I used to work as a psychiatric assessor in a downtown Denver hospital. We knew that a fair number of recently-divorced men over the age of about 50 are considered at high risk for suicide. Why this group? Because they often lose their social life when they lose their marriage. These are people who didn't develop a set of friends and social life independent from their spouse, instead letting their now ex-wife create and manage their social calendar. The wives got so fed up with being wife and social director that once the kids left, they chose to go too. How many of these men suffer from an undiagnosed mental illness called social anxiety disorder (SAD)? And if these men had been diagnosed and had received professional help, how many would still be married?
YourTango recently conducted a survey of mental health experts which concluded that 15-30 percent of married couples struggle with mental illness. Almost half of experts say that in the face of a new diagnosis, the biggest mistake couples make is not seeking professional support. Studies show that social anxiety occurs almost equally between men and women. NIH research tells us that 5 percent of the U.S. population has SAD, and that 80 percent of them have not been diagnosed. It usually starts in one's teens. Even some mental health professionals don't recognize this illness.
So what does social anxiety look like?
- A fear or dread of social situations that are unfamiliar, resulting in a tendency to avoid them
- An unreasonable fear of acting foolish or being made a fool in a way that would be humiliating or embarrassing
- The person experiences noticeable anxiety when exposed to social situations
- The person can admit that the reluctance to do these things is unreasonable or excessive, but that admission doesn't make the anxiety go away
- The reluctance to participate has a negative impact either socially, professionally, or in their personal relationships
It's important to remember that the person suffering from SAD doesn't realize that SAD is the reason they make the choices they do. If asked, they'll say that they prefer their isolation.
SAD can take on many forms in a relationship. Here are just a few examples of the many ways social anxiety manifests:
- If you're the healthy partner, you may feel like the entire family's social director. Almost all of the family activities are planned and executed by you.
- You'd like to go out to dinner, a movie, dancing, or a party, but your partner resists. A popular excuse is "it costs too much," even if money is not an issue.
- Your partner doesn't seem to initiate activities with his friends, or may not appear to have any friends outside of work. If they need help with a project, they may struggle to figure out who they can ask.
- If your partner initiates family activities at all, they're solo activities: camping, hunting, fishing, hiking. They're happy to take you or the children, but not likely to get a group to go.
- If you need your partner to take your children to events, your partner will try hard to find a way out of it.
- In social settings your partner seems unwilling to socialize without you at his side, and may even expect you to talk for the two of you.
Healthy relationships require both people to have a full life outside of the relationship, so that when you are together you are interesting to each other and have new things to share. If a partner doesn't seem to have a life outside of the home, they often stop being attractive to the other partner. If you're frustrated with your family's social life, and talking to your partner hasn't changed anything, you may be dealing with SAD. Once you know what you're dealing with, you can take some skillful steps toward making things better for all of you. Here's how:
1. Create a time and space, in an agreeable setting, to talk with your partner about how you are feeling. Let him know that you feel overloaded and unfairly burdened. Don't say it in an accusatory way, but speak calmly about how you feel. Don't make your partner the bad guy.
2. Tell them what you have observed; their avoidance of social situations, their dependence on you when in public, and anything else. Make sure to practice "objective observation." Again, don't make your partner "wrong." Stick to the facts.
3. Let your partner respond, and then find a way to suggest that perhaps SAD is the culprit. Be sure to reassure them that you don't think they are bad or defective, but that they may have a legitimate illness. Encourage them to seek professional help.
4. This next step may be the most important of all: Stop being the social secretary for your partner. Make it clear that you expect them to figure out how to do it for themselves and for the family. Be encouraging and supportive, but don't continue to do this. You have to step back before someone else will step forward.
There are three types of professional help to consider: One is to see a medical doctor to discuss medication, another is to see a trained psychotherapist to help relieve the underlying anxiety, and the third is to see a couples counselor to help with the issues SAD creates in the relationship. All of these may be helpful, and more then one option may be necessary.
If you are the partner of someone with SAD, don't suffer in silence. Recognize what's going on and encourage your partner to make positive change. Change is possible!
Larry Cappel has 15 years of experience in couples counseling and is a licensed marriage and family therapist. He can be reached through his website www.yourdenvercounseling.com if you'd like to talk about any aspect of your relationship.
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