Susan's Place Transgender Resources

After years and years of self-loathing, negative thinking, and gender dysphoria... I've realized that I have social anxiety disorder.

If you've had SAD, how have you dealt with it?

I don't really want to take medication, but I want to fix the way I think. I heard cognitive behaviour therapy works for some individuals. I hate myself, but I'm trying to change it.

So far the only 'disorder' i've been diagnosed with is GID, but I experience social discomfort in another way, perhaps the precursor to SAD??

Every once in a while if I find myself surrounded by people specifically riding the subway... I just get these panick attacks and feel very alone in the middle of all these seemingly Normal people and I become intensely uncomfortable but I manage to control sometimes, I just breathe or close my eyes. Sometimes I snap and immediately run somewhere else.

I know it leaves you feeling awful, hang in there.

Socal anxiety seems to affect quite a lot of us really.

But it seems rather silly to try to deal with a symptom while the cause remains.

Quote from: tatiana on December 13, 2010, 09:53:56 PM
After years and years of self-loathing, negative thinking, and gender dysphoria... I've realized that I have social anxiety disorder.

If you've had SAD, how have you dealt with it?

I don't really want to take medication, but I want to fix the way I think. I heard cognitive behaviour therapy works for some individuals. I hate myself, but I'm trying to change it.

I come from a family of anxiety sufferers. The only thing that really helped any of us was SSRI medication.

Medication can be part of the treatment...  And it actually can change the way that we think. There are techniques to help cope with anxiety, and counselling can be helpful, but once you don't feel the anxiety anymore, you will slowly shift your behaviour on your own as well. Counselling for these issues  can be much more successful if combined with medication. 

Most of the way you think now is influenced by your avoidance of situations that you will know cause you anxiety. Once you start to experience situations without feeling that anxiety, you'll realise that things aren't as bad as you thought they were, and therefore your thinking and behaviour changes.

I do know how you feel... I've been there. I had SAD so badly that I sometimes I wouldn't leave the house to shop for food; I couldn't even stand to go to the supermarket, and it was literally maybe 300 feet from my doorstep. I'd eat every single item in my pantry, resorting to eating spoonfuls of jelly or something else out of the jar until I ran out of everything, then I'd skip my evening meal, and breakfast the next day, and lunch... Until I was about ready to drop from low blood sugar. Then I'd reluctantly force myself to go.

Now, the only reason that I won't go shopping is due to pure laziness. Lol...

Anyway don't discount medication entirely... It can really help.



V

I was never diagnosed with SAD but I definitely had it when I was younger.

Some medications I was on for depression also helped with the anxiety. Therapy helped. I also put myself in uncomfortable situations until I got used to them. It took a long time but recently I've had people call me outgoing and friendly where before I was a loner and shy.

QuoteBut it seems rather silly to try to deal with a symptom while the cause remains.

I agree that it's important to treat the root cause but it seems like the SAD really effects your life in a negative way. Treating the SAD while working on the root cause may make dealing with the root cause easier.

Remember, you're in charge of making your life better.

Quote from: VeronikaFTH on December 14, 2010, 12:37:01 PM
I come from a family of anxiety sufferers. The only thing that really helped any of us was SSRI medication.

Medication can be part of the treatment...  And it actually can change the way that we think. There are techniques to help cope with anxiety, and counselling can be helpful, but once you don't feel the anxiety anymore, you will slowly shift your behaviour on your own as well. Counselling for these issues  can be much more successful if combined with medication. 

Most of the way you think now is influenced by your avoidance of situations that you will know cause you anxiety. Once you start to experience situations without feeling that anxiety, you'll realise that things aren't as bad as you thought they were, and therefore your thinking and behaviour changes.

I do know how you feel... I've been there. I had SAD so badly that I sometimes I wouldn't leave the house to shop for food; I couldn't even stand to go to the supermarket, and it was literally maybe 300 feet from my doorstep. I'd eat every single item in my pantry, resorting to eating spoonfuls of jelly or something else out of the jar until I ran out of everything, then I'd skip my evening meal, and breakfast the next day, and lunch... Until I was about ready to drop from low blood sugar. Then I'd reluctantly force myself to go.

