Almost everyone has had the experience of showing up to a party where you don’t know a single soul. If you’re like most people, you are probably worried about how you come across to these strangers. You may stress about what you might say to make them enjoy your presence. You may have even gone home and ruminated about what kind of first impression you made.
This is a tiny glimpse of what it feels like to have social anxiety. But social anxiety is much more than a typical human experience; it’s a serious, diagnosable mental health condition that requires treatment. It’s also more common than you might think. Over 1 in 10 adults go through social anxiety at some point in their lives.[1]
If left untreated, the fear and anxiety that come with social anxiety can start to impact your life. The good news is that you can use effective treatments and strategies to beat this type of anxiety and build a thriving social life.
Here’s everything you need to know about social anxiety disorder, how to tell if you have it, and what you can do about it if you do.
Symptoms of Social Anxiety Disorder
Social anxiety disorder, also called social phobia, isn’t just about being shy or introverted.[2] Most of us feel nervous or uncomfortable in certain social situations, and some people are just more introverted than others. On the other hand, social anxiety is a mental illness that can severely disrupt people’s lives when left untreated.
According to the Diagnostic Statistical Manual (DSM), the book that mental health professionals use to classify different psychiatric diagnoses, the symptoms of social anxiety disorder include:
- You feel intense fear and anxiety about being judged, criticized, or humiliated in social settings. You might be aware that these fears are illogical, but that doesn’t make them go away. The anxiety is persistent and severe, and not just everyday nervousness.
- You are experiencing this fear about at least one specific social situation. For example, you might be afraid of one-on-one social interactions, public speaking, or eating in front of others. These situations always, or almost always, cause severe anxiety.
- You avoid the social situations that cause fear and anxiety.
- Fear that the actual symptoms of anxiety (such as blushing or trembling) will cause even further humiliation.
- You experience these symptoms when they’re not proportionate to the social event in question.
- Symptoms are persistent (lasting six months or more) and severely disrupt everyday functioning (at work, school, or relationships).
If you notice any of these symptoms, you should tell your doctor or therapist so you can receive the correct diagnosis and start getting the treatment you need.
What Social Anxiety Feels Like
We’ve gone over the official symptoms of social anxiety disorder that mental health professionals look for to make a diagnosis. But what does it actually feel like to live with social anxiety every day? What are some of the other signs you should watch out for?
If you’re wondering whether you’re just shy or if you have social anxiety, ask yourself if you often experience the following signs and symptoms:
- You experience physical symptoms when you’re in certain social situations, like blushing, excessive sweating, trembling, or a rapid heart rate.
- You are feeling nauseous or lightheaded when you’re in, or preparing for, social situations.
- You are so anxious in social situations that you have a hard time speaking.
- You rely heavily on alcohol or drugs to feel “okay” in social situations.
- You are overly stiff in social situations, like rigid posture, speaking too softly, or not making eye contact.
- Being overly afraid of, or even obsessed with, the idea of being judged or humiliated. You may worry excessively about what others thought of you, even after the interaction is over.
- Having so much anxiety that you’re missing school or work, or turning down social invitations regularly.
No one can tell you whether or not you have social anxiety disorder besides a licensed mental health professional. However, if these signs are familiar to you, it might be good to seek support. Social anxiety is a treatable condition, and you don’t need to live with these feelings forever.
What are examples of social phobias?
The types of social situations that can trigger someone’s social anxiety are endless. The exact kind of situation that someone with social anxiety is afraid of depends on each person. Here are some examples of scenarios that may trigger fear in someone with social phobia.
1. Parties
Ralph has been invited to an office party. He desperately wants to go because he enjoys the company of his colleagues. But at work, there are set roles and responsibilities that help guide his actions. Outside of a work setting, he’s afraid that he’ll have nothing to talk about and that he’ll make a fool of himself. He forces himself to go, but stays on the sidelines the whole time and leaves early.
2. Dating
Rachel has been asked out on a date. She likes the person who asked her out, but she’s so anxious about the thought of having a 1-on-1 conversation with someone that she declines the invitation.
3. Eating in front of others
Andre is going out with a small group of friends. Interacting with this group of people doesn’t usually give him that much anxiety. However, on this occasion, they’re going out to eat. Andre has an intense fear of eating in front of others. What if I chew too loudly or spill something?, he thinks. So he ends up going but lies and says he’s already eaten; he doesn’t order anything.
