Loneliness, fear, intense shyness, humiliation, embarrassment, avoidance, sweating, blushing – this is me.’
“It’s sad, actually, because my anxiety keeps me from enjoying things as much as I should at this age.”
Also called social phobia, this is when you feel overwhelming worry and self-consciousness about everyday social situations. For example, going on a date or giving a presentation may cause that feeling of butterflies in your stomach. But in social anxiety disorder, everyday interactions cause significant anxiety, fear, self-consciousness, and embarrassment. You fixate on others judging you or on being embarrassed or ridiculed. It often leads to significant avoidance behaviours. Social anxiety disorder is a chronic mental health condition and is one of the most common mental disorders, so if you have it, there’s hope. Asking for help early, learning coping skills in psychotherapy, and taking medications can help you gain confidence and improve your ability to interact with others.
The causes can be (1) Family traits – Anxiety disorders tend to run in families; (2) Brain structure – A structure in the brain called the amygdala may play a role in controlling the fear response, (3) Environment – Social anxiety disorder may be a learned behaviour after bad experiences for example teasing, bullying, rejection, ridicule or humiliation
The fight or flight reflex
People who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations. Anxiety and fear can protect you from danger. When you feel under threat, anxiety, and fear trigger the release of hormones, such as adrenalin. Adrenalin causes your heart to beat faster to carry blood where it’s most needed. You breathe faster to provide the extra oxygen required for energy. You sweat to prevent overheating. Your mouth may feel dry, as your digestive system slows down to allow more blood to be sent to your muscles. Your senses become heightened and your brain becomes more alert.
These changes make your body able to take action and protect you in a dangerous situation either by running away or fighting. It is known as the ‘fight or flight’ reflex. Once the danger has passed, other hormones are released, which may cause you to shake as your muscles start to relax.
This response is useful for protecting you against physical dangers; for example, it can help you run away from wild animals, attackers, fires, etc very quickly. The response is not so useful if you want to run away from exams, public speaking, a social event, or a date.
Left untreated, social anxiety disorder can run your life, because it interferes with all aspects .
Symptoms:
Significant and persistent fear of one (or more) social or performance situations in which the individual is exposed to unfamiliar people, or to possible scrutiny by others due to fear of humiliation or embarrassment. Note: In children, anxiety must be present in peer situations and not only in interactions with adults.
- Exposure to the feared social or performance situation provokes significant anxiety (including panic attacks).
- The person recognizes that the fear is excessive or unreasonable. Note: In children, there may be limited insight.
- The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
- The avoidance, anticipation of, or distress of the phobic object/situation must cause significant distress or interferes with the individual’s daily life, occupational, academic, or social functioning to meet the diagnosis. The symptoms cannot be better accounted for by another mental disorder or be caused by substances, medications, or medical illness.
“Social anxiety isn’t a choice. I wish people knew how badly I wish I could be like everybody else, and how hard it is to be affected by something that can bring me to my knees every single day.”
Specifiers:
A specific social anxiety would be the fear of speaking in front of groups (only), whereas people with generalized social anxiety are anxious, nervous, and uncomfortable in almost all social situations.
- Generalized – fear is present across any social situations
- Specific – eating in public, public speaking, talking to authority figures (e.g. boss)
- Duration: Typically lasts at least 6 months or longer
Get help early.
How to overcome social anxiety disorder
1. Challenge negative thoughts
Social anxiety sufferers have negative thoughts and beliefs that contribute to their fears and anxiety.
The beliefs people have about themselves and the world around them come in 2 categories
1. Sensible or rational beliefs: they are true; they make sense or are helpful.
2. Foolish or irrational beliefs: these are untrue; don’t make sense or are not helpful.
These can include thoughts such as:
“I know I’ll end up looking like a fool.”
“My voice will start shaking and I’ll humiliate myself.”
“People will think I’m stupid”
“I won’t have anything to say. I’ll seem boring.”
Challenging these negative thoughts is an effective way to reduce the symptoms of social anxiety.
Step 1: Identify the automatic negative thoughts that underlie your fear of social situations.
Step 2: Analyze and challenge these thoughts.
Example:
Irrational belief: No one is interested in me as I am. I am going to embarrass myself if I say something.
Question the irrational belief: Are there people who will accept me as I am?
Rational answer: My family and friends accept me as I am. They listen when I talk and find it interesting. So it is not true that no one is interested in me as I am.
You should do this exercise with every negative thought you have about yourself. It is even better when you write them down and keep the list of thoughts you have challenged in a daily emotional diary.
2. Focus on others, not yourself
One thing we as humans cannot do is to multitask. It is a proven fact that if you focus more on the people around you and listen attentively to what they converse about, you will focus less on your own fears and feelings. This can help a lot to avoid anxiety when socializing. It is good manners to pay attention to the people around you, to listen to what is being said, and to be present at the moment. People appreciate someone who is genuine. If you fear you won’t know what to say – just listen to the people around you and ask them questions about themselves. People love to talk about themselves and they love the people who are interested in them.
3. Control your breathing
Relax – no one can see you are stressed or sweating. If you feel fear rising, focus on breathing deep – slowly in and out. It has a calming effect.
4. Face your fears
Avoidance keeps social anxiety disorder going. So the worst coping mechanism is to avoid the situation that you fear. The more you expose yourself to what you fear, the less the fear becomes for that situation. Face it, face it, face it. Take baby steps and try a bit more every week.
5. Create an exposure hierarchy
An exposure hierarchy is a list — akin to a ladder — where you write down situations that cause you anxiety, in order of severity. Then you perform the easiest behaviour, and keep moving up the list.
Actively seeking out supportive social environments. Take a social skills class or an assertiveness training class. Volunteer doing something you enjoy, such as walking dogs in a shelter.
6. Adopt an anti-anxiety lifestyle
Avoid or limit caffeine – Coffee, tea, soda, and energy drinks act as stimulants that increase anxiety symptoms. Consider cutting out caffeine entirely, or keeping your intake low and limited to the morning.
Get active – Make physical activity a priority—30 minutes per day if possible. If you hate to exercise, try pairing it with something you do enjoy, such as window shopping while walking laps around the mall or dancing to your favorite music.
Drink only in moderation – You may be tempted to drink before a social situation to calm your nerves, but alcohol increases your risk of having an anxiety attack.