Now, the only reason that I won't go shopping is due to pure laziness. Lol...

Anyway don't discount medication entirely... It can really help.



V

This post is very informative, I have extreme SAD so much that I had to go to highschool online (I'm 21 now), and medication has helped, somewhat. I'm trying to find a decent counselor for it but it's hard finding one that will help you with that and the mental effects of your transition, but I am still looking.

When I was 17 I went to a counselor that was recommended somehow, she looked like this old pedophiliac lesbian (no offense to that preference, but it helps describe her) who when I entered her cubicle, she looked at me like a fat hungry kid looks at a chocolate cake, which is not something you want. She was very rude to my mother and my mother snapped on her and led us out of the room... There was supposed to be an investigation on it but apparently she's still in practice...  :(

Anyway I would try to get some medication first if you can, then that may ease you into going to regular counseling to help with SAD, and I hope you are eventually able to cope with it.

Cognitive Behavioral Therapy working with a really good therapist.

After so many years of suffering with it, made tremendous progress within a few months and have been able to move on to some other issues.

SSRI/SNRI medications sorta helped, or at least gave me the capacity to help myself with anxiety. My case was rather light though. I still sorta fight it sometimes but it's been a while since I've needed the medication.

You can try it...but if you're on/planning to go on HRT, SSRI/SNRIs may tire you out all day so HRT may or may not amplify this effect.

Social anxiety disorder sucks. I have dealt with it most my life. It is very debilitating. Over the years it has been especially difficult on my wife, as she is a very social person.

This is going to sound a bit crazy, but as of a couple of months ago I no longer have SAD. The first day I went out En femme was the last time I had any sort social anxiety . The only time I start to get that feeling again ,is when I have to go out dressed as a male. Which I hope will never happen again !!!

  Hugs, Roxy

I'm waiting on mail from the local hospital calling me over for the social anxiety cognitive therapy group.

Mine is probably a result not only of gender issue, but massive bullying in grade-school.

Quote from: Erocse on December 14, 2010, 11:32:08 PM
This is going to sound a bit crazy, but as of a couple of months ago I no longer have SAD. The first day I went out En femme was the last time I had any sort social anxiety . The only time I start to get that feeling again ,is when I have to go out dressed as a male. Which I hope will never happen again !!!

Congrats. That's great! Happy for you.  ;D

Quote from: VeronikaFTH on December 14, 2010, 12:37:01 PM
Medication can be part of the treatment...  And it actually can change the way that we think. There are techniques to help cope with anxiety, and counselling can be helpful, but once you don't feel the anxiety anymore, you will slowly shift your behaviour on your own as well. Counselling for these issues  can be much more successful if combined with medication. 

Good point. Spoken like a medical professional by stating how you can attack the issue.

Quote from: spacial on December 14, 2010, 11:14:51 AM
Socal anxiety seems to affect quite a lot of us really.

But it seems rather silly to try to deal with a symptom while the cause remains.

I'm guessing you're saying that the gender issue of being in the wrong body will remain regardless. This is why I was so avoidant of everyone because I didn't want to be fake to everyone and pretend to be something I'm not. Would reasonable explain why so many of us have SAD. It's frustrating nonetheless.

I decided on not transitioning, but I'm still taking spiro to deal with the gender dysphoria. Since I'm not hating myself everyday because of the spiro, I'm finding myself to be in a better situation to deal with my psychological issues. I started school again and I'm meeting up with people all the time. I started playing computer games and I'm realizing as a result of the game that my avoidant behaviour extends to computer games. Like in Team Fortress (for those who know), staying in your own base and not venturing outside to the other team's base because you're scared. It's funny how this anxiety extends to your behaviour on computer games - aversion to risk.

