Depression or lack of confidence?

Dear Lou Lou,

So glad you wrote to us for some advice. I'll try to help as much as I can, based on your brief letter.

I like to think of counseling as "healthy conversations," so I'll be responding to your letter line-by-line, as if we were in a real conversation... (The words in italics are yours...)

So here goes...

Lou Lou

I'm a thirty eight year old mother of a nine-month old baby. Social situations have always been a little difficult for me and I find it hard to be unselfconscious enough to relax and get to know people.

Tony

Most people don't realize that there are only three things we can possibly be aware of: What's going on inside our heads, what's going on in the outside world, and what we feel through our sense of touch. Being "self-conscious" actually means that you are tuning in to what's going on inside your head instead of what's going on outside of your head!

You can even PRACTICE moving among these three areas of awareness on your own until you get so good at it that it will become easy to pay attention to the outside when you are out with friends. When you practice, just use key words such as "inside," and "outside" and "skin"... and then say or write whatever you notice after each switch. Just keep on switching until the whole exercise becomes boring because you've become so good at it! (It's not easy to describe this in enough detail in this short letter, so write to me if you want more instruction about this.)

Lou Lou

It usually takes time for me to open up, if I do at all.

Tony

This is called "social anxiety" or "fear of getting close" or "fear of intimacy" and we ALL have quite a bit of it! You may only have the same amount of it we all do, but since you are thinking about it so much (and maybe picking on yourself about it mentally too...), it becomes "too much" and you want to escape.

Lou Lou

I seem to have good and bad days but sometimes I feel deflated and depressed after a social gathering.

Tony

I'll bet the good days are when people treat you well socially and the bad days are when you have mistreated yourself quite badly AFTER the social situation! (The key to overcoming many problems about socializing is NOT what you do during the social event, but How You Treat Yourself Afterwards! And, again, this comes down to what you say to yourself mentally... your mental "self-talk"...)

Another idea for you: After a social event if you find yourself thinking something nasty about yourself (such as "well I sure screwed that evening up"), do a "logical switch" and Say The Opposite to yourself (such as "I sure did NOT screw up this evening"). I fully realize that as soon as you say this opposite thing to yourself you will be tempted to think that it's not true. But if you make yourself find the DEGREE to which it IS true, you will at least have a good start in the direction of treating yourself well afterwards.

Lou Lou

People are surprised to hear this about me as I appear switched on and confident.

Tony

This shows it's not really about the social or "outside" world, but about your mental/interior world.

Lou Lou

When I lived overseas I had a large circle of friends and acquaintances but since moving home 6 years ago I've found it hard to make new friends and, as I enjoy knowing lots of people and being part of a group, often feel isolated and lacking in confidence. Some days I feel happy and unselfconscious and can relate easily, others I feel tongue-tied, shy and even a little frightened.

Tony

You need to learn more about these different days. Are you sick some of the bad days? Is it after you've been mistreated by someone that you have the bad days? Do the bad days come right after particularly GOOD days (a common pattern, actually)? Ask yourself what's going on before these good days, and before these bad days... Try to find patterns. Then try to fix what happens before you go out or before those bad days.

Lou Lou

I have made some friends now but my life has changed so dramatically since having a baby that I have to force myself to get out and meet other mothers to avoid isolation.

Tony

Avoiding isolation is very important. If you are tempted to isolate you must be sure you don't, because this problem could turn into depression if you combine it with ongoing loneliness. (By the way, I find it interesting that you haven't mentioned anyone you live with except for your child... Do you have any adults in your household for "built in" attention and support?)

Lou Lou

I'm frightened to investigate antidepressants as my mother was addicted to Valium in the 60's and I've heard Prozac draws a veil between you and the world, flattening out any highs or lows.

Tony

I'm not an M.D. so I can't make any recommendations about medications but I can say that quite a few of the people who I've worked with in therapy have been on Prozac and they don't say such awful things about it. Their usual complaint has been basically that "it helps, but not nearly enough"...

And, by the way, there is nothing in your letter than would make me think you are depressed to any greater degree than most people are in our rather depressed culture...(!) So, unless there is much more that you haven't mentioned, I doubt if a therapist would suggest antidepressants for you.

Lou Lou

Am I suffering general depression compounded by the birth of my baby?

Tony

I don't know. This letter doesn't tell me nearly enough about when it started or how much worse it got after the birth...

Lou Lou

Is depression a physical or mental condition?

Tony

Both. Professionals debate what CAUSES depression, physical problems or social/mental problems. But we all agree that once someone is depressed there are BOTH physical and social/mental aspects to it.

Lou Lou

Is there some help for me that doesn't entail counseling.

Tony

Not really. You could read a lot of self-help literature. (I have a lot of info on depression at my own web site, for instance.) But if you are only mildly depressed and you have moderate social anxiety a good therapist is the best idea by far. You could try it online (through letters like this or a chat room or whatever) if you want too. But if you don't think it's working for you, your best approach would be an appointment with a therapist. (You may have to "shop" a little to find one that feels like a "good match" for you. No therapist is good for everyone.)

I wonder if you are under the impression that all therapists are going to suggest or manipulate you into medication! This is not at all true. Again, unless there is a lot more that you haven't mentioned in this letter, I think the most likely recommendation a therapist would make would be counseling sessions until you think you've overcome these problems enough to suit you.

Thanks so much for writing!

I wish you the very best!

Tony Schirtzinger