Social Anxiety Disorder: Understanding the Misunderstood

Dr. Tami, joined by Rob,  engages listeners in a long overdue discussion about Social Anxiety Disorder; and the overwhelming impact of the COVID shutdown on how people cope daily with this heavily misunderstood disorder. If you’re a sufferer or know someone struggling with SAD, this discussion will provide you with the basics of what social anxiety disorder is and what it’s not. 

This episode is brought to you by ND Human Services Community Engagement Unit.  Miigwech (thank you)

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Transcript

Episode 2, Season 2

Title: Social Anxiety Disorder- Understanding the Misunderstood

00;00;00;17 - 00;00;28;22

Dr. Tami

Dr. Tami here with Rob. Today, we're going to be talking about how the COVID pandemic has impacted those with social anxiety. And I'm highlighting one article that I was drawn to in medical news today. And the author is Jessica Ruscio, and it's from 2020. And so I would be I'm definitely interested in what the articles would be saying now.

00;00;29;02 - 00;01;01;01

Dr. Tami

But let's look at she has a really interesting perspective and I think really valuable information for those of us who are curious about the anxiety that has been attached to this to the COVID pandemic and where everybody's out with it right now. So when you think about, anxiety itself is an umbrella. It's a term that needs to be evaluated further to find out specifically what what type of anxiety are you feeling?

00;01;01;20 - 00;01;28;29

Dr. Tami

And so a lot of times I think people just say, I have anxiety. And then as a psychologist, the part of me wants to say, okay, wait, wait, hold on. We need to I need to understand what's causing this anxiety so then we can I can help you better understand it. And so today we're focusing mainly on social anxiety. And what could be confusing to our listeners;

00;01;29;00 - 00;02;03;19

Dr. Tami

Social anxiety is also called a social phobia. And it's also referred to as for some people, a performance anxiety. And those those are like all these different words that are talking about a intense now. I'm not talking about that. It's normal. I'm at first it's normal. Feel a little bit anxiety when something big's going on, something big like the pandemic, something big like the uncertainty of this call, this spectrum that we're all living and walking through as we speak.

00;02;04;06 - 00;02;27;20

Dr. Tami

It's normal to have some a heightened sense of physiological or your your stress response, an arousal, a heightened level. It's like we're we're on guard and our body knows that. Our brains are telling us that body's releasing some of these hormones to try to keep us alert. And we've been going through this for, well, going on three years.

00;02;28;29 - 00;03;26;15

Dr. Tami

So our body is starting to feel that that stress response of - it's chronic. Anything that's going on longer than it needs to be is is now in the range of dysfunctional for our body. We're not we're not meant to have this live daily on a heightened sense of arousal. And so when when somebody has something like social anxiety disorder, which is a disorder that is characterized by intense fear of any kind of situation where they're interacting with others who could scrutinize them, judge their behavior or feel like they're going to be ridiculed, are embarrassed or humiliated in some way in front of others, so that there's a lot of kind of miscommunication or

00;03;26;15 - 00;03;55;01

Dr. Tami

misinformation or mislabeling about what, you know, somebody with a social anxiety disorder is experiencing. And and so I think it's an important time for us to talk about this because it's to the point where the with COVID there was an immediate it wasn't a gradual. It wasn't any time to to transition or prepare. It was an immediate, like lockdown shutdown.

00;03;55;01 - 00;04;23;19

Dr. Tami

And people had to adjust. And those people who have already had social anxiety in their definitely at an area where that's even heightened because the anxiety response in general is heightened. Then on the flip side, they also, according to her article and this is this is exactly my thoughts on it being being a psychologist is they were able to get some relief.

00;04;23;24 - 00;05;04;14

Dr. Tami

Individuals who suffer with that specific kind of social anxiety disorder. It can impact their ability to function well in work, to function well in school, to achieve their goals that require them to do and speak to people in public. Individuals with this can also just struggle with; Going out to eat in the restaurant, something that people without anxiety or without that level, you know, that we we definitely take for granted when we don't know that maybe there's a person out there that is so insecure about eating in public because they feel that they're being watched and judged.