4. Making small talk
Takeshi is at a work conference, and he finds himself in an elevator with an acquaintance. He feels highly pressured to make small talk with this acquaintance, but he’s too terrified to do so. He has no idea what to say. He is silent for the entire elevator ride. Afterward, he feels mortified and wonders what his acquaintance must think of him.
5. Meeting new people
Sarah is staying at a youth hostel. She’s so afraid of meeting strangers that she leaves the hostel every morning while everyone is still asleep so that she can avoid interacting with them. Sarah knows this is ridiculous, but her fear outweighs all logic. By the time she leaves the hostel, she hasn’t met a single new person.
6. Performances
Ellis is asked to make a speech for his company about a topic he knows well. He accepts because of the pressures of the job. However, when he is on stage, he starts trembling and sweating excessively. He panics and is afraid that the entire crowd can see the sweat on his face. He ends up not being able to finish the speech.
These aren’t the only situations that trigger social anxiety, but are some of the most common ones.
What Are the Main Causes of Social Anxiety?
Like most mental health disorders, there isn’t just one definitive cause that leads to social anxiety disorder. Instead, it’s usually several factors that combine to cause any mental illness, including social anxiety.
Experts agree that social anxiety disorder can be caused by family history, biology, environment (life experiences), or a combination of all three.[3]
People who live with any type of anxiety disorder may experience irregularities in their brains that lead to their symptoms. For example, research shows that they often have trouble producing serotonin, a brain chemical that regulates mood. They also often have an overactive amygdala — the part of the brain responsible for activating the fear response.
Some researchers also think that people with social anxiety may have difficulty accurately reading other people’s nonverbal communication. For example, they might think that someone is frowning at them when they aren’t.
Anxiety disorders run in families, but researchers aren’t sure if that’s because of shared experiences, imitating behaviors, or because there’s a genetic link.
Life experiences can also lead to social anxiety. For example, if you were bullied as a child, that might lead to social anxiety. You might also have social anxiety as an adult if you weren’t provided with enough opportunities to develop your social skills as a child.
Any number of things can cause social anxiety. The way forward isn’t necessarily to examine what might have led to your symptoms, but to figure out where to go from here.
Can Social Anxiety Be Cured?
Mental illnesses like social anxiety are chronic conditions, and there is no known “cure” for them. But that doesn’t mean you just need to put up with its symptoms. On the contrary, social anxiety is manageable, and with the proper treatment, you can get your symptoms under control and enjoy your life.
Social anxiety disorder is usually treated with psychotherapy, medication, or a combination of both.
Psychotherapy for social anxiety disorder
There are many types of therapies, but most mental health experts recommend cognitive-behavioral therapy (CBT) for social anxiety disorder.
Social anxiety causes us to have irrational or negative thinking patterns. For example, we might think to ourselves, “There’s no way that these people are going to like me.” The truth is, though, that we have no idea. None of us can read the future, and there’s no way to know whether people will like you or not. Furthermore, whether or not people like you isn’t usually within your control.
CBT teaches people to recognize and challenge these negative thoughts. CBT is based on the premise that our thoughts, feelings, and behaviors are all connected. Taking the example above, this negative thought will make you feel nervous and unconfident in social situations. These feelings might then, in turn, lead you to avoid social interaction altogether.
By recognizing when your thoughts are causing you to feel bad, you can start to replace them with more realistic or helpful thoughts. For example, you might change the above negative thinking to: “Maybe these people will like me, and maybe they won’t. If they don’t, then there’s nothing I can do about that, and I won’t take it personally.”
Another type of psychotherapy that’s effective for social anxiety disorder is exposure therapy. Social anxiety causes you to want to avoid any situation that makes you feel anxious. The problem with this is that it’s only a short-term solution. You may have been successful in preventing the anxiety—for now. But the next time you need to face a social situation, the anxiety will come back.
In some situations, the best way to beat social anxiety is to face it head-on. Exposure therapists help their clients intentionally trigger, and deal with, the terror that social activities trigger for them. They might start you low on the “anxiety totem pole.” Usually, you don’t need to face your biggest fear right away. Instead, one step at a time, you expose yourself to the different scenarios that cause social anxiety for you. In this way, you can learn to deal with – instead of avoiding – triggers.
