Social Anxiety Disorder: Facts, Symptoms, Treatment, and Tips for Managing It.

Anxiety

Jul 7

Written By Turning Point Psychological Services

Photo by:: Turning Point Psychological Services — Photo by: Turning Point Psychological Services

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How do I know if I have Social Anxiety, or Maybe I’m Just Introverted or Shy?

Social anxiety (also known as Social Phobia) is a misunderstood condition. People often confuse it with being introverted or shy. But introverts are not by definition socially anxious. A person can be perfectly comfortable around people but may not enjoy loud gatherings. While extroverts feel energized after crowded get-togethers, introverts feel depleted and need to recuperate. Introverts, therefore, prefer solitary activities but do not suffer from social anxiety. They may stay home on a Friday night feeling perfectly content.

On the other hand, socially anxious people can easily be extroverts. They may crave the company of others and long to be a part of a social group, but they stay away because of their fear of being judged by others.

As to the difference between social anxiety and shyness, even though there are similarities in the behavior of people with social anxiety and shy people, shyness is a personality trait and does not necessarily lead to suffering. Social anxiety, however, is not a trait. It is a diagnosable, pervasive, and chronic disorder that causes significant distress or impairment to the person's functioning and affects many areas of a person’s life.

Why So Many People Continue Suffering from Social Anxiety and Don’t Seek Treatment

The confusion between introversion, shyness, and social anxiety minimizes the perceived impact of this condition on both the sufferers and those around them. Well-meaning friends and family members will often try to support their loved ones by saying something along the lines of “Just relax and have fun!” or “Come on, it’s all in your head!” But, as any social anxiety sufferer knows, those statements just lead to the feeling that nobody really understands them, which often makes them feel even more isolated. Such statements reinforce the belief that there is really nothing wrong, and that the anxious person just needs to cheer up a bit.

Parents insisting that their socially anxious kid is just shy also minimizes the problem and underestimates the child’s very real and very deep distress.

Social stigma is another factor as to why people go for so long without treatment. It is more socially acceptable to be introverted, or shy, than to have a diagnosable disorder.

Most anxiety disorders do not resolve on their own, and social anxiety is no exception. In today's computerized world, it is easier for people with social anxiety to hide behind their screens. Therefore, not only are they less likely to seek out treatment, but their anxiety often worsens with time.

A vicious cycle develops: socially anxious individuals try to avoid in-person social interactions at all costs, and the more they avoid, the more anxious they become.

The major part of the treatment for social anxiety includes facing social situations without resorting to “safety” behaviors. In the past, routine daily life activities themselves provided multiple daily opportunities for such social contact. Up until very recently, kids and teens naturally interacted more with their peers, thus addressing their social anxiety without even knowing it. It also allowed parents and teachers to notice a socially anxious kid and try to help. In today's world, it is easier than ever to communicate with others without needing to face them. So it's not surprising that both kids and adults go untreated for very long.

What Exactly is Social Anxiety?

Social Anxiety Disorder is characterized by the fear of being negatively evaluated, scrutinized, or judged by others in social situations. This fear could be related to a variety of social interactions or only to specific situations such as public speaking, meeting unfamiliar people, or even eating or drinking in front of others.

People with social anxiety fear that they will be humiliated, rejected, or judged, especially if they show their anxiety symptoms or act in an odd, embarrassing, or inadvertently offensive way. They may also fear being perceived as not smart or as incompetent.

Socially anxious individuals try to avoid feared social situations as much as possible. In cases when it’s impossible to avoid, they try hard to behave in ways that will mask their embarrassment, self-perceived awkwardness, and anxiety.

Common Situations That Trigger Social Phobia Symptoms

- Being the center of attention

- Meeting or being introduced to new people

- Attending a party

- Having to talk in a formal, public, or group situation

- Presetting in front of a group of people

- Talking to an authority figure

- Making small talk

- Talking, eating, drinking, reading aloud, or writing in front of people

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Treatment for Social Anxiety

The good news is that we now have a very effective treatment of social anxiety. Cognitive Behavioral Therapy (CBT) is an evidence-based, short-term treatment with a very high rate of success for this disorder.

People with social anxiety are afraid of being scrutinized, negatively evaluated, or judged by others. Evidence-based strategies for treating social anxiety address four patterns that characterize socially anxious people. Those patterns are:

1. Self-focused attention. Socially anxious people are highly attuned to their internal symptoms and feelings, as well as how they imagine being perceived by others. This “tuning in” interferes with their social interactions. Their attention is tuned inwards and they miss numerous important verbal and non-verbal social cues.

2. Avoidance and safety behaviors. Individuals with Social Phobia try to avoid situations that make them anxious, and when they can't do that, they often implement safety behaviors to cover up their anxiety signs. They may stare at their phone or look disinterested in order to avoid communicating with others, carry water everywhere, wear clothes that conceal sweating, or wear their hair down on their face to hide blushing.

3. "Postmortem" analysis of social situations. People with social anxiety often have persistent negative and unpleasant thoughts and images about their social interactions. They spend a great deal of time recalling how horrible they looked and sounded and imagine other people judging and rejecting them.

