This post may contain affiliate links. Read the full disclosure here
Have you ever had to drag yourself out of the house to go somewhere even when you hated it? Do you detest social gatherings? Does your body start acting crazy when you’re in a social situation?
Social anxiety disorder is no walk in the park. It’s a marathon in the woods, at night, where there are bears. But what if you can go for that walk in the park and even enjoy it? It’s possible if you learn how to deal with social anxiety once and for all.
You don’t need to suffer on a daily basis and live under that persistent cloud of self-doubt. Do you want to know how? Keep on reading!
What is Social Anxiety?
Before we get into the hows and whys, let’s go through what social anxiety disorder is in the first place.
Social Anxiety Disorder is an “intense fear of social situations.” To be specific, it’s a fear of being judged, embarrassed, or humiliated in front of others. Social anxiety disorder is estimated to affect around 12% of the population at some point in their lives.
In this video, Vince Greenwood, the director of The Washington Center For Cognitive Therapy goes over social anxiety in depth.
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) lists the following diagnostic criteria for social anxiety disorder:
- Has fear or anxiety specific to social settings, in which the person feels noticed, observed, or scrutinized.
- Typically, the individual fears they will display their anxiety and experience social rejection.
- Social interaction consistently provokes distress.
- Social interactions are either avoided, or painfully and reluctantly endured.
- The fear and anxiety will be disproportionate for the level appropriate to the actual situation.
- The fear, anxiety or other distress around social situations will persist for six months or long.
- The anxiety causes personal distress and impairment of functioning in one or more domains, such as interpersonal or occupational functioning.
- The fear or anxiety cannot be attributed to a medical disorder, substance use, or adverse medication effects or other mental disorder.
Signs and Symptoms of Social Anxiety Disorder
People with social anxiety feel like others are always thinking of them in a negative light. They worry about being perceived as boring or inept by others. For me, it feels like I don’t have the right social skills and constantly make social blunders.
The problem with social anxiety is that the fear is so intense that it disrupts the sufferers’ lives. They tend to avoid activities that would increase their anxiety. Avoiding these situations can indirectly lead to a negative impact on their lives.
There’s a physical aspect of social anxiety. People suffering from social anxiety have physical symptoms whenever their anxiety kicks up. These symptoms include blushing, sweating, nausea, rapid heartbeat, shortness of breath, light-headedness. In extreme cases, it can also lead to a panic attack.
Social anxiety symptoms exacerbate the situation. The sufferers are extremely conscious of their symptoms. So, their anxiety spikes even more and, in turn, making their anxiety worsen.
I suffer from social anxiety almost every time I go to social events or meet up with someone. At times, I avoid even setting up plans with friends because of the stress it will cause me. A packed room full of strangers might as well be a pit of snakes.
Types of Social Anxiety
There are 3 sub-types of this anxiety disorder:
1. Fear of Social Interaction
Someone’s fear comes at the mere idea of interacting with others and engaging in small talk. The social phobia can be so severe that sufferers will avoid any interaction with others.
2. Performance Anxiety
Performance anxiety is when you’re afraid of speaking or performing on stage or in public. Even playing sports can cause performance anxiety. It’s tied to feeling inadequate and not allowing yourself to make mistakes. A common example would be public speaking.
3. Observational Fears
Observational fears are when someone’s afraid of their actions being judged. The idea of doing something embarrassing or making mistakes becomes terrifying.
What Causes Social Anxiety?
The roots of social anxiety can be found in one of three things.
1. Inherited Traits
You can blame it partly on genetics. If you have family members who also struggle with anxiety, it could explain where you get yours.
2. Brain Structure
Let’s talk science for a bit. Remember the amygdala? For those who didn’t love biology, it’s the part of the brain that’s responsible for your fear response.
Some people’s amygdalas are working overtime. As a result, fear is pretty much a constant in these people’s lives. Social anxiety can be one of these fears.
The good news is that our brains are only predisposed towards anxious thoughts, and not hard wired to be anxious.
3. Environmental Factors
Believe it or not, social anxiety is a learned behavior. Our responses to social situations build up over time, rather than being caused by one core experience.
According to the ADAA, approximately 20% of sufferers also have an alcohol dependency. In the study, substance abuse can occur before the disorder appears and could be a trigger for it. The researchers also found substance abuse appeared after the disorder as a possible coping mechanism.
Stress can be triggered by any of the following examples:
- Being introduced to other people
- Being teased or criticized
- Being the center of attention
- Being watched or observed while doing something
- Having to say something in a formal, public situation
- Meeting people in authority (“important people/authority figures”)
- Feeling insecure and out of place in social situations (“I don’t know what to say.”)
