I got really depressed in April and have been off work. The depression has just started to lift, but now I am phobic. I find going out and socializing hard work. Is this the tail end of the depression?

Losing interest in things you used to enjoy is a central part of depression. Withdrawing from positive activities can keep you feeling depressed.  As you feel better, you should start to feel more interested in things.  And pushing yourself to do things you used to enjoy will help you to feel better faster.  Phobia or phobic anxiety adds another layer.  The core of phobia is avoiding things because doing them (or even thinking about doing them) makes you feel anxious.  Phobias tend to be self-reinforcing.  When you avoid situations because of anxiety, the avoidance helps the anxiety to grow stronger.  The surest cure for phobic anxiety is pushing yourself to gradually overcome the anxiety.  That’s easier said than done, but it helps to follow a specific plan.  Pick an activity that is important to you – something you would enjoy or something that you need to do to move forward in life. Chose a small and specific first step, then practice that step over and over until it doesn’t make you anxious.  Once you master the first step, choose a second step that’s a little more of a stretch.  And practice that one until you master it.  For example, if you’re feeling anxious about social situations, your first step could be as simple as going to the grocery store every day and saying something positive to the checker every time.  They certainly won’t mind.  If you have trouble making a plan or sticking with it, a therapist who knows about anxiety problems can be very helpful.

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist and researcher at  Kaiser Permanente Washington Health Research Institute in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.

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