How Social Anxiety Fuels My Depression

I haven’t just been “out of sorts” the past couple of weeks. I’ve been moderately depressed. Tired, sad, unfocused; I spent an entire day watching The Legend of Korra on KissCartoon because I couldn’t get myself to do anything else (and I wanted to know what would happen next; it’s a great story). I’ve also been isolating, having self-harm urges, and occasionally thinking I don’t deserve to live. The abusive voice is back; when he’s feeling kind he just tells me I’m worthless.

I feel like I’m right back where I started: feeling depressed and overwhelmed by the prospect of applying for internships. (And jobs, but if I have to choose between a job and a music therapy internship, I’ll pick the internship. It’s the last major obstacle to starting my career.) There’s nothing else for me to do, nowhere else to run, no excuses. But everything feels wrong. I haven’t been practicing my instruments, it’s been over 4 years since I last worked with real clients, and I don’t have appropriate attire for an interview. I know there are relatively easy ways to fix at least two of those issues, but I’m finding it hard to get myself to do even something as simple as stepping outside for a few minutes to enjoy the sunshine.

It doesn’t help that I’ve been fighting with my health insurance since mid-June. This is a huge trigger for me; I feel like they’re threatening my very existence. We were a couple days late re-applying for our program, so there was actually a temporary lapse in coverage while our information was being processed. Fox was taking half his dosage to make his medication last for as long as possible while we waited to regain our benefits; that made it harder for him to cope with stress and he came home from work even more exhausted than usual. When we finally got our letter confirming eligibility, I rushed to the pharmacy to refill his prescription – only to discover that our HMO wouldn’t resume prescription benefits until August 1st. I didn’t know we could have our medication paid for directly by our state’s program, and I didn’t have his card with me anyway. I got ridiculously angry, started yelling, and had to use all my willpower not to become violent.

The eligibility letter was followed closely by a letter requesting proof of my citizenship and identity. I was furious – for two reasons. First of all, they required Fox to certify my identity and used the term “child” on the form; I found this exceptionally insulting because I’m the one who’s been doing everything to get and keep health insurance for us both. More importantly, the only reason I could think of why they would have trouble confirming my identity (but not Fox’s) is because I changed my last name when we got married. I updated Social Security and got a new driver’s license over a year ago, but for some reason they couldn’t make the connection themselves. It really wasn’t much of an inconvenience to send them copies of my certificates and IDs, but I felt threatened by it anyway. I was born here, I’ve lived here my whole life, we clearly marked that I am Fox’s spouse, and it’s a long-standing tradition for one partner to take the other’s last name when a couple gets married. They should have no trouble connecting my current name to my pre-marriage identity, it should be a normal part of their procedure.

I did nothing wrong, why should anyone question my right to be here?

That’s my problem: I question my right to be here. Bullying; physical and emotional abuse; living in a world that doesn’t want to admit non-binary pansexual people exist; having a body that is hyper-sexualized, censored, stigmatized, and discriminated against; persistent invasive media promoting impossible beauty standards… It’s hard to avoid internalizing messages that I don’t have a right to be here – or, at least, that if I want to exist I must do everything both inside and outside my power to conform. I feel like simply existing day to day (and being honest about who I am) is a radical act of defiance.

Radical acts of defiance take a lot of energy.

I’m tired.

This latest return of my depression – especially so soon after I thought I’d overcome it – proves to me that I must do something to directly address my anxiety. No matter how well I feel in terms of the depression, as soon as I try to start doing things again, my anxiety fairs up. It’s so bad I can’t do anything, so I don’t do anything; the depression sets in again.

It isn’t part of my official diagnosis (yet), but I’m pretty sure I have social anxiety disorder – which is described as “extreme fear of being scrutinized and judged by others in social or performance situations.” It explains most of my functional difficulties that lead to some of my worst depressive symptoms, particularly being late for class and the couple of times I’ve chosen not to show up for job interviews. Even just going for a walk outside is difficult: I don’t want to be seen by anyone because I expect them to judge me harshly.

Fortunately, I have an appointment with my prescriber on Tuesday. She has offered to refer me for individual therapy – I think within the clinic where I meet with her. I can will ask her to refer me to someone who specializes in cognitive-behavioral therapy (CBT) for social anxiety disorder. (CBT is more effective than medication for treating social anxiety.) Hopefully I’ll be able to start with that person right away and gain the confidence I need to finally move forward with my life.

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