It's definitely a battle with yourself. I understand CBT tries to rewire your brain not to think so negatively and to remove any absurd assumptions in your mind. I started to apply some of the principles already. I'm starting to feel a little better. I'm trying my best to be outgoing and try to strike up conversation whenever possible with strangers and trying my best to be a good listener to my friends. I booked an appointment with psychiatrist this month and I got a counseling session later on in January. See how it goes.

I just wish I could be happy and stable!

Quote from: tatiana on December 16, 2010, 09:34:10 AM
I decided on not transitioning, but I'm still taking spiro to deal with the gender dysphoria. Since I'm not hating myself everyday because of the spiro, I'm finding myself to be in a better situation to deal with my psychological issues.

From a clinical perspective, I'm curious how a weak anti-androgen and not transitioning is helping deal with your gender dysphoria?  On the face of it, it almost seems like it would suggest (your) gender dysphoria is testosterone driven.  Body Dysmorphic Disorder (BDD) actually comes to mind in your situation.

http://en.wikipedia.org/wiki/Body_dysmorphic_disorder#Treatment (http://en.wikipedia.org/wiki/Body_dysmorphic_disorder#Treatment)

Studies have found that Cognitive Behavior Therapy (CBT) has proven effective. In a study of 54 BDD patients who were randomly assigned to Cognitive Behavior Therapy or no treatment, BDD symptoms decreased significantly in those patients undergoing CBT. BDD was eliminated in 82% of cases at post treatment and 77% at follow-up.[22]

Due to believed low levels of serotonin in the brain, another commonly used treatment is SSRI drugs (Selective Serotonin Reuptake Inhibitor). 74 subjects were enrolled in a placebo-controlled study group to evaluate the efficiency of fluoxetine hydrochloride (Prozac); patients were enrolled in a 12-weeks, double-blind, randomized study. At the end of treatment, 53% of patients responded to the fluoxetine.[23] In extreme cases patients are referred for surgery as this is seen as the only solution after years of other treatments and therapy.

A combined approach of Cognitive Behaviour Therapy (CBT) and anti-depressants is more effective than either alone. The dose of a given anti-depressant is usually more effective when it exceeds the maximum recommended doses that are given for Obsessive Compulsive Disorder (OCD) or an major Depressive episode.

I didn't want to be fake to everyone and pretend to be something I'm not

Why should you be the only one who gets 'to be real'?  Everyone else is faking it to a degree, from time to time - lots of them even more than that as they are doing the 'fake it till you make it' deal.

Quote from: tekla on December 16, 2010, 10:06:06 AM
I didn't want to be fake to everyone and pretend to be something I'm not

Why should you be the only one who gets 'to be real'?  Everyone else is faking it to a degree, from time to time - lots of them even more than that as they are doing the 'fake it till you make it' deal.

If you think about it, at the end of the day everyone has multiple personalities.  Who you are at home is different then who you are at work or who you are when you're out with your mates.  We adapt our personalities to the situation we are in at the moment.  Its a reflection of the different roles we take on in our lives (sons, daughters, mothers, fathers, etc).

Quote from: tatiana on December 16, 2010, 09:34:10 AM

I'm guessing you're saying that the gender issue of being in the wrong body will remain regardless. This is why I was so avoidant of everyone because I didn't want to be fake to everyone and pretend to be something I'm not. Would reasonable explain why so many of us have SAD. It's frustrating nonetheless.

To a extent.

But think about this. Are you depressed because you're unable to socialise or because you think you should?

Not everyone is super social, life and soul of any party. Many people are more reserved. Perhaps studius.

The point is, when we make so much effort to confrom to on norm, being male for example, we often end up trying to live up to an ideal that we assumed was the normal male.

I spent a short period trying very hard to live up to being male, truely male. I watch my brother picking up girls like they were snacks at a party. I watched people, especially my brother, drinking beer, laughing along with everyone and generally being a man's man. (Hope you get the image. My brother is very male).

But that isn't me.

Like you, I haven't transisoned. But try to think about how you would deal with things if you had a normal femal body. Not especially beautiful, few women are. Just a normal woman. Nothing particularly to prove.

