore obtain the remainder from our diet. One of the most important of these fats is omega-3 fatty acids. These are found in fish, wild-game, nuts, seeds and leafy vegetables. Unfortunately, these have gradually disappeared from the American diet over the past century. For example, much of the beef, cattle and fish are mostly grain fed today and therefore have little omega-3 content. Countries with the highest levels of omega-3 consumption typically have the lowest rates of depression.

Depressed patients tend to ruminate (dwelling on negative thoughts, turning them over in your mind) for hours each day. People only ruminate when they have free time on their hands, when their minds aren’t occupied with some reasonably engaging activity. The biggest risk factor for rumination is simply spending time alone. When you’re interacting with another person, your mind doesn’t have a chance to dwell on repetitive negative thoughts.

Exercise changes the brain. It increases the activity level of important brain chemicals such as dopamine and serotonin. Exercise also increases the brain’s production of a key growth hormone BDNF. Because levels of this hormone plummet in depression, some parts of the brain start to shrink over time, and learning and memory are impaired. But exercise reverses this trend, protecting the brain in a way nothing else can.

Sunlight is important because the brain gauges the amount of light you get each day and uses that information to reset your body clock. Without enough light exposure, the body clock eventually gets out of sync, and when that happens, it throws off important circadian rhythms that regulate energy, sleep, appetite and hormone levels – these disruptions can trigger depression.

We spend much less time than previous generations interacting with our friends, neighbours and extended family. Technology has promoted our increasing social isolation. Many are oblivious to the social world around them as they march along to the beat of an iPod.

After a few nights of poor sleep, people tend to get cranky. When sleep deprivation continues for a long time it can lead to health problems. We certainly average less sleep than our forbearers, having to deal with the stresses of work, the permanent twilight of modern cities, distractions from nightlife to television and, in general, less physical tiredness. Sleep is therefore a vital part of the 6 step programme.

 

My Take on the Programme

In my opinion, the programme is remarkably effective, and makes a lot of sense. In my experience, most difficult thing about depression is that one normally lacks motivation to do anything. A slight encouragement from a friend or family member wouldn’t go amiss here. However, once that first step has been taken it becomes much easier. For example, going on a bike ride or going for a jog should help to improve your mood (exercise and sunlight); in addition, it can bring you into closer contact with nature which some studies have shown to be beneficial.

Look back on my time with depression, I can see many of the problems that I faced at the time. For me, the principal cause was social anxiety, which lead to me to be incredibly reclusive and cut off from the rest of the world socially. In addition, I lacked the motivation to get exercise and my diet was appalling.

Currently, although I haven’t implemented all of the steps of the programme, I have made a number of improvements. I force myself to get some exercise 5 days a week, normally jogging in the park but also cycling, climbing and kayaking. This not only helps to keep my body healthy, it also improves my mood. In addition, most of the activities take place outside, providing me with my daily dose of sunlight! I would also suggest that enough physical exercise improves sleep at night, as your body is physically exhausted.

Socially, whilst I am never going to turn into some sort of extrovert (being an INTP), I tend to meet regularly with people to practice my French and Chinese. Again, forcing oneself to meet these commitments is well worthwhile. There are many times when I wish to cancel a meetup but I know that if I do so I will probably end up ruminating and feeling isolated due to lack of social contact!

Food-wise, I tend to eat quite healthily, avoiding fast food as well as sweets/desserts in general. The only part of the programme that I fall short on is the intake of omega 3 fatty acids.

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