Some life situations seem primed for having jitters. Who hasn’t felt a bit nervous before a first date or job interview, and who hasn’t had a hollow feeling or butterflies in their stomach before standing up in front of a crowd and giving a speech or presentation?
Walking into a roomful of strangers can be quite unnerving, especially if they turn to look at you as you make it to your seat. It’s normal to feel a bit anxious in these situations, but it’s also natural to be concerned if you find yourself feeling anxious a lot.
Anxiety is a natural reaction to stressful or threatening situations; that sense of threat can come from the possibility of actual, physical danger, but our bodies can respond the same way to imagined danger.
For some people, anxiety is tied to specific circumstances, and outside of those situations, they generally don’t feel anxious. One can be anxious in social situations, a condition which, depending on its severity, can be called social phobia or social anxiety disorder.
Understanding social anxiety.
Social anxiety disorder or social phobia is the term used to describe when a person feels long-term, overwhelming anxiety in social situations. Instead of coming and going, social anxiety disorder lingers, and its effects can be quite debilitating.
Being socially anxious is more than just feeling a bit shy around people. When a person is socially anxious, they are gripped by anxiety before, during, and after any situations that require social interaction with others. This can make even the thought of going out quite a challenging experience.
Sometimes, the feelings of anxiety and the symptoms they trigger are so severe as to prevent normal functioning in everyday life. Some people with social anxiety struggle with being in social situations so much that they may start to avoid them altogether. This can make everyday activities like going to school, church, work, or simply hanging out with loved ones quite difficult. In this way, social anxiety can be disruptive to daily routines.
Some people are more comfortable in crowds, while others are a bit more reserved, whether due to their personality or because of certain life experiences they may have had. The thing with social anxiety, however, is that it goes beyond this and is rooted in fear, feelings of anxiety, and the desire to avoid social situations.
People with social anxiety will often carry a fear that they are being scrutinized or judged negatively by others around them. This sensitivity makes them feel awkward and hyperaware of themselves and everything they say or do when in public.
Social anxiety can result in several negative outcomes such as having low self-esteem from a lot of negative self-talk and being hypersensitive to criticism. It’s common to find social anxiety associated with substance abuse and suicidal thoughts. Avoiding social situations and interactions can mean isolation and having difficulty maintaining meaningful relationships with others; without good social skills, one can struggle professionally, too.
Signs of social anxiety.
Social Anxiety Disorder often begins in one’s early to mid-teen years, but it can begin at other stages of life as well. Social anxiety disorder is quite common, affecting around five million people in the United States.
In younger children, the signs of social anxiety include the following:
- Being afraid of and not asking for help when at school.
- Crying or getting angry and having temper tantrums more than usual.
- Refusing to speak in social situations.
- Being overly reliant on their parent or caregiver, and clinging to them.
- Avoiding interaction with other children and adults.
- Fear of going to school or participating in school events.
For older people, some of the signs of social anxiety include these kinds of behavioral, physical, and emotional symptoms:
- Struggling to do things like eat or use the restroom in public settings.
- Fear of speaking in public, like asking or answering questions in class, or interacting with someone in a store.
- Discomfort around large numbers of people, whether strangers or familiar people.
- Getting physically ill when thinking about social occasions or when you have to attend one.
- Worry about talking with strangers, starting conversations, or even talking on the phone.
- Avoiding doing things out of embarrassment, or fear that you might be at the center of attention.
- Worry over showing any signs that you’re anxious or nervous, such as sweating or blushing.
- Difficulty making eye contact.
- Physical symptoms such as sweat, trembling, rapid heartbeat, nausea, upset stomach, feeling like your mind has gone blank, muscle tension when in or are anticipating social interactions.
- Panic attacks, which are intense and overwhelming experiences of fear and anxiety that peak in a few minutes and leave you shaken.
- Doing postmortems of your social interactions, analyzing what you said and did during a conversation and identifying flaws in your conduct.
- Expecting the worst possible consequences if you have a negative experience during an interaction with someone.
- Difficulty starting conversations.
Diagnosis of social anxiety.
If you experience any of the signs of social anxiety, you must see a mental health professional or your doctor for a proper diagnosis. There may be other, underlying health conditions that are producing the symptoms you’re experiencing.
Through a physical examination, your doctor can eliminate any other medical conditions that may be triggering your anxiety. Your doctor will listen as you list your symptoms, and they may review the kinds of situations in which you feel anxious, worried, or panicked.
If your doctor thinks that you could have social anxiety, they will refer you to a mental health specialist for a full assessment and to develop a treatment plan. The criteria that your doctor or mental health specialist will use to determine if you have social anxiety disorder comes from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.
The criteria that are listed in the DSM-5 for Social Anxiety Disorder include:
- Fear or anxiety that doesn’t stem from a medical condition, medication, or substance abuse.
- Avoidance of situations that instill anxiety and fear.
- Persistent intense fear or anxiety about specific social situations that are accompanied with a belief that you may be humiliated or get judged negatively for your actions.
- Excessive anxiety that’s disproportionate to the situation.
- Anxiety or distress that interferes with daily activities.
If the mental health professional determines that you have social anxiety, you can talk through several treatment options to help you overcome your social anxiety.
It can be tempting to avoid social situations to avoid the feelings of anxiety that often accompany them. In the long run, this isn’t a winning strategy, because avoidance only makes those situations even more daunting and anxiety-inducing. The treatment that is most effective to address your social anxiety will depend largely on how much your anxiety affects your ability to function in daily life.
Some of the treatment options available include the following. You can discuss the options with your doctor to determine what will work best for you.
Cognitive Behavioral Therapy (CBT), which is generally considered the best treatment, is a therapy that helps identify unhealthy patterns of thought and behavior that feed your anxiety. Your therapist will help you in this process as well as in cultivating ways to change those patterns, and you can do this individually, or in a group setting.
In exposure-based CBT, your therapist will help you face the situations that induce anxiety and fear for you. CBT can also be accessed through guided self-help which involves working through a CBT-based online course or workbook, with regular support from a therapist.
CBT is often accompanied by medication, and typically the kinds of medications prescribed are antidepressant medicines such as selective serotonin reuptake inhibitors (SSRIs), though these are usually not prescribed for younger people. Anti-anxiety medications and beta-blockers may also be prescribed to address social anxiety.
Relaxation therapy is a therapeutic approach that teaches you ways to relax like visualization, meditation, and breathing techniques. However, relaxation therapy is not effective in all situations.
God created us as social beings, and we thrive when our relationships are flourishing. Because of this, social isolation and fear in social situations are painful realities to experience. With the treatment options available, you can overcome social anxiety, even in its more extreme forms. If you experience signs of social anxiety, reach out to a doctor or a counselor for a proper diagnosis and an effective treatment plan to bring your anxiety under control.
“Crowds”, Courtesy of Cameron Casey, Pexels.com, CC0 License; “Discomfort”, Courtesy of Craig Adderley, Pexels.com, CC0 License; “Anxious”, Courtesy of Kat Jayne, Pexels.com, CC0 License; “Crowded Square”, Courtesy of Davi Pimentel, Pexels.com, CC0 License
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