Social Anxiety Disorder

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 about others judging you or on being embarrassed or ridiculed. It which often leads to significant avoidance behaviors. Social anxiety disorder is a chronic mental health condition, 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 behavior 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, the 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 attack).
• 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 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