Reading/Talking Anxiety

[marc.knuckle]

Hi Guys

Firstly a quick background. I work for a major bank and have interviewed customers for approx 16 of my 19 years with them. I have always been comfortable with this and have always felt i was the 'pro' and that i had something to offer customers with my expertise.

Just before xmas i went to a big meeting with many managers there and had to present back my table's findings on a subject. this wasnt a standing up at the front type thing, i just had to read a few sentences from my sheet which i had done many times over the years. Half way through i was suddenly aware that i was the centre of attention and everyone was staring at me and found it hard to complete my findings as i felt that it was getting hard to read and i was getting hot and panicky.

From then on i found while reading out certain declarations to customers that i have to do multiple times per day, it was a little uncomfortable even when it was only 1 person in front of me. After xmas i then had another sort of panic attack while interviewing a couple but fortunately it started to come on just as they were about to leave so they didnt see my discomfort. From then on those uncomfortable feelings when reading were much worse and even when simply talking to customers, that discomfort is there in my chest and while talking.

I even get the discomfort when reading a bedtime story to my sons.

I have had my 15mg per day mirtazapine prescription ive been on for 6 months increased to 30mg pd, i'm yet to see any benefit as it isnt quite 2 weeks of the higher dose.

I am due to see the doc tomorrow and she said she'd sign me off work if i hadnt seen a big improvement in the last 2 weeks. i feel i need this time off as i feel burnt out but i'm not sure if it will reduce the 'overflowing cup' down sufficiently to cope with the issue better when i go back.

any thoughts and suggestions would be much appreciated.

thanks, marc

[MyNameIsTerry]

Hi and welcome to NMP :welcome:

Its possible that a break may calm you down enough to go back to it. Its also possible that it may not and you will need to work on this problem to habituate to it so the fear goes away.

It doesn't sound like its an issue about reading as much as it is about the pressure of others focussing on you, perhaps like a Social Anxiety Disorder style of condition? Do you have any other issues with people? Have you had any knocks to self confidence, self worth or self esteem running up to this?

It may help to learn techniques to remain calm when reading these declarations so that over time they fear subsides and you can stop doing the techniques. This could be as simple as having an object to handle to try to focus your senses on but it needs some exploring to find a compatible technique.

Has work been very stressful running up to this? If so, this might be how being overwhelmed has manifested itself and stress reduction on an ongoing basis will be important to keep it at bay.

I don't think you would feel under the same pressure with your kids which made me think it is more about actually getting anxious when reading as opposed to the pressure of others (eg "what if I get it wrong, they will think I'm incompetent" types of thoughts).

Could you try reading to your kids after a few days of being off and see how you feel? This needs the support of your partner because this would be an exposure exercise meaning you start small but this won't perhaps work for your kids hence you starting and your partner finishing until you feel ready to read the whoole way through to them.

Do you feel anxious in anticipation of the exercise? Or do you feel anxious all the time?

[marc.knuckle]

Hi, thanks for the reply.

Leading up to this i had had a knock to my confidence in my personal life but not in any way connected to this so although i think it added to 'the cup' overall, it wasn't one of the main things to cause it to overflow.

I have been feeling this way for over a month now and just doing the reading and interviewing to desensitise myself to the problem hasn't so far reduced the anxious feelings with it.

When i read in an interview i use my own copy of the declaration while the customer reads their own which is a little better than reading the same sheet as them.

I will try to read more to my sons to see if i can desensitise that a bit.

Yes, i do feel the anxiety leading up to the events.

[MyNameIsTerry]

That might explain it partly because if the previous knock caused you some level of anxiety it can make it easier for the next knock. Its only a question of at what point it tips you over the edge into an anxiety disorder. I didn't realise my signs and then it hit me one day and I couldn't even stay in the office without panicking. Basically, the pressure had been getting to me for a while and I had missed the signs of insomnia, feeling worse than normal, etc I just thought it was a bit of stress but it was far more underneath.

What I can tell you is, work on it now. It may feel raw but it will be harder to address a year later. Its learnt behaviour, as science has proven, and the more it is allowed to reinforce itself and make those associations of neurons, the more ingrained it becomes.

If you follow the exposure route you have 2 forms:

1) Exposure Therapy - this relies on 'flooding' or exposing the patient to their worst fears to remove them. It doesn't always work and its not appropriate for everyone.

2) Exposure Response Prevention (ERP) Therapy - this relies on starting small and working your way up through a hierarchy of fears. This is useful because it allows more gradual habituation and the ability to go back a step and insert smaller goals inbetween if the next goal is just too big to achieve.

Exposure tends to mean being in the situation and tolerating it without avoidance or using distraction and after a certain amount of time the anxiety reduces. Typically, panic will reduce after about 20 minutes. This makes it hard to use exposure in shorter scenarios and I don't know much about how therapists work with that. If you look at my thread (I've only raised about 4) there is one that includes an ERP pitfalls guide for professionals and this might help give you some ideas here.

I found that being in the stressful environment didn't work for me, it was overwhelming and just served to prove to me that I wasn't finding it any easier.

Starting with your kids, with support from your partner for their needs too, is a less stressful environment than work so a good way to start structuring some exposure. At work, it may help practicing doing it as people often do with mock interviewing as this is again within your control in terms of creating a structure for the level of exposure.

If exposure isn't the way forward, CBT has other tools too that work on changing your thoughts about fear. Its not easy in my opinion though but its always worth a try. There is a free online course on the panic board I believe if you want to learn more about that without searching around.

Anticipatory anxiety is tricky. You can try and distract yourself leading up to it so that you are too busy to allow a lot of time for thinking but I find this hard to be honest as my physical symptoms just keep pulling back my focus. Maybe others will have some advice there?

Being more relaxed in general can help so using relaxation techniques, visualisation, etc can help there. You may find that some level of visualisation helps in the lead up or the rationalisation/affirmation methocd of CBT.

Its probably going to be about restoring confidence though so don't allow it to slip in other areas as it may impact this. Try not to let it get you down either as depression can give self confidence a real knock and you want to avoid that trap.