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Spouse of a GAD sufferer reluctant to seek treatment
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An_255806 posted:
Hi all,

I am the spouse of someone with severe symptoms of SAD and depression, and he is EXTREMELY reluctant to seek treatment.

Before we met, he was the child who was forced to move around a lot. Never had many real friends. His constant company was his mother, who has anxiety and depression herself.

He did not have his first job until age 25, which was an extremely part time position at a clothing retailer. Even this simple job was overwhelming to him. In addition to this, he has an extreme fear of driving, and does not have his license.

On top of this, he is almost incapable of carrying on normal conversation with anyone, especially my family unless I am around. He will avoid human contact completely when I am not around him. Even when we are in social situations he stays attached to my hip, and has to be prompted to converse.

We are at a point in our lives where he needs to both find full time employment and start driving, as my income is not enough to support both of us.

I have been working with him for months, doing everything I can to help him. I've also been suggesting treatment constantly, but none of it seems to be helping.

I myself am a diagnosed bipolar, with mild anxiety but I've had extensive therapy and have been properly medicated for years. While I am in a healthy place right now, I am being slowly worn down to a point where I do not know what to do anymore.

I love him and want him in my life but these problems are causing extreme strain on me, and while he acknowledges he has a problem, it seems there has been no change.

I don't know where to turn, because he refuses treatment.

Has anyone run into this?
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Reid Wilson, PhD responded:
I'm so sorry that you and your partner are struggling with his social anxiety disorder.This is a very tough situation. First, he needs to shift his attitude to one of willingness to confront his doubt and distress. Second, he needs to find a good specialist in anxiety disorders who can gain his trust and help persuade him to do the work. (Depending on where you live, that may not be easy. Go to www.adaa.org and use their "Find a therapist" link.) One sign that they know what they are doing? He comes home with homework assignments every single session. And, third, he needs to stay with it. Overcoming social anxiety disorder takes grit: you have to persist with your work over time. You will get better gradually. It's not quite like panic disorder, where many people can catch on relatively quickly and produce major changes.
Unfortunately, you may need to give him an ultimatum. If he wants to keep you in his life, he must seek treatment. (Again, let me repeat: this must be treatment from a competent specialist in anxiety.) I will assume that you will literally have to be willing to risk the continuation of your love relationship. You will have to put it on the line. And that will not be easy. But you cannot give idle threats. And you can use a competent therapist to help you get the strength to do this work. You will need support; this feels very risky.
If necessary, he can begin through medication treatment. The medications for social anxiety are distinct, so he should see a psychiatrist who is familiar with them (and not try to get them from his primary care doctor).


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