Social anxiety disorder is the second most commonly diagnosed anxiety disorder in the United States after specific phobias, and the condition affects about seven percent of the adult population. While many people experience occasional feelings of social anxiety, social anxiety disorder can completely take over a person’s life. It can make even the simplest activities such as talking to a cashier at the grocery store seem overwhelming and terrifying. However, it is possible to overcome social anxiety disorder and get your life back.
What is social anxiety?
Social anxiety disorder is more than just shyness.
While many people feel nervous in certain social situations and may feel uncomfortable or awkward going on a first date or speaking in front of a crowd for an important presentation, people with social anxiety disorder experience significant fear, anxiety, embarrassment, and self-consciousness in social situations.
As a result, people with social anxiety disorder often try to avoid social situations as much as possible and feel constant stress that can affect all aspects of their lives, including school, work, and home life. While social anxiety is common and affects most people on occasion, social anxiety disorder is a chronic mental health condition that affects about 15 million adults in the United States or about 7 percent of the population.
Most people begin to develop social anxiety disorder as teenagers, and while many people with social anxiety disorder report being shy as children, it is important to note that not all shy people have social anxiety disorder. The condition is characterized by an intense fear of social situations as commonplace as talking to someone else in public. As a result, they begin to avoid as many social situations as possible for fear of being perceived as awkward, stupid, boring, etc.
Fortunately, it is possible to overcome social anxiety disorder, and the condition doesn’t have to define your life. There are different treatment options you can discuss with a mental health professional, that may include medications and talk therapy, as well as developing coping mechanisms for when you are forced to take part in a social situation.
What are the symptoms of social anxiety disorder?
Signs and symptoms of social anxiety disorder are emotional and behavioral as well as physical.
Emotional and behavioral symptoms of social anxiety disorder include persistent instances of the following:
- Fear of situations in which you may be judged
- Intense fear of talking to or interacting with strangers
- Fear of the physical symptoms associated with social anxiety that can cause embarrassment, such as:
- Having a shaky voice
- Avoiding situations where you might be the center of attention
- Enduring a social situation with intense fear or anxiety
- Expecting the worst possible consequences from a negative experience during a social situation
Children may express social anxiety disorder differently than adults, including crying, clinging to parents, having temper tantrums, or refusing to speak in social situations. Physical symptoms of social anxiety disorder can sometimes accompany the emotional and behavioral symptoms.
- Upset stomach or nausea
- Dizziness or lightheadedness
- Muscle tension
- Fast heartbeat
- Trouble catching your breath
- Feeling that your mind has gone blank
People with social anxiety disorder have difficulty in social situations, and common, everyday experiences may be challenging for them to navigate.
Social situations that are commonly avoided included:
- Interacting with unfamiliar people or strangers
- Going to work or school
- Making eye contact
- Entering a room in which other people are already sitting down
- Eating in front of others
- Attending parties or social gatherings
- Starting conversations
- Returning items to a store
- Using a public restroom
When left untreated, social anxiety disorder can interfere with your entire life and begin to infiltrate many different areas. Social anxiety disorder can cause sufferers to develop:
- Low self-esteem
- Negative self-talk
- Poor social skills
- Low academic and employment achievement
- Suicide or suicide attempts
- Trouble being assertive
- Hypersensitivity to criticism
- Isolation and difficult social relationships
- Substance abuse issues
What causes social anxiety disorder?
There are many causes of social anxiety disorder, but most researchers believe that a complicated interaction between biological and environmental factors triggers the experience of social anxiety disorder. Possible causes of social anxiety disorder include:
- Inherited traits: Anxiety disorders often run in families. Scientists are unsure of whether this is genetically linked or learned behavior.
- Brain structure: People with overactive amygdalas are more likely to have an overactive fear response, which can cause increased anxiety in social situations. The amygdala is believed to play a large role in controlling the fear response.
- Environment: Some people develop social anxiety disorder after experiencing an embarrassing or uncomfortable social situation, making it a learned behavior. Parents who model anxious behavior in social situations, are overprotective of their children, or are particularly controlling of their children, are more likely to have children with social anxiety disorder.
