Trigger warning: this piece discusses themes of anxiety, social anxiety, and suicidal ideation. Note: the experiences shared in this article are personal to the writer. Some of what has been discussed may be different for you - and that’s totally okay.
Life ‘After’ Anxiety
*or how to pretend you don’t have avoidant personality disorder
I have avoidant personality disorder, and if you’re not familiar, here’s the short version: imagine you have social anxiety, except where going to your mailbox and possibly being perceived by another person counts as ‘social,’ and lingering physical pain and permanent mental scars as a result of daily existence qualify merely as ‘anxiety.’ As a result, I have been severely dysfunctional since the age of seventeen, which was just about ten years ago. I’ve spent the past couple of years trying my heart out to get better and, while I’m not there yet, I am better. So, what does ‘trying’ look like, and what does ‘better’ look like, when you have crippling anxiety and depression? Here are my top five tips on pretending you don’t have avoidant personality disorder.
1. The Treatment Trifecta
Yes, it had to start here. You need help - this might include medication, individual and group therapy - and the good news is that it is out there.
The bad news is that it will be hard to find. The unfortunate reality is that there are many professionals who are woefully under-equipped to help people with treatment-resistant anxiety. It is often repeated that folks suffering from mental illness must “take the first step and ask for help.” I say that you must take every last step and insist on receiving help - in other words, learn to advocate for yourself.
In practice, that means creating a treatment plan for you.
With medication, your goal is to find the one with the fewest side effects that is actually helpful. My abridged advice? I went through many different medications - SNRIs, TCAs. Those didn’t help, and I went to medications classed as anticonvulsants but used off-label for anxiety. Fastforward to now - I’m on the granddaddy of social anxiety medications. It’s an old medication, neglected by contemporary research and regarded by many psychiatrists as being too difficult or risky to use. Yet, it’s also the only medication that has ever done anything for my anxiety.
With therapy, your primary goal is to find a therapist who is considerate of, and patient with, the intensity of your condition. For me, the end-goal of therapy is exposure - making myself do that stuff that makes me super anxious, so I can have the experiences or relationships I’ve been missing out on. You will find that a lot of therapists have no difficulty in encouraging you to attempt exposure. The bigger obstacle is finding the one who does it the right way - which is to say, very slowly, and not always steadily. You need someone who is inquisitive, flexible, and a good fit for your personality; someone who is unlikely to be the first therapist you pick.
Where individual therapy is about helping you feel safe - and build willpower - group therapy is about helping you feel strong - and use it. It is exposure, but with other anxious people in the room, it’s the safest form of exposure that there is. Find a great individual therapist first, then look for a group. If there’s not a group in your area, why not ask your therapist to start one? You never know - it seems to have worked for me.
The long and short of it is - never give up on yourself, but give up on an inadequate treatment provider at the drop of a hat. Do not let anything that anyone says make you believe that it’s your fault treatment didn’t work. Do not assume that you are beyond help because two or three random dudes decided they couldn’t help you. Let cynicism fuel your resolve. Pick another psychiatrist or therapist and forget about the last one.
2. Dream Differently
“A fortress crumbles from inside
No fix when you're building on the broken
Ah, and happiness is just a smile, oh!” -
‘Happiness is a Smile,’ The Dillinger Escape Plan
What do you enjoy? What has the power to make you feel happy? What really matters to you?
If you’re anything like me, you might think you know the answers to these things. I have x, y, and z hobbies that I don’t totally hate. I smile sometimes; does that count as feeling happy? I don’t suppose that anything really matters, though.
I eventually learned that these are all trick questions - at least, in the sense that the answers you give today are not the answers you will give tomorrow, not if you’re really trying to answer them. And you should try to answer them every single day. Every day, you need something to make you feel content until tomorrow. Every day, you need the goal that lets you care about making it to tomorrow. And every day, you need to know what you’re doing to work towards that goal.
Ever seen a scene in a cartoon where a character very conspicuously stands in front of something to ‘hide’ it from someone else? That’s your anxiety, and, cartoonish as it is upon reflection, your anxiety often succeeds in concealing something from you that I bet you’d really want to see. Stop and think about all of the things you’ve ever discounted or disregarded without real consideration - all because of anxiety. Me, enjoying a group activity? You’ve got the wrong guy. Actually wanting to talk to people? Laughable. Craving an emotional connection with another person? Stop, you’re making my heart ache with all these impossibilities.
Think about the painful possibilities more than anything else because you’ve been overlooking them for so long. Your anxiety literally has a motivation from hiding them from you - because they make your anxiety worse. But your anxiety is an asshole who we’re not going to be friends with anymore. If you want to get past your anxiety, you first need to look past it in order to find the reason.