00;05;05;09 - 00;05;54;09

Dr. Tami

And this fear isn’t minor. It's intense in order for it to classify as something that is bothersome and interfering with their daily life. So, this and this is actually social anxiety disorder is what is a very common form of anxiety. And I think it's much more common then than we know about because, of course, it's going to be difficult for someone with this type of anxiety to come in and talk to a stranger, a doctor, about the way they feel, because that alone already is the definition of what they're struggling with, intense fear of talking to somebody and having to communicate with somebody they don't know well, or don't know at all.

00;05;54;10 - 00;06;25;07

Dr. Tami

So it's it's really one of those situations where doing things like applying for a job, being called out on in class, if there's a group of your peers. For young kids, you know, this is one thing when they're asked to read out loud, and sometimes people assume that they can't read or that there a problem with reading when in reality, if they're if they're really struggling with that, we have to look at social anxiety, just calling somebody out in front of others.

00;06;26;15 - 00;06;47;12

Dr. Tami

For many people without this disorder, it's like, well, that's part of life. You know, you got this is what you have to do. You just have to deal with it, maybe get a little nervous. But for somebody who has the actual disorder, it's - this is chronic. This isn't every now and again. And it's day-to-day tasks. It's paying for for groceries.

00;06;47;12 - 00;07;14;21

Dr. Tami

It's calling somebody on the phone and requesting an appointment. It's it's even showing up. Even virtually can can it can limit that. But it can also be really intense for them to show up virtually during this time. And so I just want to start talking about this because it's now we're with the with the pandemic. There was some temporary relief.

00;07;15;22 - 00;07;49;12

Dr. Tami

You know, they're starting to see like; oh, right. By avoiding. And that's the common that's the common symptom. So when you start to avoid public situations because you want to avoid that feeling of fear of embarrassment, and fear of being judged or ridiculed by other human beings, that that's a real phenomenon. And now the those who maybe have been just ‘white knuckling’, white knuckling, it means they're pushing through, they're showing up.

00;07;49;23 - 00;08;27;19

Dr. Tami

But they're so physically and emotionally uncomfortable and but they're doing it. So now they may have had some exposure or they have to relief, some temporary relief. ‘I don't have to walk into that school. I don't have to face my coworkers. I don't have to deal with my supervisor there’. All of this stuff, ‘I get out of those presentations that I had to make for work’ and all of a sudden their body gets to see how it feels to avoid and not not out of their own choosing.

00;08;28;02 - 00;08;50;21

Dr. Tami

But it's like you get a hall pass, you know, where it's like, ‘Oh, okay, I don't have to go, Wow. So I can do the presentation from home. I don't have to do it,’ you know. So then their bodies are suggesting go, ‘Wow, okay, this is this is for weeks’. And then I guess what Lockdown's done. ‘Get back out there.

00;08;50;21 - 00;09;17;12

Dr. Tami

Go back to work’. So we're, of course, going to see another adjustment that people with this already difficult disorder now they're having to try to get back out there again and having to readjust and learn how do I how do I start to cope with because ‘I don't get to stay home anymore, I don't get to I don't have my hall pass.

00;09;17;12 - 00;09;19;27

Dr. Tami

So now my anxiety again is increasing’.

00;09;20;25 - 00;09;44;11

Rob Jollie

In that, you are saying it's normal to have a little social anxiety. Right? Where it's very common and everybody goes through it, but what is it they preventative nature of the social anxiety is when you should start addressing it? But it's preventing you from doing things?

00;09;44;12 - 00;10;20;14

Dr. Tami

It's definitely and that's everything in the area of your mental health. It's it's understanding that if something is is interfering with your day to day, if your what if what I just said, you know, fear of being in public fear, not fear of people, but fear of being humiliated by people, fear of being ridiculed, judged, embarrassed and thinking about those if it's causing causing enough distress where you're physically alerted.

00;10;20;19 - 00;10;50;11

Dr. Tami

And then so when you're physically are alerted, that means your body, you're you're perceiving something threatening. And the threat is usually almost oftentimes irrational. And so the difficult thing is that many of the people who suffer from this type of disorder, they know it's irrational. They can't help it. It's it's an uncontrollable worry that they feel powerless over.

