Social Anxiety
WHAT IS ANXIETY?
Every person feels anxiety on occasion; it is a part of life. All of us know what it is like to feel worry, nervousness, fear, and concern. We feel nervous when we have to give a speech, go for a job interview, or walk into our boss’s office for our annual performance appraisal. We know it’s normal to feel a surge of fear when we unexpectedly see a photo of a snake or look down from the top of a tall building. Most of us manage these kinds of anxious feelings fairly well and don’t allow them to disrupt our lives.
But millions of people (an estimated 15 percent of the population) suffer from devastating and constant anxiety that severely affects, and sometimes highly restricts, their lives. They experience panic attacks, phobias, extreme shyness, and obsessive thoughts and compulsive behaviors. The feeling of anxiety is a constant dominating force that disrupts their lives. Some become prisoners in their own homes, unable to leave to work, drive, or visit the grocery store. For these people, anxiety is much more than just an occasional wave of apprehension.
STRESSFUL SITUATIONS
People with social anxiety disorder often find the following kinds of situations extremely stressful:
- Meeting almost anyone in public, especially strangers
- Being introduced to another person
- Having to introduce oneself to a group
- Having to participate in a group discussion
- Being observed while doing anything
- Meeting an authority figure, such as a supervisor
- Having to mingle and talk with others at a social gathering
- Being evaluated
- Being made fun of
WHAT IS SOCIAL ANXIETY?
Social anxiety, or social phobia, is a fear of being around other people. People suffering from this disorder always feel self-conscious around others. They always have the feeling that everyone is staring at them and being critical in some way. Because the anxiety is so painful, people suffering from it learn to stay away from social situations and avoid other people. Some eventually need to be alone at all times, in a room with the door closed. The anxiety is pervasive and constant, and it even happens with people one knows.
People with social anxiety know that their thoughts and fears are irrational. They know that others are not actually judging or evaluating them at every moment. But this knowledge does not make the feelings disappear.
Here are some examples of people with social anxiety:
- A man standing in line at the video store is very uncomfortable because he feels that the other customers are watching him. He knows they really aren’t watching, but he can’t help feeling this way. As he looks through the racks of videos and DVDs, he feels like people are staring. As he checks out and faces the clerk who helps him, he feels even more self-conscious. He looks down at the counter and mumbles. He knows that he looks stupid and is sure the other customers are laughing at him. He feels extremely anxious, turning red and trembling.
- A young woman doesn’t want to go to work because a monthly staff meeting is scheduled on the next day in her department. These meetings always include a few minutes when each staff member talks about what he/she has been working on. Just thinking about having to speak to the people she works with makes her feel extremely worried. She lies awake all night and is very nervous when she walks into the office the next morning.
- A man works as a lab technician and does a good job. He has been out of school for nine years and hardly has any social interaction. He is extremely lonely but is unable to ask anyone to join him for social events and hasn’t ever had a date. He has gone out to lunch alone a few times but had a miserable time because he felt that people were watching and criticizing him. He tells himself that this feeling is ridiculous, but he can’t shake it and is unable to relax. He spends nearly all his free time alone in his apartment with the curtains drawn.
People with social anxiety often experience a sense of intense fear, along with shaking, rapid heartbeat, blushing, dry mouth, difficulty in swallowing, and other symptoms of nervousness. The prevailing feeling is intense, overwhelming, unrelenting anxiety. Most sufferers realize that their feelings are irrational, but this knowledge does not help relieve their anxiety.
WHAT IS THE TREATMENT FOR SOCIAL ANXIETY?
Most people who suffer from anxiety disorders begin to feel better when they receive the proper treatment. It can be difficult to identify the proper treatment, however, because each person’s anxiety is caused by a unique set of factors. It can be frustrating for the client when treatment is not immediately successful or takes longer than hoped for. Many clients feel better after a few weeks or months of treatment. If a person has an anxiety disorder in combination with another disorder (e.g., alcoholism and depression), treatment will be more complicated and will take longer.
Although a treatment plan must be specifically designed for each individual, a number of standard approaches exist. Mental health professionals who specialize in treating anxiety most often use a combination of the following treatments. There is no single correct approach.
Cognitive therapy.
The client learns how to identify and change unproductive thought patterns by observing his/her feelings and learning to separate realistic from unrealistic thoughts. Most experts agree that this type of therapy is the most effective in treating social anxiety.
Group therapy.
People with social anxiety benefit from being in an ongoing therapy group with other clients who also have the disorder. The best type of group is one in which the focus is learning new skills and overcoming the isolation that people with this disorder feel.
Relaxation training.
Many people with social anxiety disorders benefit from self-hypnosis, guided visualization, and biofeedback. Relaxation training is often part of psychotherapy.
Medication.
Antidepressant and anti-anxiety medications can help restore chemical imbalances that cause symptoms of social anxiety. Using medication, especially in combination with psychotherapy, is an effective treatment for many people. People with social anxiety benefit from being in an on-going therapy group with other clients who also have the disorder.
WHERE CAN I GO FOR MORE INFORMATION?
Social Phobia/Social Anxiety Association (www.socialphobia.org).
Burns, David. Ten Days to Self-Esteem. New York: William Morrow, 1993.
Zimbardo, P. Shyness: What It Is and What to Do about It. Reading, MA: Addison-Wesley, 1987.