Then, try to understand how you will deal with things.

It's a serious mistake to assume the anxiety is preveting you from fulfilling a norm. It is preventing you from getting to know who you are.

There is nothing wrong or disturbed about knowing a lot of people and only having a very small circle of close friends.

Quote from: regan on December 16, 2010, 10:47:56 AM
If you think about it, at the end of the day everyone has multiple personalities.  Who you are at home is different then who you are at work or who you are when you're out with your mates.  We adapt our personalities to the situation we are in at the moment.  Its a reflection of the different roles we take on in our lives (sons, daughters, mothers, fathers, etc).

For fakeness, I think there's a distinction between multiple personalities and also being able to express yourself as your proper gender. My comments of fakeness had to do with not being able to express myself. Sorry for not being clear enough. For example, I'd love to be more feminine in my presentation, actions, and etc... I'm into make-up and hair. I really like it. I have no qualms about being fake to people in personality, but I do have issues when I have to 'always' act male. It's the inability to do things that women would do in the male role.

For testosterone driven gender dysphoria, I do have to agree to a certain extent. I was fine when I was E, Progesterone, & Spiro with gender dysphoria. I really don't like the effects of testosterone. I didn't really have an issue with BDD until I had surgery that went wrong for my face. So you are right that I also have BDD. This trigger for SAD was actually a result of the surgery and BDD. But I never thought about this distinction until now. Even before though the surgery, I did have underlying BDD issues because of the face and some social anxiety issues because I wasn't able to cope with social situations. Interesting...

You ladies have given me lots to think about... Oi...

Quote from: spacial on December 16, 2010, 04:23:34 PM
To a extent.

But think about this. Are you depressed because you're unable to socialise or because you think you should?

Not everyone is super social, life and soul of any party. Many people are more reserved. Perhaps studius.

The point is, when we make so much effort to confrom to on norm, being male for example, we often end up trying to live up to an ideal that we assumed was the normal male.

I spent a short period trying very hard to live up to being male, truely male. I watch my brother picking up girls like they were snacks at a party. I watched people, especially my brother, drinking beer, laughing along with everyone and generally being a man's man. (Hope you get the image. My brother is very male).

But that isn't me.

Like you, I haven't transisoned. But try to think about how you would deal with things if you had a normal femal body. Not especially beautiful, few women are. Just a normal woman. Nothing particularly to prove.

Then, try to understand how you will deal with things.

It's a serious mistake to assume the anxiety is preveting you from fulfilling a norm. It is preventing you from getting to know who you are.

There is nothing wrong or disturbed about knowing a lot of people and only having a very small circle of close friends.

It seems like there's multiple layers of issues. My premise of gender issues leading to avoidant behaviour might have been a confused attempt at trying to understand things. I do try to live up to a male norm and have high expectations. That could be a factor. You've said a lot of things I'll have to ponder for the next little while.

Well, I did manage to walk to the library a few days ago (about a 7 minute walk from my house, each way) and it was around 37 F outside and I didn't have any gloves on or a scarf and I couldn't feel my hands or face when I got home... But it was a huge step for me, since I rarely go out of the house anyway even with my mother. But I walked there and registered for a library card, which gave me a large boost in confidence.

It just takes a leap of faith you could say to do things like that to help try to fight your SAD, it's very hard to do, though.

Laruza.

Well done. That would have taken a lot of courrage. Understand this, it's easy to compare ourselves to others. But your only measuring stick is you.

You did really well.

I might/might not have SAD.

I'm kinda scared of people, to the point where I seem to have an internal mandate to cover certain aspects of my personality, despite all costs.

My feelings about people are mostly I don't think about them much. I help people where I can, but I don't feel like I can do the same things.

Quote from: Miniar on December 15, 2010, 06:35:28 AM
Mine is probably a result not only of gender issue, but massive bullying in grade-school.

I think my social anxiety has alot to do with this, even before I was bullied I was pretty shy but bullying made it alot worse.