00;10;51;07 - 00;11;22;26

Dr. Tami

So they may try to self-talk, positive talk themselves into these situations and they know like, ‘Gosh, there's no way that everybody in here is staring at me right now and thinking I'm a that I'm not competent or I don't know what I'm doing. But yet, that's that's the way I feel. And therefore I don't want to walk into that room and have all those people stare at me because then I just want to avoid that feeling.

00;11;22;26 - 00;11;49;28

Dr. Tami

Because when I'm around that feeling, I perceive threat - my brain does and it triggers my nervous system to start to release adrenaline and other hormones to then activate my fight or flight because I need that, then that means I need to protect myself.’ And so a lot it can become a cycle. And they may think, ‘Well, there's nothing I can do about this because this is how I always get.

00;11;50;17 - 00;12;19;28

Dr. Tami

I've been like this since I was young. This is part of my personality. People say I am shy or I'm an introvert. And this this is I've just learned this is part of what I do’ and it's part of maintaining the disorder is then learning to avoid. And that's for overall anxiety disorder in general, like the umbrella and the anxiety. When we have an anxiety that's causing that,

00;12;20;13 - 00;13;05;19

Dr. Tami

our first our first thought is, ‘Oh gosh, then stay away from that. Don't feel that.’ So if you're being triggered by, let's say, work, then your body and your mind go, ‘Then don't go to something something that feels that is threatening, you know, stay, protect yourself.’ And so it's like, we really have to go. ‘Okay, wait.’ This is where getting some help to understand this, because trying to figure this all out on your own can get very overwhelming. Now that I think that hopefully the way that I'm presenting it means that there's definitely hope and there's a there's if there's so many treatment options out there. And so I can't go through them

00;13;05;19 - 00;13;31;16

Dr. Tami

all, but I'm going to make sure to post this article so you can if you're somebody who struggles with this type of anxiety there, that article talks about a lot of the things that you do. And talking to somebody like me, a psychologist, is one huge step in the direction of saying, 

I don't know if I have this, yet,

00;13;32;06 - 00;14;21;28

Dr. Tami

I need your help to tell me what to do. And here's here's what I'm going through.’ And that's where I think in today's age, with so much information, I'm getting a lot of patients into the clinical course trying to self diagnose, figure this out on their own and with social anxiety, you’re already feeling a little isolated, you're already feeling self-conscious about certain things this this type of thing can be as as obvious as people who are who really avoid using public restrooms, who avoid eating out in public, who avoid going, you know, maybe they'll shop in the grocery store, but they won't check out.

00;14;21;28 - 00;14;49;03

Dr. Tami

They'll have asked their person to check out for them. Or this may be the individual that if you're pulling up to a fast food restaurant, they won't place the order, but they'll have somebody else in the car do it. And so these are all of the signs of that could be leading up to: how uncomfortable is this for you and is this impacting your ability to do what you want in life?

00;14;50;23 - 00;15;20;22

Dr. Tami

And so getting them to understand that this this is even if it was part of personality, we're looking more at shyness is in this is for another episode where we can talk more about the difference between a social anxiety, being an introvert in somebody who's more introverted, and then also the shyness. Those are all different things. And so they may share some common could.

00;15;20;22 - 00;15;51;22

Dr. Tami

There might be some commonality, yet there's differences. And our listeners, since this is so common, I'm assuming that some of our listeners are struggling with this social anxiety and that they're definitely or they know somebody who's who may be struggling with it. And I use struggle because I if there is, there's treatment for it. So sometimes we don't know that. We we need to hear that.

00;15;52;10 - 00;16;17;02

Dr. Tami

I kind of say exactly, we don't have enough time to go into all of the treatment, but talk therapy is one of them. Cognitive behavioral therapy, which is something that I think we, I mentioned on this show often because it's the one therapy that it's that I rely on in my work most most times. I do a lot of approaches, but cognitive behavioral therapy is one of the major ones

00;16;17;22 - 00;16;34;24

Dr. Tami

when you're dealing with anxiety and depression. And other areas of disorders where we just need more information on how those, our thoughts, can impact the way we are behaving and how those can impact the way that we're feeling.

00;16;35;25 - 00;17;07;24

Rob Jollie

Another question, the is there an outside element that is kind of expecting us to be social? It's mostly coming out of COVID, right? Where we got like, no, that seems like the world is kind of trying to go back into things that we've been normally doing outside influence. You know, has COVID exasperated a lot of this social anxiety as well?

