Social Anxiety Disorder: A Med Student’s SAD Tale (with a HOPEFUL Ending)

Social anxiety disorder. Millions have it and hate it. And why not? It can pull every ounce of joy from any social situation, any time. Our guest poster, a third year med student, compassionately shares his SAD tale – with hope…

Out of nowhere last week I received an email from Subhi, a third year medical student. He’s struggling with social anxiety disorder (SAD) – aka social phobia. By the way, let’s not confuse this “SAD” with seasonal affective disorder.

Subhi shared some of the details of his psychiatry rotation, which of course included a significant amount of time on inpatient units…

…was really taken aback by all the mental health illnesses. I was helping people with all sorts of psychiatric illnesses and I couldn’t believe how emotional I got from all of that. There is nothing sadder than seeing all those people and their families affected like that.

Between Subhi being so open about his social anxiety disorder and my gut telling me he has a heart – empathy – for those enduring emotional/mental health disorders, I decided to make my move. “Would you be willing to write a guest post about your SAD experience?”

He quickly agreed and a couple of days later sent along the following…

Social Anxiety Disorder (SAD) is one of the most debilitating and crippling psychiatric disorders. For those who are unfamiliar with SAD, it’s a mental health illness which causes someone to feel very nervous in general social situations. In fact, the nervousness gets so bad that a person will start to sweat and blush profusely. The heart rate increases and the force of heart contractions becomes stronger.

It’s not a good feeling, especially when others notice (which is most of the time).

Since around my early college years I’ve had SAD. However, it had only gotten worse during medical school. As a current third year medical student, I am required to do clinical rotations in a bunch of specialties in different hospitals. This past winter (2016), I was in New York doing a 12-week rotation in internal medicine.

The Patient Presentation Story

While reviewing some notes in the hallway of the hospital right outside of a patient’s room, I was approached by an attending physician (one of the head physicians in that specialty). He told me to present the case of the patient in 7B. I knew this patient pretty well and was confident that I could present to him without a problem. So he stood right in front of me and we were both surrounded by three other medical students who were watching me present.

The problem, however, is that no matter how confident I was with the material, I knew that I was about to be in the spotlight. Ask anyone with social anxiety – we don’t like being examined in the public eye. People like us prefer to just blend in with the crowd without being in the limelight. Unfortunately, I was about to be analyzed and examined by the doctor and my classmates.

As I’m presenting, the attending doctor kept interrupting me telling me that I am wrong. He kept saying that I’m presenting in the wrong format, or my differential diagnoses were off, or my treatment plan for this patient was incorrect. The truth is, I was actually doing a very good job. I’ve presented to attendings plenty of time before and was always complimented for my work. Even my classmates afterwards told me that I did a good job. This doctor was just known for being aggressive and strict with students.

So as I’m being interrupted time and time again by the doctor, I noticed the eyes of everyone on me. I start to notice that this patient presentation is taking much longer than normal. I started to hear whispers from my classmates. I started to think that I was doing a bad job.

The Embarrassment to Sweat Progression

This made me feel embarrassed and embarrassment causes me to blush. And since the warm blood rushes to my face, I start to get hot. So what does the body do when it feels heat? It cools itself down through sweating. So now I begin to sweat. However, I don’t stop presenting. I keep going and pretend that nothing is wrong.

Half a minute or so later, my sweat changes from tiny developing immobile droplets to thicker, heavier, mobile droplets. I feel the sweat move toward my forehead. Then I notice the doctor’s eyes shift from looking at my eyes to my forehead. This makes me even more anxious and I blush and sweat even more. I don’t stop presenting though. I just let the sweat keep dripping, trying to wipe it off using the sleeve of my white coat. All the while I keep on presenting.

By the time I finish presenting, the doctor looks at me in disgust. I could tell he was displeased with me because of my sweating and blushing, not so much my presentation. At the conclusion of this traumatic event, I felt my whole body covered in sweat. One of my classmates told me that it looked like I just finished playing a game of full court basketball.

I was so embarrassed. I went into the bathroom afterwards, cleaned up, and listed all the reasons why I shouldn’t quit med school. I couldn’t take these highly social environments anymore. But here I am battling SAD with a “never quit” attitude.

The SAD Truth

No one could identify SAD, not even doctors. I was in a hospital in front of doctors and medical students, all of whom know psychiatry very well (highly tested subject on the national boards). No one identified my condition that day.

If medical personnel can’t identify SAD, then you know that awareness toward SAD and all mental health disorders is low. That is why I believe that a key approach to treatment and management of mental health disorders is creating awareness. The more awareness generated, the better treatment options and possible cures that can be developed.

For anyone out there fighting the good fight against mental health disorders, just know that there are millions of us fighting alongside you. Keep fighting on and may the world eventually understand what it is we go through.

The Rest of Subhi’s Tale

Due to financial aid problems, Subhi has taken a leave of absence from med school. Needless to say, his top priority is raising money so he can finish-up.

Clever guy that he is, he created Million MyriADS, a pixel advertising/fundraising website. But it goes beyond just raising funds so he can go back to school.

Because of his own anxiety, and what he’s seen on psych units, Subhi wants to create awareness of emotional/mental health situations and minimize the stigma that often accompany them. So you’ll see the website has the indicated theme (and you’ll also see his handsome mug).

Thank you, Subhi, for reaching-out to us and sharing your tale. Here’s hoping you get back to school quickly. I’m thinking you’ll make a fine physician (psychiatrist?).

The Frosting on the Cake | More than Butterflies: Overcoming Social Anxiety

Received an email from Jessica from the website FIX. Well, it was in follow-up to a previous email asking if I’d look at, and perhaps feature, an article about social anxiety disorder that was posted on their lifestyle blog.

“Hmmm,” I said to myself. “I’m going to be posting Subhi’s guest post on social anxiety disorder. What better frosting on the cake than this article?”

So here it is. It’s a great piece with wonderful illustrations, written by psychologist Dr. Barbara Markway. Please be sure to check-out More than Butterflies: Overcoming Social Anxiety – The Signs, Symptoms, and Learning how to Cope.

All Done

Well, you can’t say you didn’t get your money’s worth with this post. Right? Plenty to talk about pertaining to a formidable, but treatable, anxiety disorder. Thank you Subhi, Jessica, and Dr. Markway. I’d say it was one heck of a team awareness effort.

Social anxiety disorder. Yes, millions have it and hate it. And millions need to think long and hard about accepting and managing it.

Can do, actually.

Would you like to check-out more Chipur mood and anxiety disorder titles? How ’bout 697 of ’em?