I tend to have the need to wear a mask whenever I talk to someone I don't know, but it's usually painfully obvious to me that everyone else is doing it to me as well, a serious feeling of "fitting in" emanates from them. Getting outside can help my feeling of lethargy a lot. I'll walk alone and won't engage in conversation unless I have to, I don't see getting outside as a social event, as I don't plan on meeting people at all, and spend most of that time thinking and daydreaming as I walk.

A little update... I took a general sweeping look at my entire situation.
1. I identified things that would give me more confidence & acted on it
2. Bought a book on cognitive behaviour therapy (CBT) : http://www.amazon.ca/Feeling-Good-Handbook-David-Burns/dp/0452281326 (http://www.amazon.ca/Feeling-Good-Handbook-David-Burns/dp/0452281326)
3. Started reading the book & got a therapist

One thing I really like about the book is that it outlines the negative thoughts that usually go through our head and debunks them in the first chapter. Also, knowing that I have support & direction of a therapist helps.

Confidence Building:
Lately, I have been feeling happier. My viewpoints on things are slowly changing. To also better facilitate being "social"... I started cutting out less mainstream activities or culture I absorb to increase the things that I have in common with everyone else. Essentially, I'm telling myself to accept culture & society as is that I'm living in and work with it instead of fighting it.

As for my body image, I am learning to accept it for what it is. Learning to take a different perspective on things and overall, trying my best to think positively. I'm trying very hard to stop procrastinating with my social life and skills. Polishing it up. Stopping to smell the roses. The HRT meds have removed the fog of frustration on my part and it's helping me resolve the social issues. Reading many posts that re-confirmed that transitioning, HRT, or SRS does not change the fundamental problems in your life, I agreed mostly to this. SRS would not make me more of a sociable person. I'd have to work hard to be sociable to be sociable, rather than looking to unrealistic things to make a change.

I've had much difficulty with dealing with wearing a sports bra as it made me nervous because people can see the shape of it when I wear fitted clothes sometimes. I switched over to Spanx for Men to hide my breast development. It's been a total confidence booster as I know I'm wearing a guy's piece of clothing and it looks just like a wife-beater undershirt kinda thing. I feel more normal these days. More relaxed as a result.

Go with the flow:
I've also realized that in social situations, it's always good to say yes to offers by other people. Go out there and put effort into your conversations. Don't wait for people to make plans with you. Make the plans and go out on that Friday & Saturday instead of staying home. Relax and let things flow - might it be the conversation or whatever. Try not to control everything if you're a control freak like me. It's the people around you and the interplay of interaction that affect the conversations.

Regan & spacial, thanks for giving much food for thought. You guys helped me think more clearly about my situation. Thank you.

it's always good to say yes to offers by other people

True that, 'good fortune' in life often has a lot to do with being in the right place at the right time taking to the right people.  In other words, massive blind luck.  But you have to be there for that luck to happen.

"I know someone you should talk to" (or conversely, "I know someone who should talk to you") is frequently the beginning a very productive string of events.

And take in all the culture and cultures, it's all good.  That's all you have to say, 'it's all good' and like Bruce Springsteen said: Just stand back and let it all be.  Have to, you - as one person - are not going to be able to do much to either promote or demote any given culture, so you can either join in, or not.  That's about it.  And hey, when in Rome...

Once you free yourself of the need to judge, critique, police or pontificate on any given culture, or group, or society, or association or whatever you can just be in it without being of it.  And hell, you can do all that stuff later anyway, you just don't have to do it in real time.

Tatiana those are awesome changes! I'm really impressed with your positive attitude about your situation.

Keep at it and don't let yourself become discouraged, everyone has little bumps or setbacks. Just remember to pick yourself up and keep going when they occur.

Good work!

Quote from: Tamaki on January 23, 2011, 09:37:11 AM
Tatiana those are awesome changes! I'm really impressed with your positive attitude about your situation.

Keep at it and don't let yourself become discouraged, everyone has little bumps or setbacks. Just remember to pick yourself up and keep going when they occur.

Good work!

Thanks for your positive words Tamaki! =D