00;17;08;17 - 00;17;39;03

Dr. Tami

Well, it's it's we we've dealt with it as if social anxiety is not a factor. So this is where we need to step back and have some compassion and understand the transition that we've asked people to make without educating them on mental health. So and not just in general, like those broad statements of your mental health matters, because to me, that's not enough.

00;17;39;03 - 00;18;09;27

Dr. Tami

That doesn't do it for me, especially if I don't know what I'm dealing with classifies as a mental health disorder. So you're not helping me feel any more connected or safe in what I'm personally experiencing. So when I'm taking a look at it and that's why I enjoyed her article, Jessica's article, she really looked at this from a from her point of view in terms of her area of expertise.

00;18;10;20 - 00;18;41;02

Dr. Tami

And it's it's one of the things that I realized as a psychologist, we didn't do a great job of really trying to be part of educating people in terms of ‘here's what you could be dealing with at home and here's how asking you to now giving you some temporary relief that was justified, temporary relief from having to show up in social situations to now, no longer is that justified,

00;18;41;18 - 00;19;11;14

Dr. Tami

get back out there.’ You know, we cannot just shut down, go back to work, go back to school, go back to socializing, because we we need connection with others to be outside of our our own isolation and our own homes. We need to. So just telling somebody that who has the disorder is already terrifying to me because it's like, ‘What are you telling me?’

00;19;12;04 - 00;19;38;10

Dr. Tami

And there is a level of cognitive confusion that nobody's talking about for these individuals. And it's it's a high prevalence that we know of. Think about all the individuals who are suffering with this in silence. And we're just asking them or we're telling them kind of ‘Just deal with it because we're not thinking about you,’ which is true because it's hard to do.

00;19;38;11 - 00;20;03;28

Dr. Tami

You think about every single human being out there and have compassion and have enough time and resources to individually try to reach out to them. But this is one way that we're, you know, I feel like what we're doing right now, this is one way I feel that I'm trying to reach out to people. And I see this disorder so often, and most times it's overlooked.

00;20;05;08 - 00;20;36;04

Dr. Tami

Most times the individual, the person I'm talking to is just kind of like, ‘Wow,’ you know, they knew something. They felt like they were shy, but they weren't shy. They were in situations that they were fearful of being embarrassed, humiliated, being ridiculed, and being just totally misunderstood by the people around them and publicly embarrassed. So then that's that's one of those things

00;20;36;04 - 00;21;06;23

Dr. Tami

it's hard to say all that somebody you know, that's one of those things, ‘Oh boy, that's that's still vulnerable, you know, that feels like nobody else is telling me that they're feeling like that. So am I alone in this? Is this something that I just have to tough toughen up and deal with and just keep doing it?’ So this person who's just kind of stuck in this, especially with the pandemic: that that causes stress for all of us.

00;21;07;08 - 00;21;51;28

Dr. Tami

So if you're somebody who already has preexisting mental health conditions, medical conditions, this is going to hit you even harder. And so that's the those are the individuals that I think now we really have to try to try to help them in terms of just giving them some education, our language. Language, for them to start to think about that their what their situation or somebody they love or care for is going through and saying, ‘Okay, so now, what do we, what can we start to maybe do about this?’ other you know, For those listeners out there, some of the other signs of it:

00;21;52;05 - 00;22;19;13

Dr. Tami

So I talked about performance anxiety. Now, there are those individuals who have social phobia. Now, a phobia is an irrational fear. So, it's a, it's an irrational it's something irrational where your mind, the likelihood of that happening is not there. It's something that your mind is creating a lot of fear about. And so we have there are justifiable, rational, real fears.

00;22;20;00 - 00;22;49;10

Dr. Tami

That's why the the pandemic is complex, because there are there are real fears. This is it's rational to be fearful of what was what's going on with COVID. But it's then you've got to measure what's irrational. ‘What part of what we're our uncontrollable worry is the likelihood of it happening is so little and it's interfering with my daily life?’