Medication for social anxiety disorder
On top of therapy, you might also need psychiatric medication to help relieve social anxiety symptoms. There are several types of medications that are shown to be helpful for people with social anxiety disorder.
These include:
- Selective serotonin reuptake inhibitors (SSRIs). SSRIs are a common type of antidepressant medication that is also helpful in the treatment of social anxiety. These medications are the most commonly prescribed for social anxiety. In addition, Sertraline (Zoloft) and paroxetine (Paxil) are FDA-approved to treat social anxiety disorder.
- Serotonin norepinephrine reuptake inhibitors (SNRIs). SNRIs are also antidepressants that are effective for social anxiety disorder. Extended-release venlafaxine (Effexor), specifically, is an SNRI that is FDA-approved to treat social anxiety.
- Anti-anxiety medication. These medications, including benzodiazepines like Xanax, are sometimes used as a second-choice and temporary treatment for social anxiety disorder. These medications work quickly and can relieve you of anxiety in the moment, but they aren’t a long-term solution. On top of that, many people develop a dependence on these drugs.
Whether or not you choose to take medication for your social anxiety is between you and your healthcare provider. Keep in mind, however, that medication can be a very effective way to relieve anxiety symptoms. There are some side effects to keep in mind, but most of them are mild and temporary.
Talk to your prescribing doctor for detailed information about which medication might be best suited for you.
How Can I Calm My Social Anxiety?
If your social anxiety is severe, then professional treatment is probably necessary to manage your symptoms. At the same time, therapy requires teamwork. You, yourself, can make many changes in your life that will help you be in a better position to handle social anxiety symptoms.
1. Considering cutting back on caffeine
It might be a tough pill to swallow, but many experts say caffeine can worsen anxiety symptoms. So it’s okay to have a cup or two in the morning, but don’t go overboard.
2. Get plenty of rest
Getting enough restful sleep every night is one of the best things you can do for your overall mental health. Experts recommend 7 or more hours a night for most adults. However, if you’re not getting that regularly, think about how you can adjust your schedule or lifestyle to prioritize sleep.
3. Exercise
Physical activity has been proven to be one of the most effective ways to boost your mental health. Research shows that aerobic activity, in particular, is an excellent tool for blasting your social anxiety away. So find ways to move your body; going for a walk in nature, taking a dance class, or going for a bike ride are all great ideas to exercise in fun ways.
4. Try mindfulness
Mindfulness is now considered an evidence-based intervention for many mental health challenges, including social anxiety disorder.[4] If you’re a mindfulness beginner, start with the following simple exercise.
Find a comfortable seated position; be relaxed but not slouching over. Close your eyes if you feel comfortable. Now, breathe normally. As you breathe, pay attention to how the air feels going in and out of your body. There is no need to adjust your breathing in any way; simply notice how it feels. The more you practice, the more present you will learn to be. Also, the more present you are, the more often you’ll be able to catch yourself when you’re engaging in negative thoughts.
5. Take a deep breath
If you’re already in an anxiety-provoking social situation, then deep, controlled breathing is a tool you can use in the moment to find quick relief.[5] If you can, put one hand on your chest and the other on your belly (if you feel too embarrassed to do this in front of people, that’s okay).
Breathe in; as you inhale, bring all of the air into the deepest part of your belly. Next, breathe in slowly through your nose for four counts. Then, hold the air inside for three to seven seconds. Finally, breathe out slowly through your mouth to the count of eight. Repeat this exercise until you start to feel your anxiety lessen.
Social Anxiety Treatment at The Center • A Place of HOPE
If you’ve been suffering from social anxiety disorder, there is hope. The Center provides a safe and respectful environment where you can focus on overcoming this painful disorder. There is a thriving social life waiting for you on the other side of treatment.
Our unique Whole Person Care approach ensures that your anxiety treatment will address the physical, emotional, intellectual, relational, and spiritual elements of your life. In this way, you can start healing from the different ways that social anxiety has affected you.
Beat social anxiety and start connecting with others in the way that you want to. Contact us today to learn more about how we can help you and your family.
1 https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder
2 https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness
3 https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness#part_6257
4 https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01783/full
5 https://www.health.harvard.edu/mind-and-mood/relaxation-techniques-breath-control-helps-quell-errant-stress-response
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