Reader’s Question

I have this feeling of a dream-like state. I always feel like I am dreaming or drunk. I went to my regular doctor and she ran a bunch of tests on me, but all came up fine. She sent me to a psychiatrist and she said I have some social anxiety. I don’t really like to be around people, but I know this isn’t the problem. I think it’s more than this.

Anyway the problem is really what happened on the way out. I was sitting in the waiting room and when she gave my file to the office staff she made a comment that she couldn’t help me if I was going to lie to her. I didn’t lie to her. I told her everything. I haven’t even told my family any of this. They know nothing, but I told her everything. She also made a comment that they had to call social services because I work in daycare. I would never hurt anyone so why does it matter that I work with kids? I wouldn’t hurt myself either. So my question is can I lose my job over this? Also will I need to go the hospital for treatment? I have two children to feed and care for. I can’t go into the hospital for this. There is no one to help me with this. I feel like I am crazy and I don’t know what to do.

Our Clinical Psychologist’s Reply

This question has several parts. First, the dream-like state can be associated with social anxiety or just anxiety. It’s not uncommon to have a feeling of unreality, like we’re living in a dream. The psychiatrist may be correct. If you’ve always been shy and don’t like to be around people, you’ve probably increased your contact with people in your job and social activities. That will increase your anxiety as well as your social discomfort. You may not see it as a major problem because you’ve always been this way in your personality. I’d recommend continuing to seek mental health care about this.

The office problem is another matter. The psychiatrist probably wasn’t concerned about possible harm to children or yourself. Instead, the psychiatrist was concerned about your periods of dream-like states and feeling drunk. The major concern is your poor attention and concentration when caring for children. It’s like interviewing a man for a bus driver position and he tells you that his mind wanders and he daydreams a lot — you can’t approve him for bus driving! In most countries, psychologists and psychiatrists are required to inform authorities when they identify anyone who might be a danger to self or others. If a patient tells me he is having seizures each day — and he drove to the office alone — I’m required to notify both his physician and the Department of Motor Vehicles. This may create problems for your job as you are required to be fully alert as a childcare worker. In employment settings, people who feel dreamy, drunk, and not fully alert are not allowed to drive equipment, operate machines, perform inspections, monitor high-risk equipment, and care for others. When we’re not fully alert, there is too much danger of something bad happening.

You’ll need to see another psychiatrist. This is not likely to need hospitalization. You can be treated in the office for anxiety issues. It’s very possible that your stress level and responsibilities have increased over the past 18 months, producing a type of anxiety disorder. This is very treatable and shouldn’t create problems on a job once you are under treatment.