00;22;51;00 - 00;23;28;04

Dr. Tami

So those are the kinds of things where that CBT can be helpful, but that's working with somebody. And a lot of the research that's out there shows the best way is a combination of seeking out some medical advice from a psychiatrist or somebody who can prescribe medications to help you, but also dealing, doing therapy and engaging with somebody in therapy so everybody will has their own approach that they can seek out, seek help for this, but they can't do it on their own.

00;23;28;04 - 00;23;39;08

Rob Jollie

Yeah, it's like telling me I'm a pilot all the time and then I get into the cockpit and you're like, ‘Are you a pilot?’ And I'm like, ‘No. They told me I was a pilot, though, so everything's okay. Let's go flying.’

00;23;40;22 - 00;24;10;09

Dr. Tami

Right? And with this, it's looking at it in terms of, ‘Okay, so all of these symptoms that I'm feeling, they're not just not just all me, it's not in my head. This is a real condition that I'm dealing with.’ And so it's looking at it. And it's for some of those of you where I want a little more detail, some of the symptoms, a lot of it's physical.

00;24;10;29 - 00;24;41;16

Dr. Tami

So if you're somebody who when you're having to perform, walk into a crowded room, and you're you can feel that adrenaline rush, not because you're super excited, you know, like when I walk into a concert and I'm excited and I got this adrenaline rush of excitement and it feels good like that. Good energy. This is the adrenaline rush of ‘Yikes, I'm perceiving threat.’

00;24;42;04 - 00;25;11;12

Dr. Tami

So some of these individuals who have the disorder may have heavy blushing. So the discoloration of their skin where they fear that people didn't even notice the blushing. So they do. And they're self-conscious about their reaction already. Oh, now I have physical markers that people may be able to see and then they look at me, maybe looking at me even more, because now I feel embarrassed and I'm blushing even more.

00;25;12;20 - 00;25;40;28

Dr. Tami

The other thing is those like palms sweating or sweating just starting to sweat when you're in public, Not just because it's hot or it's crowded, but because you're fearful, You're fearful that you might do something embarrassing. You may have to engage in conversation. Somebody might call you out on something, something everybody might just put the spotlight on you and you weren't prepared for it.

00;25;42;06 - 00;26;07;29

Dr. Tami

Some nausea. So when you feel  physically sick, your stomach is kind of queasy, a lot like butterflies in the stomach that are abnormal. So butterflies in the tummy and they go away. But this is like you got a lot of those. But it's just a feeling, not just a little nervous, but a little nauseous and that you have to look at where am I feeling this?

00;26;08;05 - 00;26;36;23

Dr. Tami

And it's when I'm in this situation and then your heart can race. All of a sudden your heart starts to pick up and then your mind goes blank, having a period where your brain kind of feels like you're malfunctioning and you can't find words to express yourself. If somebody does talk to you, you know what the word is?

00;26;36;23 - 00;27;16;25

Dr. Tami

It's on the tip of your tongue. And you have this group of people staring at you and your stomach starts to feel queasy. Your face may start to feel warm. It may even blush. You may start to sweat a bit. It could really feel like a panic attack is coming your way. And yet, you have this group of people that you're talking to waiting for your response if you're in a conversation with them. That's the, that's the level of discomfort that I would I, I wouldn't want people to experience on a daily basis as, as their, as their doctor.

00;27;17;21 - 00;27;57;20

Dr. Tami

You know, to me that I have compassion for that. I felt that I can relate to that uncomfortable feeling. And I believe every single human being has been there a time or two yet, on a daily basis or, you know, throughout your lifetime. It's it's that's where we start to say this is a piece of suffering that doesn't have to be endured. That there's, there's ways to not normalize health and your healthy anxiety response and then there's ways to go, ‘Okay, that's interfering.

00;27;57;20 - 00;28;32;17

Dr. Tami

I'm distressed by this. It's impacting my relationship, my relationship, my comfort with myself, my comfort with others, my ability to finish this program.’ But I thought, you know, it has to have some kind of impact where you're actively seeing that this level of anxiety is starting to interfere with your life. I'll just put this out: I don't have the exact book, but it takes a person, a person with anxiety an average of ten years to actually seek out help.

