I believe that my 30 year old son is suffering from social anxiety disorder. I have struggled all my life with the symptoms which were treated with xanax and now effexor which has been very effective. My son lost his rental house after a roommate moved out and he was unable to to what was necessary to find someone else. He currently lives with his father and step-mother, and two babies, sleeping on the couch and seems very content. He is a college grad with great verbal skills, great sense of humor but stuck in a dead end public relations job that pays just over poverty level. He admits that he wants a change but can’t bring himself to take action. He has never had a serious or even much of a non serious relationship with girl or even a male for that matter. His younger brother has a good job in Denver and has tried to get him to stay with him and look for work out there but again he finds excuses not to. He retreats into a world of books or on line chat rooms or the security of family. Only recently have I thought of his problems in terms of my own until I discovered the literature on a possible genetic component. I now believe that my father and sister also had the disorder. I have coped by using my spouses to help ease my way socially and focusing on my strengths and now the medication is enormously helpful. My question is what can I do to help my son explore this possibility? After the housing crisis his father got him to try therapy but he only went a few times and stopped. I worry about the depression that he admits to having sometimes and possible self-injury. It is so hard to see a bright intelligent child not live to his potential and to deprive himself of meaningful intimate relations. What is your opinion of the hereditary factor?
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There is very good evidence to support the idea that there are genetic vulnerabilities for anxiety-proneness that are passed on biologically from one generation to the next. What is inherited is probably best not thought of as a proneness to a specific and particular anxiety disorder (although that possibly can happen), and more as a dimension of temperament (biologically driven components of personality) called ‘Neuroticism’ by personality theorists. Neuroticism is thought of as a bipolar dimension describing how emotionally stable a given person is. Highly neurotic people are labile, meaning that it is easy to upset their emotional equilibrium. Highly neurotic people are thought to be more prone to developing anxious and depressive disorders. Low neurotic people on the other hand are stable in the sense that it is difficult to perturb them emotionally. They are ‘rocks’ who can go with the flow more easily without getting ‘bent out of shape’. We all fall on this dimension somewhere, as we all have a personality. Note please that my use of the term neuroticism here is technical – meaning a dimension of personality. This usage is different from the normal meaning given to this term (e.g., the psychoanalytic meaning suggesting minor mental problems, tics, etc.)
In anxiety disorders, so the current thinking goes, a high-neurotic person panics, and then learns to avoid doing things that would possibly make them panic again. In a sense they learn to avoid feeling fearful, and in so doing, restrict their range of activities sometimes down to a bare minimum required for life. Effective treatment for anxiety disorders is available, and words on the principle that one can learn, through successive approximated exposures to feared-but-not-actually-dangerous events, and through teaching one how to make a realistic rather than a fear-driven appraisal of threat, to tolerate fear feelings. You’ll want to look into cognitive-behavioral therapy for anxiety, available in most cities (and nowadays towns too) through a licensed Clinical Psychologist.
You can possibly help motivate your son by educating him on the facts (e.g., that anxiety problems tend to run in the family, that it is not a weakness, but rather a feature of the family, that you’ve had problems yourself and are functioning better with the help of treatment, that you’ve noticed (and he probably has too) that his life has become restricted, that you love him and want to help him grow out of this, that help is available (via cognitive therapy and via anti-depressive medication), but that he has to engage the therapy himself. If he doesn’t want to confront his avoidance, it will be hard for you to force him to do so. However, he might also appreciate the nudging and do something with it.
One other thing that can be considered, but I can’t know for sure, is that the family may possibly be enabling your son’s difficulties by providing him with shelter on a non-temporary basis, thus allowing him to continue to avoid facing any fears around having to find shelter for himself as an independent adult. Think about this and if there is any truth to it, maybe discuss it with the father and your son (best to do this in a compassionate, non-judgmental way). Good luck!