Psychiatry & Psychology--General/Bipolar? Social Anxiety?

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Question
Hi Daniel, hope youíre having a great day!

Iíve asked someone off of ĎAll Expertsí this question before and I was promptly and rather bluntly told to get professional help, so I was wondering if you may be able to help me.

Iím a very confident 20 year old individual, Iím very comfortable around people, and am usually the centre of attention, something which I crave. Iím also really great at chatting up girls, and exploit my exuberant, silly personality to great effect.

However, before this sounds like a lot of boasting, there is one caveat! Sometimes, Iím just the complete oppositeÖ Almost as if I have bipolar. Theyíll be occasions sometimes where for whatever reason Iím not the centre of attention and people are interested in people over than me, and Iíll just suddenly go a lot quieter almost like I'm having a strop, and usually become unhappy due this, maybe appear unresposive. Then later I will overthink it TOO DEATH, and usually become quite depressed about my lack of Ďa personalityí, compared to earlier points in the day when Iíd been on fire and everyone had loved me.

When Iím in public places in a group, Iím silly, outgoing, and very very comfortable. Iíll chat to strangers, show off and generally be very happy. Although when Iím on my own I almost feel like I have some sort of social anxiety. Why Iím like this Iím not sure, but I kind of feel like Iím not totally being myself when Iím on my own, and just a crappy second rate version which depresses me, small things like going shopping on my own can result in panics that I might come across as 'shy'Ö However, hereís the odd thing, itís not the actual people that scare me, but how I might come across to them that I fear. Iím so ensnarled in my own ego itís awful.

For example, I saw a rather attractive girl in a grocery store recently, and didnít start talking to her, we just both went our separate ways and carried on living our lives. Anyone else would say that is completely normal, but myself, with such incredibly high social expectations of myself, beat myself up mentally over it for days after. I tried to rationalise it (barely any people chat up girls in the street or shops, it was 9am in the morning) but I still felt down about it.

Lastly, if Iím one of my introvertive moods I will overthink social scenarios way too much! Iíll think about how I need to act at them, how can I be seen as the most confident, and then after I will analyse every aspect of my Ďperformanceí, if itís gone well then Iíll be happy, if Iím come across as anything below Ďconfident, centre of attention, flamboyantí Iíll be down.

I also have a tendency to dramatise things, so this problem isnít too HUGE. But itís a big enough problem in my head to ask for an explanation, if not some help!!!

Thanks,

John

Answer
From what you are describing you are having social skills problems.  This is best improved through some social skills training, usually in a group format, almost always with a psychologist or similarly trained professional. It does not imply a major psychiatric disorder; as you say this is not a huge problem, but it seems bothersome enough that recommendation for some professional intervention might be helpful.

Psychiatry & Psychology--General

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Daniel S. Harrop, M.D.

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Dr. Daniel S. Harrop received his B.A. and his M.D., both from Brown, and his M.B.A. from the Edinburgh Business School, Scotland. Board-certified in adult and geriatric psychiatry, he is a past president of the R.I. Psychiatric Society and a member of the Committee on Medical Quality of the American Psychiatric Association and the Committee on Continuing Medical Education of the R.I Medical Society. He serves as a consultant to four of the top five major medical management companies, including OptumHealth/United Healthcare, Magellan Behavioral Health Services, ValueOptions and APS Healthcare, and maintains a private practice in Providence, R.I. He also serves as chief psychiatric consultant on the Medical Advisory Board at the R.I. Workers Compensation Court. He was formerly on the faculty at the medical schools at both Brown University and Harvard University.

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