What is Social Anxiety?
Social Anxiety Disorder is one of the most common mental health conditions and is associated with a reoccurring and extreme fear of social situations, mainly where the individual may be negatively evaluated by others.
It’s not so much that the person is fearful of the social situation itself, however it’s a fear of how others will react/respond to their presence.
Symptoms of social anxiety:
Fear of social situations where you may be judged negatively.
Avoidance behavior of the feared situations.
Anxiety when speaking up in front of others, are the center of attention, vocalize disagreement, engage with people of authority, and during meetings or interviews.
Dysfunctional beliefs about themselves and others when in feared social situations or thinking ahead about the interaction.
Display flaws in social behavior and often misconstrue positive social cues.
Post event processing- negatively overthinking about how the social interaction went.
Struggle to display genuine smiles and are less able to share other’s positive emotions and experiences.
Have fewer close friendships, likely to live alone, avoid association or club involvement, and less likely to engage in romantic relationships.
Individuals who do have a few friends tend to be less content with the quality of friendships.
Turn to substance use to numb feelings of anxiety prior to feared social event.
Expecting the worse outcome of a negative interaction.
Treatment Ideas:
Pharmacology
The National Institute for Health and Care Excellence (NICE) recommends psychotherapy and pharmacotherapy as first choice, evidence-based treatments for SAD. A medication evaluation to evaluate the possible effectiveness of mediation to relieve symptoms of social distress could be beneficial.
Cognitive-Behavior Therapy (CBT)
The aim of CBT is to reduce anxiety by focusing on unhealthy thoughts and behaviors. A therapist will assist in identifying and changing the substance of these thoughts to be more practical. Negative thoughts that are addressed consist of cognitive distortions that relate to social situations.
(See my article next week all about “challenging unhealthy thoughts”
Mindfulness-based intervention
Helps to change the relationship to your thoughts by noticing and accepting them without judgment.
Interventions include acceptance, decreasing social avoidance, and behaving with greater awareness.
Exposure therapy
Gradually expose yourself to the anxiety producing social scenarios while implementing relaxation techniques, such as deep breathing. For example if you have a fear of socializing with large groups, and you have been avoiding these scenarios, start by socializing with one friend, and work your way up to socializing with a small group of friends. Another idea for gradual exposure- allow yourself 30 minutes with the group of people, next time work your way to 1 hour, and so on.
Anxiety Management Skills
Learning how to stay focused on your behavioral goals and learning how to “ride the wave of anxiety” takes practice. Next time you are heading into an anxiety producing scenario, or need to “take a break” from a scenario, try this breathing exercise:
Breathe in through your nose while counting to 4. Continue inhaling for the entire 4 seconds. The breath should be slow and steady.
Hold your breath for another 4 seconds.
Exhale through the mouth for a count of 4. The exhale should be slow and steady.
Repeat as many rounds until you feel calmer.
Have self compassion
Healing takes time. I’ve had to remind myself time and time again, I’m not gonna nail it every time, I am human, and I still struggle some days. Having self-compassion means you can forgive yourself and accept your self in scenarios that are not ideal.
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DISCLAIMER* this is not a substitute for individual therapy*
According to the American Psychological Association (2013), in order to meet the diagnosis of SAD the symptoms must be existing for a minimum of six months, the anxiety must be out of proportion to the actual threat, the avoidance behavior must cause intense distress or impairment to one’s life, and the anxiety cannot be better clarified by the effects of a medical condition or another psychological disorder.