Understanding Social Anxiety (aka Social Phobia)
Social Anxiety is when a person feels symptoms of anxiety or fear in situations where they may be scrutinized, evaluated or judged by others. The most common form of social anxiety is speaking in public but it can also happen when meeting new people, dating, being on a job interview, answering a question in class, asking for help, or having to talk to a cashier in a store. Even doing everyday things like eating or drinking in front of others or using a public restroom may cause anxiety or fear due to concerns about being humiliated, judged or rejected.
Social Anxiety usually starts during childhood or adolescence and may resemble extreme shyness or avoidance of public situations or social interactions. The mean onset age is 10-13 years old. Recent data suggest that 9% of adolescents (13-18 years old) experience social anxiety disorder, with approximately 7% of American adults. It tends to occur more frequently in women than in men. A person with Social Anxiety can also have co-occurring mental or physical health disorders or conditions, including depression, other anxiety disorders, OCD, ADHD, body dysmorphic disorder or bipolar disorder. Alcohol and substance misuse is also commonly associated with Social Anxiety.
While there is not a specific cause to Social Anxiety, there are several risk factors that can increase a person’s likelihood of developing it.
Family History: a person with a first-degree blood relative who has Social Anxiety is anywhere from two to six times more likely to experience Social Anxiety DO.
Environment: Social Anxiety can be a learned behavior. Parents who are controlling, overprotective, or exhibit anxious behaviors in front of their children can also place their children at a higher risk for anxiety.
Brain Structure: Fear and anxiety are related so when a person has an overactive amygdala, it can increase their anxiety and heighten their fear response.
Trauma: certain life experiences can increase risk of anxiety.
Low Self-Esteem: Those with low self-esteem may struggle in social situations.
A person with Social Anxiety typically tries to avoid the situations that create the fear and anxiety. If they are unable to avoid the situation, they may experience the following:
Blushing, sweating, shaking or a racing heartbeat
Feeling nervous to the point of nausea
Avoiding eye contact
Having a stiff body posture
Being very self-conscious in front of others
Feeling embarrassed or awkward in front of others
Mind going blank or not knowing what to say to other
Feeling very afraid or worried that others will judge you negatively or reject you
Expect the worst possible consequences from a negative social situation
While anyone can experience some social anxiety from time to time, it’s important to note that people who have a clinical form of Social Anxiety experience these symptoms consistently and they affect their daily life.
There are several ways to treat Social Anxiety and it’s important to find the one that best fits you and your needs.
Cognitive Behavioral Therapy (CBT), is an evidenced based therapy that is commonly used to treat Social Anxiety. CBT teaches a person different ways of thinking, behaving and reacting to situations to help them feel less anxious and fearful.
Exposure Therapy focuses on progressively confronting the fears underlying an anxiety disorder to help a person engage in activities they have been avoiding. Relaxation techniques are often taught with this type of therapy.
Acceptance and Commitment Therapy (ACT), is different from CBT in that it encourages a nonjudgmental acceptance of thoughts and behaviors and promotes engagement in meaningful activities. It incorporates mindfulness and goal setting to reduce a person’s discomfort and anxiety.
Medication like SSRIs or SNRIs, Beta-blockers and anti-anxiety medications.
If you or someone you know has Social Anxiety, it’s important to know that it is treatable and often respond well to any treatment. However, if left untreated, social anxiety can be debilitating and can result in poor education outcomes, declining job performance, lower-quality relationships and an overall decreased quality of life. It can also lead to depression and/or alcohol use disorder.