00;28;32;20 - 00;28;59;12

Dr. Tami

It's the same anxiety. And so hopefully some of our listeners out there may go, ‘Okay, so it's okay to, you know, give this, give it a look.’ And if it's not, then your provider, you know, a doctor, psychologist, they'll be able to tell you what it is because, you know, there is these things that we all have to look at medical stuff can create, can feel panic.

00;28;59;12 - 00;29;29;16

Dr. Tami

All the symptoms I said could be could be caused by lots of different things. But what I'm talking about specifically is if your it's when you're triggered by being in crowds and you're not necessarily scared of panic, but you're scared of being humiliated, being the center of the attention, having all eyes on you, that's, that's more, it's more of that social or if I have to perform.

00;29;30;28 - 00;30;04;24

Dr. Tami

And so performance anxiety is very specific. So individuals, they're like, ‘Oh, I'm fine in a crowd, I can talk to people. But to give a speech, I want to call in sick that day. I don't, you know, or I anticipate it with such fear and anxiety and dread for weeks and months before that I'm just uncomfortable. And I may do it with them feeling so uncomfortable doing it or I may just avoid it in the long run,’ you know, whatever the outcome is, they don't know.

00;30;04;24 - 00;30;19;17

Dr. Tami

But it's like this excruciating anticipation. And so not everybody goes through that. Not everybody has that kind of anxiety response to the situation where I was just talking about.

00;30;20;26 - 00;30;44;17

Rob Jollie

I think the way you're saying what you said is you can say, ‘What's the worst that can happen,’ but you actually have to learn what that is because we can say it, but if you don't understand it, it means nothing. You know, because you brought up making  a speech as a number one fear for a lot of people.

00;30;44;17 - 00;30;51;06

Rob Jollie

Some people will not do that. It is a required course at college. You wanna pass? You have to do it!

00;30;51;09 - 00;30;54;26

Dr. Tami

Public speaking. Yeah, public speaking.

00;30;54;26 - 00;31;23;17

Rob Jollie

And I've been I've done it. I've done it multiple times. You know, it got easier the more I understood what worse could happen, because not nothing happened after I did it other than the usual whatever, maybe applause or kind of like on to the next person. But I didn't really understand that, you know, I, I and just to kind of bring it around to this other sense of being out in public that what you brought up.

00;31;24;28 - 00;31;49;24

Rob Jollie

I found myself in a restaurant at the age of 21 or 22. I had to leave the restaurant because I just started feeling overwhelmed and nervous. And when I was out in the parking lot, my friend was like, ‘What's wrong?’ And I couldn't explain it, but I was just feeling this way. And this happened to me when I was like 21. This is a long time ago.

00;31;49;24 - 00;31;50;27

Dr. Tami

Right.

00;31;50;29 - 00;32;08;24

Rob Jollie

And I didn't understand it. And it wasn't as common for me to learn that I was being nervous around people in public because I was afraid of the unfamiliar aspects of it. But I didn't know these people. I was around and I just started feeling wild about it and you know.

00;32;09;02 - 00;32;40;25

Dr. Tami

Wild about it. And so just you sharing that, I think our listeners can appreciate that. And I've been there, you know, I have a lot of my stories as well, and I think that that's part of what what I hope happens from this conversation is that we want, I don't want people to get more to feel like knowing about it means ‘I'm more scared about it’ because I want our listeners to know knowing about it is what's empowering about healing it.

00;32;40;25 - 00;33;22;27

Dr. Tami

And that it is treatable. And so there are lots of ways to start to think about that. I guess I want them to start just seeing the image of uh, hope in terms of that type of anxiety. And knowing more about it is the key factor of CBT. You start off with what's called ‘psycho education’ and it is key. You cannot press fast forward and start talking about what, you know, just start talking about just engaging in it or just doing it, you know, trying to say it.

00;33;22;28 - 00;33;50;21

Dr. Tami

‘Just get out there and do it and come back and let me know how I felt for you.’ You know, just so you have a therapist say, you know, that there's different techniques. You know, this could go on and on and on. That's called exposure. And part of, Before you want to be exposed to something that is terrifying. Remember, we use the word ‘phobia’, those phobias, they're irrational fears, yet, they're real fears for you.