- Embarrassing easily (e.g., blushing, shaking)
- Meeting other peoples’ eyes
- Swallowing, writing, talking, making phone calls if in public
It’s important to realize that these are situations that lead to stress, not the causes of the social phobia.
How is Social Anxiety Disorder Treated?
You don’t need to suffer in silence and isolation. There are several effective ways that you can use to treat your social anxiety.
1. Cognitive Behavioral Therapy for social anxiety
Cognitive Behavioral Therapy (CBT) is one of the most practiced forms of treatment for social anxiety. It focuses on changing the automatic negative thoughts into neutral or even positive ones over time. This change in thinking is built into a habit, which means even if the therapy sessions stop, you will still have the capability to help yourself. This aspect of CBT resonates with me, and sounds
CBT starts with identifying the thoughts that bring about anxiety.
A popular starting point is to journal at the end of the day, reviewing situations and your thoughts during them. Another common method is talk therapy with a counselor who can provide an unbiased look at how situations are being processed.
Next up, the sufferer starts working on the negative thoughts by critically processing them. Considering how likely an imagined negative outcome is compared to what will actually happen puts these thoughts into perspective. Most of the time, these huge negative situations will never happen.
There are several other therapy techniques besides CBT.
People with social anxiety can grow anxious even during role play, which is why it’s an effective method.
Practice makes perfect. The more the sufferers practice, the more they get used to social interactions. Even if it’s just with their therapists. They grow to be more comfortable with social interactions.
The simulation of a stressful social situation usually ends up triggering the sufferers. At the peak of their anxiety, the therapists have them pinpoint the source of their fears.
This brings us to the next technique, which seems to be the most effective one. Exposure therapy is going out and doing things that seem scary. It’s scientifically proven to cause significant improvement.
Facing your fears is the key to dealing with anxiety. An anxious person’s instinct is to withdraw into his/her own bubble. The purpose is to avoid stressful situations. This is the worst thing they can do since it feeds the anxiety rather than cure it.
According to Dr. Tracey Marks , the fear ladder is a gradual way to address fears. It allows people with social anxiety to gradually overcome smaller challenging situations, then build up to more stressful ones in an exposure hierarchy.
The therapist asks the patients to identify the situations that cause them anxiety. These fears are then ranked in a fear ladder in order of their intensity.
The patient is then tasked with making their way up the ladder. They face one stressful situation after another, gradually building up resistance to each situation, and overcoming the negative thoughts they’ve associated with each scenario.
This is an example of a fear ladder for social phobia and the fear rating for each step:
Giving a prepared presentation in the boardroom after work
with no one present – 2
Giving the prepared presentation in the boardroom with only
a close colleague present – 4
Giving the prepared presentation in the boardroom with a
few close co-workers present – 5
Giving an abridged version of the presentation to a few coworkers
and having them ask questions – 6
Asking the supervisor a question after the meeting with other
co-workers present – 7
Asking questions during meetings – 8
Giving a short update of a project during a meeting – 9
Giving the prepared presentation during a staff meeting and
answering questions – 10
This gives the patients the chance to ease into the social life rather than be thrust into it. It gives them time to adjust to new and challenging tasks before moving onto the next one. Step by step, the patient is able to reach his/her goal at their own pace. The fear ladder also helps to work on social skills gradually, and as you improve, some of the anxiety will go away.
Medication is usually used in combination to talk therapy. When combined with CBT, it leads to better results by giving the sufferer relief from symptoms and allowing them to focus on the root cause. It’s important to realize that anxiety medication can only treat the symptoms, rather the what is actually causing the symptoms.
The most common form of medication is selective serotonin reuptake inhibitors (SSRIs). Paroxetine (Paxil) or sertraline (Zoloft) are some of the most used medication.
Herbal supplements can be used if you are worried about taking medication to manage anxiety and its side affects. The FDA doesn’t regulate supplements however, so be cautious of what you buy and do research. Some common supplements negatively interact with drugs, such as St. John’s Wort and anti-depressants.
3. Support Groups
Did you know that social anxiety affects nearly 18% of the America’s population? You’re not alone in your suffering, and you can overcome it with the help of others dealing with the same challenges.
In a support group, you’d get to talk about what you go through with others who are experiencing the same thing as you. You can listen to their stories and get advice, help, and support.
Finding people whom you can relate makes it easier to reduce your fear of socializing. They would understand you, which would help ease your anxiety. The Anxiety and Depression Association of America lists support groups by state ; I was able to find 4 near where I live. If the thought of being in a group of people makes your heart race, having a close friend or finding a small group can ease into larger settings.
