Why People Might Use Anxiety To Avoid Depression: Part 3

This is the third installment in my series on anxiety as a defense against depression. See here.]

QuixoticBlues has a number of videos on YouTube. One of them is titled: "Yeah I'm a bit crazy." The following is a transcript of some of his opening thoughts (expletives omitted).

"I'm sure that everyone who watches these things [his YouTube videos], thinks I'm a nut case. What I'm worried about is that they might be right.

"God, I hate wondering if I'm crazy, you know.

"…In my free time, most people would want to go hang out with their friends. They would not endorse spending hours alone by themselves in their room. And yet that is exactly what I do.

"There it is, though. I'm worried that, you know, I'm crazy."

Those are common thoughts for people with anxiety disorders.

In a typical evaluation of someone with anxiety, she or he might start out by saying:

"I don't know why, but every time I think about going out dancing or even to church…any place that's crowded, I get really anxious."

I then ask what they worry about happening if they go out.

"I'm not sure. I like dancing and I like going to church. But I'm worried that I'll do something that will make people look at me weird. That I'll do something stupid. People will look at me funny or they'll think I'm a jerk."

So, I ask, has anything like that happened to you recently?

"No, not really. When I go places, I'm quiet and stay by myself. I don't want to stand out. I don't want people to see how nervous I am. I don't want people to judge me or make fun of me. I think it could happen if people see how I really am. Or maybe I'd say something dumb and they'd think I wasn't smart. I dunno. It's bad enough that I see how messed up I am; I don't want other people to know."

The list of potential bad outcomes is usually pretty long. And so are the number of flaws that the anxious person thinks might be discovered. It's very painful for people to think like this. It would be even more painful, they believe, if they really were made fun of, rejected by or judged poorly by other "normal" people.

However, notice in these statements that the bad things remain only potentially true. They have not happened yet. There is a big "IF" in front of all the negative judgements and embarrassments.

This "IF" does at least two things. One, it preserves a slim hope that a person is not as messed up as s/he thinks. Two, it forms a tightly reasoned and logical argument. This bit of logic provides the rationale for giving into some of anxiety's other symptoms such as isolation, avoidance, self-doubt, worry and others.

Bear with me for a moment while I get a bit technical about the reasoning involved here.

Cut down to the essentials, these concerns form a valid logical argument called a chain or hypothetical syllogism.

If I go out, then people will judge me as flawed and no good.

If other people, too, judge me as flawed and no good, then my worst suspicions about myself will be confirmed.

Therefore, if I go out, then my worst suspicions about myself will be confirmed.

We can look at this in a symbolic logic form.

Let "P" equal "I go out." Let "Q" equal "people will judge me as flawed and no good." And "R" will equal "my worst suspicions about myself will be confirmed."

If P, then Q.

If Q, then R.

Therefore, if P, then R.

So, once I go out, people will confirm my worst fears about myself.

Now let's see the opposite or negative of those statements.

If I don't' go out, then people won't judge me as flawed and no good. If not P, then not Q.

If people don't judge me as flawed and no good, then my worst fears about myself won't be confirmed. If not Q, then not R.

Therefore, if I don't go out, then my worst fears about myself aren't confirmed. Therefore, if not P, then not R.

Okay, the technical aspects of this bit of logic are over. (By the way, this same logic holds true for most anxiety-ridden thoughts. You can fill in the lines with contamination, orderliness, phobias, etc.)

We can now see the logic behind choosing anxiety. Doing so fends off the final proof of one's worst fears and the depths of depression. There is no "if" in these depressions. It is seen as a proven truth that I'm no good. There is, then, a logical argument backing up the desire to isolate. Staying home, or putting on a false front if I do go out, lets me have some lingering doubt about my worst fears about myself. Hope remains alive.

But if I go out, I am damned. In my anxious reasoning, it's a foregone, logical conclusion that my worst thoughts about myself will be validated. There is no doubt or hope left.

Once it seems like someone looks at me oddly, then it is proof that I suck, my life sucks and everybody knows it. There is no escape from these facts. This is depression.

Sometimes people believe that it will never get any better. I suck and always will. That road leads, at times, to suicidal thoughts. Why continue in the pain of depression if there will never be any relief?

An example of depression crashing in after anxiety is found in Donovan Campbell's Joker One. The anxiety preludes in this book are discussed in the first and second posts in this series. Towards the end of the book, the anxiety is gone. Instead, he writes "I wished fervently that I had died in Bolding's stead [a soldier under his command]….I finally realized that, no matter how hard I prayed, God didn't owe me anything, not even life….Finally, I considered myself already dead, with each day a precious gift that I didn't deserve."

Campbell was not frankly suicidal. However, there is a darkly depressive quality in the belief that he should have died, that he was already dead and did not deserve another day of life.

Okay, on the level of how some people rationalize and experience anxiety and the transition to depression, I think the point is made by now. There are any number of other levels at which we could discuss this topic. Those other realms range from the biological to object relations theory. But those discussions will have to wait for a different day.

The next question is: what's to do when people use anxiety as a guard against depression? How is that situation best treated in therapy?

Clearly, we do not want to take away someone's defensive anxiety if that will plunge them into a depression. Nor would we want to eliminate the anxiety at the cost of an otherwise preventable divorce or similar problem. Yet, we do want to treat the anxiety and bring about a higher quality of life.

I'll try to shed some light on those issues in the next few posts in this series.

Comments
  • Inge

    I have both depression and anxiety, but more anxiety than depression. With this article are you saying that I am using my anxiety to cover up my depression? In my case I just HATE the names of my diagnoses. I'm not overly anxious and I'm very happy with my life...I have an inherited chemical imbalance and I'm not trying to hide ANYTHING.

  • Michael Adamowicz

    Sorry for any confusion.

    I'm writing about a narrow sub-set of cases. I have only recently noticed this common thread for some people. It certainly does not apply to everybody who has depression or anxiety. As you rightly point out, there are many times when an "inherited chemical imbalance" is to blame and the dynamics I'm writing about don't apply.

    My observations are based on my own clinical practice. As a result, I cannot be sure how often widespread this phenomena occurs in the general public.

    I'll try to be more clear about this in my upcoming posts. And thanks for pointing out my lack of clarity so far.