3. Become a Sage of Socialisation
Wanna know the coolest part of pretending you don’t have avoidant personality disorder? Before the end of it, you’re going to be the most socially skilled adult in any given room.
It’s hilarious and also not a joke. Severe social anxiety makes literally everything hurt. Maybe it’ll get better with exposure, like everyone else seems to think. I wouldn’t count on it. When I make myself go run in my neighbourhood, shop inside the grocery store, have a chat in group therapy, join a book club, sign up for an art class, try to start a casual hiking group… It’s not really about having a good experience that I want more of. It’s about having a decent experience that I can endure more of.
Why bother? It’s in service of the end goal. It doesn’t matter if it’s a hobby you want to be a part of which involves other people, a career path you’ve long dreamed of which involves other people, or a need for interpersonal connection (which apparently sometimes involves other people). The truth is that you’re not going to get any of it while remaining dysfunctionally homebound.
To my understanding, socialisation is weird for most adults in our modern society; a lot of people that don’t have anxiety are still low-grade avoidant of a lot of the inherently awkward meet-people-and-try-things. They get by with the friend, hobby, and professional groups they have known since no later than very young adulthood. You and I might not have the advantages of having those groups, at least not any longer. So, for us, the weird forms of modern adult stranger socialisation are not optional - in service of the end goal.
No matter how much it continues to suck, we’re going to become objectively very, very good at it.
4. Go On and Wring Your Neck (Like When a Rag Gets Wet)
So advises Mike Patton of Faith No More in the song ‘Midlife Crisis’ (or, at least, I’m going to construe it that way to make my point).
You’re going to want to give up. Your brain is wired in a way where anything but total, immediate success feels like complete, inexorable failure. The reason why is usually pretty simple - people you trusted might have punished you emotionally for ever being anything less than flawless. You feel stupid, boring, uncaring, worthless, disgusting, and broken. Who cares about having goals when you keep proving to yourself that you can’t reach them? Should you somehow make it happen, who will even be there to care? What is the point in going on?
I had a fresh experience of this variety just today. I’m supposed to be going to a book club for the first time on Thursday; today was Tuesday, and I went to the library (one I’d never visited) to find the room where the club is meeting. It was very stressful. The drive was unpleasant. The interior of the building is imposingly enormous. I did manage to get myself a library card at the desk. I did not, however, find the room I was looking for, nor did I ask any of the many employees where it was.
The experience was not bad. I did get a library card. I know I’ll be able to get help finding the room come Thursday. Yet, I felt absolutely horrible all afternoon. I couldn’t get any exercise; I couldn’t focus on any of the projects I wanted to work on. I didn’t want to go to the book club. It would end up being humiliating, exhausting, depressing… and it would prove that I would never achieve anything that might really matter to me. I spent a few hours with intense suicidal thoughts and waves of sobbing.
Well, sometimes it’s tears that keep the rag wet.
Now, I’m doing something productive and positive with my night. Then I’m going to play a video game before getting plenty of sleep. Tomorrow, I’m going to answer those trick questions again and get right back at it. I’m tired of giving up.
Between the first draft and getting back later to edit this, I did go to the book club! After all of my worrying, it was in a different room this time… All the stressing about planning ahead only does so much.
5. Stop Pretending
I semi-jokingly presented this as a guide on pretending you don’t have avoidant personality disorder. That really is what it feels like from the inside. I’m always going to have anxiety about the vast majority of socially-adjacent situations - so much anxiety that pleasant experiences are no better than neutral, and neutral experiences feel like emotional torture. I have to live my life as if that is not the case in order to actually do the things that will make me happy. I need regular in-person interactions, personal relationships, and emotional fulfillment that I do not have, and, unfortunately, I’m not going to get them without leaving my house.
Yet, my final ‘tip’ is to stop pretending.
Outwardly, I am pretending.
Internally, I am accepting.
I am going to have an atypical adulthood. I am going to differ from others in how I find contentment, how I can find strength, and how I can use it. I may never have standard, stable employment - I suspect I will remain a self-employed creative. For me, personal aspirations will take the place of greater ambitions. I want to be a follower of someone else’s lead. Right now, the life that appears ideal to me is to one day be a homemaker for a lady who loves me. It goes against everything I was told I was supposed to be ‘as a man’; I feel that my dad would be disappointed and ashamed were he to read this.
Yet, there comes a time to stop pretending and to start living. Look forward to it!
-Jake
Thank you to Jake for sharing your experiences with avoidant personality disorder with us. If you would like to follow Jake's journey, you can do so here.
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