Is it Social Anxiety?

Have you ever shied away from fun social opportunities or group activities because you can’t get past the idea of what others may think of you? Is the fear of the grocery store or gym making your knees shiver?

Maybe you are great at what you do, but the idea of sparking up a conversation with colleagues is terrifying, leaving you feeling isolated in the workplace or feeling like you can’t climb the corporate ladder. You may be dealing with more than shyness, but Social Anxiety Disorder, a very real and treatable condition affecting millions of Americans.

Diagnosis Criteria

The Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association defines Social Anxiety Disorder as having the following criterion:

• A persistent fear of one or more social or performance situations in which the person is  exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or  she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.

• Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack.

• The person recognizes that this fear is unreasonable or excessive.

• The feared situations are avoided or else are endured with intense anxiety and distress.

• The avoidance, anxious anticipation, or distress in the feared social or performance  situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the  phobia.

• The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.

• The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs, medications) or a general medical condition not better accounted for by another mental disorder.

Lived Experiences

Those living with social anxiety disorder live with a fear of being judged or scrutinized that may manifest itself as racing thoughts of what others may be thinking of them, low self esteem, and  even physiological signs of anxiety such as a racing heart, shaking hands or even a full blown panic attack.

Oftentimes they may understand that the anxiety is out of proportion to the social situation yet can’t shake the feelings. It may significantly interfere with daily life, impeding one  from developing friendships or romantic relationships, pursuing scholastic or career  opportunities, or hampering your ability to complete day to day tasks.

Learn more about other types of anxiety here.

Treatment

Now that you have a sense of what it is, if this describes how you have been experiencing life you may ask what you can do about it. Addressing social anxiety through psychotherapy is the best way to see improvement. Currently, cognitive-behavioral therapy (CBT) has been tested  and found to show the best results.

Specifically, Exposure Therapy, a technique of CBT where you are asked to take progressive steps toward feared situations allowing one to gain  confidence step by step.

Medication management is also available for the treatment of social anxiety and your therapist may refer you to a physician if you choose to explore this option. Some medication options  include benzodiazepines, SSRIs, SNRIs and beta blockers.

You should always speak to your physician about which would work best for you and consider side effects, if the medication  should be used for more short term treatment or long term, and other mental and physical  health conditions you may have.

Helping Yourself

Here are some more practical solutions to helping yourself through this until you can see a  professional, and even while going through therapy and/or medication management.

Practice Getting Out There

Set small goals. Start on your own “exposure therapy” so to speak. For example, if you feel lonely at work, you can set a goal to build on these friendships, but start with just one person then make these goals progressive. For instance, if it is speaking up that feels terrifying, start with just saying hello to one person. Do this until it feels easy and comfortable, then the next time you take it a little further and ask about their weekend plans.

It may be easier for you to  show interest in them and ask questions as opposed to leading by talking about yourself. In little to no time, you will have a new work acquaintance who just might strike conversation  with you first the next time. (Phew, pressure’s off).

Build on Your Confidence

Be mindful of your inner voice which can be your worst critic. Are you talking yourself down before you even know what someone else has to think or say of you? Be kind and  compassionate to yourself.

It may be a good idea to journal some strengths or personality characteristics you like about  yourself to boost your confidence. Remember you can use these strengths in any social  situation you are in.

Consider the Spotlight Effect

This is a proven concept in social psychology that says we overestimate how aware others are of us, because most people are more focused on themselves and what they have going on. This is not to say that others are uncaring, but that we are ego-centric-a psychological term meaning we live our lives and see things from our own experiences and perspectives.

Oftentimes when we think others definitely notice something we are embarrassed about, they may in fact have not noticed at all or be more busy paying attention to the next thing they have going on (an upcoming meeting or dinner). If they did notice they often do not care nearly as much as we may believe that they do.

When putting this in perspective to social anxiety, it is actually quite a liberating concept that can help us more confidently be ourselves.

Self-Care

Lean on those who you do feel safe and comfortable with whether that’s a parent, spouse or even a pet. Take comfort in your loved ones to give you strength. Take care of your mind and body through adequate nutrition, exercise and rest. These are powerful forces in the battle with anxiety.

Find a support group

There are online or in person support groups for social anxiety. These groups may help provide helpful feedback, give you tools and help develop skills you can use in your day to day life, or just help you feel that you are not alone in this. Follow this link to learn more about finding a support group.

Conclusion 

According to a 2007 survey by the Anxiety and Depression Association of America, it took 36% of social anxiety sufferers ten years to seek treatment. Social anxiety can really put a damper on life, making your relationships or career less than fulfilling.

My hope is this article has encouraged you that there is no need to wait ten years to start your journey to recovery and confidence. Talk to a therapist who can help you figure out a treatment plan that works for you and you will be on your way to showing the world more of yourself in no time.

References

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders  (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

2. Anxiety and Depression Association of America. “Facts & Statistics.” Anxiety and Depression  Association of America, 2021, https://adaa.org/understanding-anxiety/facts-statistics

3. Social Anxiety Disorder (Social Phobia) - Diagnosis and Treatment - Mayo Clinic. www.mayoclinic.org, www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/diagnosis treatment/drc-20353567#:~:text=Your%20health%20care%20provider%20may%20prescribe %20paroxetine%20(Paxil)%20or%20sertraline.

4. Social Anxiety Disorder (Social Phobia) - Diagnosis and Treatment - Mayo Clinic. www.mayoclinic.org, www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/diagnosis treatment/drc-20353567#:~:text=Your%20health%20care%20provider%20may%20prescribe %20paroxetine%20(Paxil)%20or%20sertraline

5. Photo by fauxels.