00;33;51;01 - 00;34;29;06

Dr. Tami

And they have a fear response that can feel frightening. And so, we do not want to underestimate the power of this disorder especially when somebody is brave enough and vulnerable enough to walk into your office as a health care provider and try to try to ask you, just try to talk to about this. And so not only for listeners, but for those of you who do this type of work, if you haven’t experienced this level of anxiety or fear, have some compassion.

00;34;30;15 - 00;35;04;09

Dr. Tami

Think about that. You're you're this is part of think about your norm. But you have, every person has a normal anxiety reaction. We all have levels of nervousness. We all have adrenaline rushes. As you know, we all have the, this nervous system that can activate and heighten. And so just imagine that, if that happened to you every time you had to engage in a social situation, that that your body perceived it as threatening, then that's how you can start to put yourselves in and empathize.

00;35;04;15 - 00;35;34;18

Dr. Tami

For these individuals who are going through this. And I just want to just really quick put out for children. Some of the things that I think this is one of the areas we’re, again, we got to catch this earlier because it happens around early childhood and then it's more common in females than than males. And that again, that's data. That can mean that or maybe that more females are coming in for help.

00;35;34;18 - 00;35;59;12

Dr. Tami

So when we give data, that doesn't mean it's a fact, it means this is what the numbers show, but there's also numbers where it's almost like we classify males as experiencing more of this and females more of that. And then guess what? We overlook something that we could have caught because our minds expect to do an either or.

00;35;59;29 - 00;36;23;03

Dr. Tami

And so on this show, on all of this podcast, I want to make sure that people know that, that a child who, when they're in public or you're wanting them to enter, if they start crying, having a tantrum, I'm freezing. Now, I said fight or flight. Freeze is the other nervous response that your body will get when it has an adrenaline rush,

00;36;23;20 - 00;36;49;28

Dr. Tami

extreme fear where they can't move. And sometimes parents are like trying to pick them up and push them. ‘Keep walking, get into the school’ and your child is freezing or they're clinging to somebody or, you know, these are all things I used to do as a child. I'm just, I just kind of gotta throw that out there. I'm just imagining, you know, this is what I would do to my sisters there.

00;36;50;00 - 00;37;23;28

Dr. Tami

I have three older sisters. Shrinking, so trying to hide behind a caregiver, ‘Protect me from this stranger that you want me to talk to,’ and just not speaking. So this and but Commonly, parents will go, ‘We'll say your name’ or ‘Tell them how old you are’ or, you know, just kinda pressure without realizing this, this poor child is trying their body is telling you they're really uncomfortable. And forcing them,

00;37;23;28 - 00;37;46;05

Dr. Tami

In a way, it's kind of like tough love. Yeah. You also you got to you got to balance that with some compassion and then friendly like, okay, you know, one thing I had to do to one of my lovely children is eventually I did have to say to try to help them is ‘Order your own food at a restaurant.’

00;37;46;05 - 00;38;06;03

Dr. Tami

And you know, mommies, we want to get in there. We want to do it for them. We know maybe they're getting anxious and eventually that, I think that was like one of the big steps. It's like ‘You want that hamburger’ or ‘You want that milkshake? All you gotta, You got to ask for it, because mommy can’t do that for you.’

00;38;06;03 - 00;38;33;11

Dr. Tami

And eventually, guess what? You know, just starting with something like that and then realizing it was tough maybe the first time, but then guess what happened after that? She got the milkshake or she got the burger or whatever. And so I think that's just an example of the kind of pushing that we need to do. But be aware of those kinds of symptoms because they're really the same for adults.

00;38;33;23 - 00;39;01;11

Dr. Tami

Maybe we're not visibly clinging, but boy, you know, sometimes we are. We're clinging to our house. We are in our cars, you know, maybe just not wanting to get out and enter the situation. There are a lot of things that we're doing as adults that are physically showing us how uncomfortable we feel. That's how distressed we feel.

00;39;01;11 - 00;39;39;06

Dr. Tami

And starting the conversation about that and starting to educate is one way of starting to gain some control over this. We’ll end our conversation today. Thank you for being part of this. Miigwetch, P.S.: COVID and the pandemic has been tough on everybody but having compassion for those who already struggle with anxiety, depression, substance use, all of those other mental health issues. It can go a long way, and I think it's needed more than ever.