4. Biased self-image. Socially anxious people believe that if they feel anxious or awkward, they must appear as such to others.

6 Effective Evidence-Based Strategies for Overcoming Social Anxiety.

Overcoming those unhelpful patterns brings fast relief. Some very effective strategies are:

1. Stop avoiding social situations. On the contrary - start actively seeking them. If you are very anxious, begin with having conversations with telemarketers or returning purchases to a store. This will help you habituate to social interactions. Then, start gradually exposing yourself to social interactions; first one-on-one, and slowly building the courage to interact with groups of people.

Other small steps to overcome avoidance may include:

- Make it a goal to smile and say hello at every opportunity (at a store, in an elevator, at work, and in your neighborhood).

- Identify the eye color of every person you talk to throughout the day to get used to establishing eye contact.

- Try to learn at least one new person’s name whenever possible (at work, at a yoga class, or at an event).

2. Examine the situation objectively. Remember, your feelings and thoughts are not facts, and the "how I feel is how I look" approach is incorrect. The information from your internal sensations is biased. How we feel inside is not an accurate reflection of how we come across to others.

3. In a social situation, keep shifting your focus to what's going on around you instead of focusing on your internal sensations and thoughts. Shifting attention away from the self and concentrating on others instead facilitates social interaction and helps you stay engaged. Make a conscious effort to look at the other person’s face, establish eye contact, and concentrate on the content of the conversation.

4. Drop any "safety behaviors" you may be using - such as avoiding eye contact, staring at your phone, carrying a bottle of water, pretending to be disinterested, dressing or styling your hair a certain way, etc. They may seem helpful, but in reality, they just make anxiety stronger in the long run.

5. Ban the "postmortem" analysis and overthinking by not engaging with the thoughts and images of recent social interactions. You may start by allocating a certain time frame, say, 15 minutes per day, to “analyze” past social interactions. But, when you start thinking about them at other times, gently remind yourself that if you still need to, you will allow yourself to ruminate about them during the allocated time.

6. Do not try to adhere to any specific social rules, as this will just make you more focused on yourself rather than the situation. The best social skill is to attend to the situation and to be flexible in your response.

It is important to know that breathing, relaxation, and other safety behaviors only have a very limited and short-lived effect. If you have social anxiety, you need to stop avoiding social situations and structure your behavior for success by practicing the strategies above.

How We Can Help Our Kids Avoid Developing Social Anxiety

As a society, we are getting better in terms of effective psychological and medical treatment and reducing stigma, but we are simultaneously falling behind as younger people become increasingly socially isolated.

Raising awareness from the beginning of elementary school will help both reduce stigma and identify mental health problems earlier. Kids and teens often have school assignments on mental health disorders, which they then discuss in class and find thought-provoking and interesting. Kids often choose to do a project on the issue that they themselves are experiencing, which helps them become better educated about the treatment options, and to feel less lonely and stigmatized, and more hopeful.

Additionally, strongly encouraging social connection and activities that do not include screens is a significant part of managing social anxiety in kids and teens, as well as adults.

Tips for Parents of Socially Anxious Kids

- Be supportive of the child, but not of his anxiety. Instead of announcing to everybody that “he is just a little shy,” encourage the child to take small steps toward social interactions.

- Acknowledge your child’s feelings and team up with her against the anxiety.

- If necessary, move in very slow steps. You may start from working with your child toward saying hello to people she knows and to family members, then working toward practicing saying hello to a neighbor, a cashier, and other less familiar or completely unfamiliar people. Try to expose your child to a variety of situations and places and help her gain confidence.

- Invite a child’s peer to a play date at your house. After your child becomes comfortable with his friend, invite another kid to join them. You can also arrange a playdate for the child at the friend’s house so that he can experience a social interaction at an unfamiliar territory.

- Assign the child the responsibility of answering the home phone. Yes, this includes talking to pesky telemarketers, which is a great opportunity to practice engaging in a social interaction.

- If you are shopping or going out together, use every opportunity to have the child ask for directions, find out where the bathroom is, or inquire whether the store carries another size or color. The child can also ask for a menu and order at a restaurant.

- Teach your child not to believe everything he thinks. Encourage him to hold his thoughts lightly and not get too attached to them.

When we change our attitude from one of avoidance to one of seeking the challenge and overcoming it, things fall into place. Start now! Identify an anxiety-provoking social situation and set yourself up for success by actively engaging in it.

Do you suffer from social anxiety? have you found strategies or treatment that helped? Share your story in the comments below!

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Anna Prudovski is a Psychologist and the Clinical Director of Turning Point Psychological Services. She has a special interest in treating anxiety disorders and OCD, as well as working with parents.

Anna lives with her husband and children in Vaughan, Ontario. When she is not treating patients, supervising clinicians, teaching CBT, and attending professional workshops, Anna enjoys practicing yoga, going on hikes with her family, traveling, studying Ayurveda, and spending time with friends. Her favorite pastime is reading.

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