Do I have Social Anxiety?

Social anxiety makes it difficult for people to engage in everyday activities such as just going to work or heading to Starbucks to have a coffee with friends. These activities can be incredibly intense for someone with social anxiety. The fear of having a panic attack in public or being humiliated or embarrassed is so strong that many people choose to avoid social situations entirely. If you have a friend with anxiety and they are inconsistent with plans or cancel often, try not to internalize this behavior. Anxiety causes a fight, flight, or freeze response, which is biological in nature. Someone with anxiety needs help to overcome their intense fear before they can be more consistent in social situations. 

Social anxiety disorder (social phobia) is the third largest psychological problem in the United States today.  Millions of people quietly endure this pain every day, believing there is no hope for them getting better.

What is life with Social Anxiety like?

• “I couldn’t go on dates or to parties. For a while, I couldn’t even go to class. My sophomore year of college I had to come home for a semester.”
• “My fear would happen in any social situation. I would be anxious before I even left the house, and it would escalate as I got closer to class, a party, or whatever. I would feel sick to my stomach–it almost felt like I had the flu. My heart would pound, my palms would get sweaty, and I would get this feeling of being removed from myself and from everybody else.
• “When I would walk into a room full of people, I’d turn red and it would feel like everybody’s eyes were on me. I was too embarrassed to stand off in a corner by myself, but I couldn’t think of anything to say to anybody. I felt so clumsy, I couldn’t wait to get out.” 

1.  What is Social Anxiety?

Social anxiety is characterized by marked and persistent fear of one or more social or performance situations in which a person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. When exposed to the feared social situation, the individual experiences anxiety, which may lead to a panic attack.  

People with social anxiety often recognize that the fear they experience is excessive or unreasonable. They may also choose to avoid feared social situations or to simply endure them with intense anxiety and distress. In order to receive a formal diagnosis of social anxiety, the avoidance, anxious anticipation, or distress in the feared social or performance situation(s) must interfere significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia. 

2. Who develops Social Anxiety?

Social anxiety affects about 7% of the general population, with women more likely than men to develop the disorder. It typically begins around adolescence, though research has revealed that the average age that individuals begin to seek treatment is 30 years old. There is a small percentage of the population who develops social anxiety later in life.  Many people do not seek treatment for social anxiety specifically, especially because it is often comorbid with other anxiety disorders, depression, and substance use disorders. 

Individuals that develop social anxiety have biological and psychological vulnerabilities to experiencing anxious apprehension. They also evolve to be more sensitive to anger, criticism, and disapproval. 

3.  How does a person develop Social Anxiety?

An individual with biological and psychological vulnerabilities to anxious apprehension and a specific psychological vulnerability to believing that social evaluation is dangerous can develop social anxiety disorder, especially if they are exposed to negative experiences in childhood such as teasing, bullying, abuse, rejection, or humiliation. 

4. What are some triggers of Social Anxiety?

• Public speaking 
• Meeting new people
• Initiating/maintaining conversation
• Eating in public
• Dating
• Being assertive
• Using public restrooms
• Speaking to authority figures
• Writing in public

5. Is Social Anxiety there all the time or is it something that will be triggered?   

Social anxiety occurs when a person is exposed to the social situation that they fear. In other words, certain situations such as public speaking or going on a date or making eye contact with others would trigger the anxiety. Although this is true, 46% of people struggling with social anxiety are also diagnosed with depression, anxiety, and other co-occurring disorders. Individuals with Generalized Anxiety Disorder may experience high levels of anxiety throughout the day and a social anxiety trigger will then elevate the anxiety, possibly to the point of having a panic attack. 

6.What do Social Anxiety symptoms look like?

Are there physical symptoms like sweating? Or all behind the scenes? Is it easy to tell that a person has Social Anxiety or can they hide it well? 

Social anxiety has emotional, behavioral, and physical symptoms. Emotional and behavioral symptoms of social anxiety include worrying that you may embarrass or humiliate yourself, fearing that you will be judged in a social situation, intense fear of interacting with strangers, expecting the worst possible scenario to occur in a social situation, spending time after the social even scrutinizing ever flaw you may have made, and fearing that others will notice your anxiety or the physical symptoms that accompany it. 

Physical symptoms of anxiety include blushing, trembling, experiencing a rapid heart beat, sweating, having an upset stomach or feeling nauseous, feeling that your mind is blank, having trouble catching your breath, feeling dizzy or lightheaded, and having muscle tension. 

Individuals with social anxiety often have a distorted perception of how others see them, especially when experiencing the symptoms above. Oftentimes, people around them cannot tell that they are having a panic attack or experiencing intense anxiety.

7. How can Social Anxiety be managed?

Any tips or tricks? Does it require professional help? If so, who should you go see? 

If you are experiencing social anxiety that impairs your ability to live a normal life, I would advise you to seek professional help. A therapist or psychologist can help you train your brain to turn off the alarms that social situations set off by using research-driven treatments such as Cognitive Behavioral Therapy (CBT) and Exposure Therapy. In order to unlearn the association between the fear that you experience and the event that causes the fear, the brain must be exposed to this fear. Over time, the anxiety will dissipate as the brain begins to create new associations with those fearful social situations. 
In addition to seeking treatment for social anxiety, you may choose to manage some of the symptoms on your own.

Exercising and eating healthy can help your body manage stress. In addition to these tips, practice the “Catch it, Check it, Change it” skill. Catch yourself having negative thoughts such as “she didn’t even look at me, she doesn’t like me”, then check the thought. Stop and think about whether the thought is true. Do you have evidence to back it up? Would someone else interpret the situation the same way? What are some other possibilities? After you catch and check your negative thoughts, you can change them. Maybe the person didn’t look at you because they were upset themselves or maybe they were distracted by something happening with them. Instead of retreating, consider asking the person if they are okay and if there is anything you can do for them. Take the focus off of your negative thoughts, look outside yourself, and find other possibilities. 

Catch it, check it, change it can be difficult without the support of a therapist. If you are having a difficult time checking your thoughts, reach out to us here at Thrive— we specialize in anxiety treatment for an objective point of view. If therapy causes anxiety, check out our online or text therapy. 

8. How is Social Anxiety different or the same as regular anxiety?

Generalized Anxiety Disorder is characterized by excessive worry in all situations. Oftentimes, social anxiety is comorbid with generalized anxiety, meaning they occur at the same time. If your anxiety is not limited to social situations alone and you find yourself preoccupied with worry thoughts, it is a good idea to seek support from a specialist. 

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