What are the risk factors associated with social anxiety disorder?
Anyone can experience social anxiety disorders at any time in life, but some factors make individuals more likely to develop social anxiety disorder. Risk factors associated with social anxiety disorder:
- Family history: Having biological parents or siblings with social anxiety disorder makes people more likely to develop social anxiety disorder.
- Temperament: Children who are timid, restrained, shy, or withdrawn when meeting new people or experiencing new situations are more likely to be at risk of experiencing social anxiety disorder.
- Having physical features or a condition that draws unwanted attention: People who have physical features that draw unwanted attention or have other characteristics such as stuttering that attract attention, may have increased feelings of self-consciousness that can trigger social anxiety disorder.
- Negative experiences: Children who are rejected, teased, bullied, or humiliated are more likely to develop social anxiety disorder. Additionally, experiencing childhood trauma, including abuse, family conflict, and other negative events, can also make children more likely to experience social anxiety disorder.
- New social or work demands: Social anxiety disorders often start when people are teenagers, but they can also arise as a result of new experiences, such as giving a speech in public.
How can you overcome social anxiety disorder?
According to the Anxiety and Depression Association of America, more than a third of people with social anxiety disorder experience symptoms for ten years or more before seeking help for their social anxiety.
The first step towards overcoming social anxiety disorder is talking to your doctor about your experience with social anxiety. Be prepared to discuss your symptoms and describe how you feel in social situations. Your doctor will perform a physical exam and discuss your medical history in order to make sure that there is not an underlying physical problem that is causing your symptoms.
Assuming there is no underlying medical issue that is contributing to your symptoms, your doctor will likely refer you to a mental health specialist for diagnosis. Know that you are not restricted only to your referral for help–other resources such as online mental health clinics like YANA are also available, and are generally more affordable and easier to access while still offering professional mental health specialists and the option of prescription medication as needed.
Following your diagnosis, your mental health specialist will likely recommend one of the following three treatment options for social anxiety disorder, or a combination of several treatments. Treatment options for social anxiety disorder include psychotherapy, also known as talk therapy, support groups, and medication.
Psychotherapy, sometimes referred to as talk therapy, can be helpful in treating social anxiety disorder, especially when a technique called cognitive behavioral therapy (CBT) is used. CBT helps people with social anxiety disorder learn and practice how to navigate social situations, and can teach different ways to think about and react to situations that typically cause anxiety or fear. People with social anxiety disorder often benefit from receiving CBT in a group setting.
Whether found in person or online, people with social anxiety disorder often benefit from joining a support group of other people who have social anxiety disorder. Because one of the biggest concerns that people with social anxiety disorder have is fear of how others perceive them, it can be helpful to receive honest feedback from other people who also have social anxiety disorder. Hearing how you are actually perceived can help people with social anxiety disorder overcome thought distortions and work through their fears of judgement and rejection. Additionally, you may benefit from learning tips and coping mechanisms that other people have used to overcome their social anxiety.
Social anxiety disorder is usually treated with one of three types of medication: anti-anxiety medications, such as Xanax or Ativan, antidepressant medications, such as Lexapro or Wellbutrin, and beta blockers, such as propranolol. Anti-anxiety medications are fast acting and relieve symptoms quickly, but they cannot be taken for long periods of time due to their habit-forming nature. They are most appropriate in emergency situations. Antidepressants typically start to work after being taken for several weeks and can help treat social anxiety disorder; many people take an anti-anxiety medication while they wait for the antidepressant to start working. Beta blockers are another medication commonly taken for social anxiety disorder; this type of medication addresses the physical symptoms of social anxiety, including sweating, increased heart rate, or tremors. People with performance anxiety have been found to benefit the most from taking beta blockers.
Hopefully this information has been helpful! Social anxiety is hard, but with a little help and guidance, you can find ways to make it more manageable for a happier and healthier life. Take the first step and get in touch with a mental health professional today. Remember, You Are Not Alone!