2 - Overcoming Social Anxiety During the Reimplantation Process

 We are all familiar with the feeling of anxiety. Preparing for an exam, getting ready to go on stage, or handing in your thesis are all examples of situations that could cause anxiety. Anxiety can also occur at random times. The symptoms of anxiety vary for each individual. It usually consists of body shakes, racing heart, face turning red, feeling scared, irritated, sweating, feeling of doom or shortness of breath. Anxiety can become a disorder when these symptoms lead to difficulty in performing everyday tasks.

There are different types of anxiety disorders. The most common disorder is generalized anxiety disorder (GAD), which consists of persistent anxiety and worry about different things. For example, while waiting to write an exam, the person could start shaking uncontrollably to the point where they could not write the exam. We will focus on social anxiety, which is another type of anxiety disorder that involves feeling anxious in social situations, such as talking to people. You are often worried about what people think of you, how you react in front of people, or both. Past experiences and environments can cause social anxiety. Social anxiety can become a chronic condition known as Social Anxiety Disorder (SAD) or social phobia. Parents with SAD can pass this on to their biological children. The child could get anxious quickly in social settings. They could become energetic at random times or become "hyper-anxious" when exposed to a stressor. For example, when a child is on their way to school to meet other children, they would start to experience rapid heart rate to the point where it becomes uncontrollable and would likely miss school.

I am an extrovert. I love interacting and sharing laughs with people. Before the COVID-19 pandemic affected the world, I enjoyed hanging out with friends and spending time with family. However, in January 2020, my Cochlear Implant malfunctioned, and I had to get reimplantation surgery. It took almost one year of therapy to get my hearing back to where it was before (see my previous blog about my experience living with a Cochlear Implant and the reimplantation process). Since I could not hear like I used to, my social life diminished, to only immediate family and a friend who also wears a Cochlear Implant. I tend to be more of a “listener” in conversations, so during the recovery process, I tried my best to improve my hearing skills every day. I did this so that I could regain my hearing skills to where they were before, as early as possible.

Although the pandemic has negatively impacted millions of people’s lives, the social restrictions for COVID-19 actually made it easier for me to focus on my recovery. It gave me an “excuse” to not see people until my hearing improved. For the past year, I did not want to tell people about my hearing issues because I was afraid that they would think differently of me. I was also worried about not being able to communicate clearly. I didn’t want people to misunderstand why I couldn’t hear the same way anymore. I’m an excellent lip reader, but lipreading is not the same as lipreading and hearing simultaneously. I was also afraid that I would become mentally weak and that my life was now completely changed for the worst. 

After the surgery and before my implant was switched on, I had to rely on my weaker ear. It was so weak that everything sounded muffled and soft since it was left in the dark for the first 11 years of my life. I was not ready to meet anyone other than my immediate family. During that time, I felt like I was slowly fading away, as though I was losing my identity as a human being with feelings and emotions. Yet, the very human feeling of anxiety never seemed to leave. Being an extrovert but unable to communicate with others added another layer to my anxiety – what if my hearing never goes back to the way it used to be? What kind of person will I become?

After my implant was switched on in July 2020, I started seeing people other than my immediate family members. On the day of the switch on, we went over to a close family friend’s house. I felt nervous at first since I had not spoken to people other than my immediate family in months. Still, the extrovert inside of me wanted to come out again. I wanted to regain that love for socializing and avoid feeling anxious and nervous when meeting people. So I started seeing close family more often until I got comfortable seeing other people. My close friend and I went to eat at a restaurant. That experience was comfortable since she also wears a Cochlear Implant, so she understood what I was going through more than anyone else did.

I recall a memory when we had a picnic just a few days after my switch on. A family that I didn’t know was also there, and the feeling of anxiety immediately came over me. In retrospect, it was a good experience since it helped me overcome my social anxiety and challenged me to communicate with unfamiliar people. However, at the time, I felt like I had butterflies in my stomach, and my heart was beating out from my chest. I remember talking to them and not being able to understand most of the things they were saying. I was just casually nodding my head, saying yes to everything, while feeling anxious and embarrassed internally.

After that, I stopped taking an interest in meeting people. I focused on my hearing therapy so that I could be comfortable seeing and communicating with people again. When my mom video called people, they would always want to see me. She had to come up with excuses for why I wasn’t available. I could not say it myself because my mental health still needed work. My priority was to focus on improving my hearing and not stress about anything else. My parents became my “personal assistants” and dealt with other things for me while I was focusing on my hearing.

When my hearing became 65-70% recovered, I started visiting two more families (which is all I could do given the pandemic restrictions!) There were moments when I had issues understanding when conversing with the two families. Still, it was much better than my experience at the picnic. The pandemic posed another unexpected obstacle - it was much harder to lipread when everyone was wearing masks. When shopping, I would always use the self-checkout to avoid communicating with cashiers. When out with my parents, I would let them communicate on my behalf. Everyday errands became a new experience for me.

