What is Social Anxiety Disorder?

Social Anxiety Disorder. Social Phobia. Social Anxiety. We hear these terms quite a bit in our modern vocabulary. In order to be clear, I'd like to define a couple of terms.

When I speak of social anxiety, I am referring to

A feeling of uneasiness or apprehension about social interactions and how we appear to others. Very often, the source of the social anxiety is a concern that one is or will be judged negatively by other people, regardless of whether this is actually the case.

It’s important to note that mild to moderate feelings like this effect almost everyone. I would say that at least 90% of people that I've worked with over the years in counseling have a mild to moderate degree of anxiety in social situations. For example, most people who are speaking in front of a group will have considerable anxiety. This is normal.

However, it is a matter of degree. I often think about anxiety and other feelings on a scale (say, from 1-10), rather than having social anxiety or not having it. At a certain point, the anxiety goes beyond nervousness and apprehension to the point where it either 1) significantly impairs our ability to function in that situation or 2) we avoid the situation altogether.

When I use the term social phobia....

I mean the avoidance of necessary activities in one’s life due to the level of social anxiety that one feels. In this case, the anxiety that one feels causes significant impairment in his/her life. The avoided or feared circumstances may be very specific to a particular type of situation, or they can be so broad that they apply to most of one’s social contact with other people. When individuals have this degree of anxiety, they will usually fit the criteria for Social Anxiety Disorder.

Interestingly enough, Social Anxiety Disorder and Social Phobia are considered the same diagnosis in the DSM-5. If you are concerned that you or someone you love may be suffering from this condition or something similar, please read on. 

NOTE: A fantastic resource for Social Anxiety can be found at this link

What Creates This Type of Anxiety?

A combination of things. As you probably guessed, certain social situations create anxiety for many people, and for those living with a social phobia, the anxiety can be almost intolerable.

But let’s look closer. Anxiety is a feeling, one that is hardwired in our being. It has historically served a purpose--to help us be alert for danger. Then we react: typically by

  • Fighting
  • Flighting (running away) or
  • Freezing

I have had all of these reactions to anxiety. So have most people. Some of us tend to favor one of these three reactions in most anxiety-provoking situations.

What’s behind the feelings? Thoughts, and thinking patterns. The good news: These patterns are LEARNED. Thus, they can be unlearned, and you can teach yourself (or have a professional help teach you) new, healthier thought patterns. Very often, people with a lot of social anxiety are very concerned about what others think, or lack the skills and knowledge to function in certain social situations. This brings us to the big question: how does one address their social anxiety? Or to put it another way--what is out there that really works in addressing this problem?

Being constantly fearful of others, and not being able to trust others (and sometimes not trust ourselves) can certainly contribute to social anxiety. More on the critical importance of trust on this page

Social Anxiety Disorder: What Can Help Me?

Enough talk about causes and symptoms. I’ll get to the point. Can social anxiety disorder be treated? Yes! Let’s turn our attention to tools that have been shown to work for people.

  • Cognitive-Behavior Therapy, otherwise known as “CBT”. This model has been effective in helping people successfully address their social anxiety. The main idea is that we have events in our lives every day, all the time. We then have thoughts in response to those events. From those thoughts come certain feelings. It could be summed up like this: EVENTS>>THOUGHTS>>FEELINGS. For a counselor using CBT, the focus goes to a person’s thoughts. In other words, examining one’s reaction to events (especially one’s thoughts), and helping someone change their thought patterns will result in a change in one’s feelings. A good example of how this works can be found on this pageIn my experience, these simple methods work very well in treating social anxiety, because they get to the heart of the problem--our thinking patterns. Try it out. I certainly encourage you to consult with myself or another mental health counselor if you find that it is difficult to ‘get the hang of this’, as some people have shared with me.

         For more about the basics of CBT see this link

  • Behavioral techniques: There is nothing like practice. Consider practicing the very behavior that causes anxiety for you. I would recommend first doing this in a relatively safe environment, and then move to gradually more challenging situations as you gain confidence and experience. For example, if you have trouble speaking in front of groups, try to do this in front of a mirror, then in front of friends or family (or whoever feels safest to you), and continue this in increasingly challenging steps. While doing this step-by-step process, it’s helpful to have a trusted friend or professional to consult with along the way.
  • Acceptance of self: Quite often, people suffering from social anxiety are also struggling with self-acceptance. For example, if I don’t feel as though I’m good enough or that I’m somehow inferior to others (or not smart enough, not attractive enough, too short, etc.), it will be very hard to function in front of others without significant anxiety. In this case, consider mental health counseling. I would also encourage you to check out my pages on: low self-esteem, depression, and coping skills.
  • Social Skills Training: Some individuals are socially anxious due to a lack of social skills. In these cases, providing some social skill building can make a huge difference in one’s confidence. I would add that it can be very helpful to practice these skills in a safe environment--with friends, family, or a counselor--before going out and trying them on strangers
  • Medications--If nothing else helps, certain medications can help individuals suffering from social anxiety disorder to feel calm enough that they are able to function in situations that seem overwhelming. Consult with a trusted family doctor or psychiatrist. I must add that I feel that this is a last resort, only if other methods don’t work. If you do take medications to cope with social (or other) anxiety, please continue to work on yourself via some other methods too. Remember, meds are treating the symptom, not the problem. Furthermore, many anti-anxiety medications are highly habit-forming and may stop working after a period of time.

Consider the Worst Case Scenario

I often encourage clients to get to the bottom of their anxiety by considering what the worst case scenario is in a given situation. I encourage you to write this out (or think it through), and then consider 1) the likelihood of this scenario actually happening and 2) how you would cope in the event that it does actually happen. Doing this tends to be very calming, especially once you consider other, more likely scenarios.

Example: You are going to give a speech in front of 30 classmates. Your worst case scenario is that you fumble your words, your voice gives out, and your classmates laugh at you. Okay, this is the worst thing that could happen? Good to know. Now, consider the likelihood of this happening--assign a percentage to it. Next, consider other alternative outcomes, and assign percentages to those possibilities also. This exercise helps many, many people. Try it out!

What’s in a Label?

You may be wondering: do I have social anxiety disorder? A social phobia perhaps? Labels are less important than getting to the root of the problem. When in doubt, see a mental health professional for an accurate diagnosis of your problem.

In any case, if you feel that you struggle with social anxiety to the extent that it interferes with your ability to live your life the way you want to, please understand that this is a treatable condition! Use of the methods described on this page, and/or consultation with a mental health counselor can prove very helpful in coping with social anxiety disorder and related conditions.

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