Another benefit of support groups, you’d be doing exposure therapy. You’d be in a social situation that makes you uncomfortable. It would be practice but in a safe space. You don’t feel the threat of being judged harshly as you would in an uncontrolled environment.
Other Methods to Try
Here are some other methods worth giving a shot. They’re tried and true methods by fellow sufferers.
1. Just Breathe
When in doubt, breathe. Taking deep, slow breathes keeps yourself calm and centered. Focusing on your breathing gives some relief. It distracts you from the negative thoughts swirling through your head and slows your heartbeat.
A useful calming breathing technique I’ve used to calm my heartbeat when in a crowd or stressful situation is:
Exercise is crucial to our mental health. Even though exercise feels like mental torture, it actually reduces anxiety. So go for a run and get it out of your system! When a stressful social situation is coming up, I like to go for a run before hand. The natural mood boost from a runner’s high helps keep my anxiety at bay, and can make the situation a positive one, instead of a negative.
3. Focus on Others, rather than Yourself
Ignore yourself, that’s the advice. Aim the spotlight in your mind on someone other than yourself. It keeps you from overthinking your own thoughts, actions, and physical symptoms.
Oftentimes, it feels like there’s a spotlight on you, and the smallest mistake gets caught by everyone. But, most people are just as worried about what you think of them as you worry what they think of you! Realizing this took the pressure off, and helps me relax.
4. Avoid Anxiety Boosters
Let’s just say you have your plate full of anxiety, there’s no need to add to it! Avoid anxiety boosters such as caffeine, alcohol, smoking, and sleep deprivation. For instance, you could switch out coffee with tea to lower how much caffeine you consume.
5. Plan Ahead
Think about it, your phobia is about you not knowing what to do or say, right? So, what would happen to it if you did know?
Plan it out, write it down, and rehearse it in your head. This mental exercise will make you prepared for what to do, say, and some possible outcomes too. It will make you feel ready,boosting your self-confidence.
6. Think Positive!
The pillars of social anxiety are negative thoughts. So, think rainbows and unicorns instead!
Even when you’re at home and in your safe bubble, try to train your mind to think positively. Take a more positive outlook on life and, more importantly, show yourself some love!
Self-love boosts your self-esteem, which gets damaged with each anxiety attack. Give yourself a break from the critical thoughts, and praise the things that you’ve done well.
I’ve started meditating after work and before bedtime. Even with a simple 5 minute deep breathing exercise, I saw a huge decrease in how often I felt anxious in general. It also became a tool to use when I interact with others to keep calm and in control.
When I feel the symptoms beginning, starting to breath deeply and focus on what’s happening inside my mind and body re-centers me.
Risks of Social Anxiety
Although social anxiety is sometimes used as a joke, even by people who suffer from it, it’s not something to take lightly. The awkwardness people laugh at can lead to serious risks.
The negative thoughts lead to even more negative thoughts. This can spiral into a full-blown clinical depression. Clinical depression means that there’s a risk of self-harm or even suicide.
Not to mention, if you let your fear control your actions, you will avoid situations that will set off the negative thoughts. This will definitely interfere with your life. Your work would be affected, it would put a strain on your relationships, and you would miss out on positive life experiences.
Can Social Anxiety be cured?
Studies show that nearly 85% of people who underwent CBT had drastic improvement. Each person responds differently to treatment, so you can never predict the outcome.
Healing from social anxiety is a process. Some people never reach 100%, they just learn to control and live with it.
So, go to therapy, work on yourself, and find the will to challenge yourself and face your fears. Do this and you’ll be on the road to recovery.
Difference between Social Anxiety and Shyness
People often mistake shyness for social anxiety. There are stark differences between the two.
Shyness is when you feel reserved or anxious around people whom you’re not used to. It can be categorized as discomfort, which you can overcome.
Social anxiety, on the other hand, is more painful. It is an intense fear of interacting with others, and often prevents you from engaging in those situations. It makes you go to extreme lengths to avoid social interaction.
Social anxiety is a serious disorder that’s not to be taken lightly.
It starts out as negative thoughts and spirals into a loss of control over your thoughts and body. Your fear keeps you in and puts you down, which amplifies your fears even more. Your body’s reaction backs your fear up, making it even worse.
Don’t let it get too bad before you start fighting back! If it gets bad enough, social anxiety can ruin your life!
Now that you know exactly what to look for, how to treat it, and what the risks are, start your road to recovery. You’re not alone, as an anxiety sufferer myself, I’d love to help you!
Sign up for our email list and we’ll be there with you every single step of the way with tips, new articles, and worksheets to tackle your anxieties and improve your mental health.