Fast forward to January 2021, when I restarted school. In one year, I went from communicating with only immediate family to having lectures via Zoom with hundreds of other students. I realized that even though this year has been filled with lots of ups and downs, I came out on the other side stronger than ever. 

Now let us talk about tips on overcoming anxiety - not only social anxiety but other anxieties as well. These tips include getting exposed to the anxiety source, how to stay calm after being exposed to stressors and how patience is key.

Slowly Getting Exposed to the Anxiety Source (Exposure Therapy)

Studying psychology in school has allowed me to understand psychotherapy basics and reflect on how it applies to my own experiences. One type of psychotherapy is Exposure Therapy, which is used to treat phobias. Exposure Therapy lets the client get exposed to the anxiety source without the intention to cause any harm, in order to overcome their anxiety gradually. The psychologist would usually follow it with an activity that helps cope with the stressor after getting exposed to it. For example, I was exposed to a stressor at the picnic when forced to communicate with an unfamiliar family. After that experience, I forced myself to get “exposed to the stressor” by socializing with different people to help overcome my fear. At the same time, I focused on my hearing therapy to improve my communication skills. 

If I only focused on my hearing therapy and avoided socializing with anyone, I likely would not be comfortable socializing with people today. I would have taken a longer break from school and essentially put my life on hold indefinitely. Exposing myself to the source of the stress helped me overcome my anxiety and speed my recovery process. I slowly built up the magnitudes of exposure. I started small, like communicating only with my immediate family. I then forced myself to socialize with two more families, and so on. Now I am comfortable over Zoom with hundreds of people. My anxiety hasn’t disappeared though. There are still times when I feel anxious in group settings, so bouncing back from a stressor is important. Now let us discuss ways to “bounce back” after being exposed to the stressor.

Staying Calm After Being Exposed to Stress

There are multiple ways to cope after being exposed to a stressor. These ways all depend on the individual. Most people try different tactics and end up sticking to a few that helps them the most. I do some breathing exercises before I go to bed every night. I do it every night, not only when I am stressed out since breathing exercises help me sleep and make me feel happier in general. I also have at least an hour for “me” time every day, just to do the things I enjoy. 

Humans are social beings, and we need each other for emotional support. Depending on the type of stressor, I confide in different people which helps me calm down and overcome the stress. For example, if the stressor was that I was in a social setting where I could not hear or understand anything, I would talk to my friend who has a Cochlear Implant since she would understand me more than anyone else. If I had issues with a family member, I would talk to my sister and brother-in-law since we share similar experiences. If I am struggling with a school assignment, I would speak to my professor or a classmate. The type of people you talk to depends on the stressor. Seeking professional help in the form of therapy can be helpful if people in your life are not able to help you overcome a stressor. There are many other ways to stay calm that I have not mentioned. It is essential to find something that you love to do or that can help you calm down. 

Patience is Crucial!

Mahatma Gandhi quotes, “To lose patience, is to lose the battle.” In my opinion, patience is the most critical factor that can help you cope with your stress. Most of the time, you will not recover from a stressor right away, so staying patient in order to overcome the stress is key. A strategy I use to stay patient while overcoming a stressor is to remind myself of my ultimate goal. If I encounter a stressor that is hindering that goal, I look ahead and remind myself of what the overall goal is. This takes my mind off the stressor, helps me stay patient and calm while coping with the stressor. For example, when I was exposed to a stressor that my Cochlear Implant malfunctioned, I constantly and actively reminded myself to be patient, which helped me stay calm. I focused on my goal of fixing the issue with my Cochlear implant, which helped me stay patient and focused. 

Impatience can lead to frustration and worsened anxiety, resulting in the stressor getting out of hand.      In extreme cases, these stressors are called traumas and could result in self-harm, drug or alcohol abuse, suicide, and other behaviours that could harm oneself and others. It is common to portray negative behaviours when you are beginning to get exposed to the stressor. Still, it is crucial to remain patient and stay focused on overcoming the stressor. For example, I indulged in negative behaviours when my hearing issues first began. One day, I inflicted self-harm. Fortunately, I quickly realized that this behaviour was not healthy. I told myself, "This was a one-time thing, and it will never happen again. This action does not represent who you are as a whole. Good things will happen soon. Be PATIENT and focus on getting my hearing back." Since then, thanks to my patience, I have progressively changed for the better. Mentally, I am now at the strongest place I have ever been in my life.

The COVID-19 pandemic has been a source of anxiety for many of us. We feel lonely, weary and anxious about what the future of our world will look like. I encourage everyone to use some of these strategies mentioned above to help get through this global stressor that has affected us all. We live in a virtual world – keep your friends and family close, even when they seem physically far. There is no shame in seeking help. Reach out to a professional if you find your mental health has suffered during this pandemic. 

Thank you so much for taking the time to read my second blog. I hope this benefits you in any way. Please feel free to contact me or comment below if you have any questions, concerns or anything else you would like to know more about.

-  Shobana Ramesh