Anxietyis a normal reaction to uncertain and stressful situations. When you are facing a big life decision such as buying a house or when you decided to quit your job to start your own company, it is completely normal to expect some anxiety and insecure, stressful moments. Anxiety can then be helpful to make you aware of the risk and give you the extra motivation to think your choices through. But in some cases, the anxiety is too much and can cause sufferers to avoid everyday situations out of worry.

What Is Anxiety?

Anxiety is a feeling of fear, worry, nervousness, or a feeling of apprehension, typically about a future event where the outcome is uncertain.

You can also experience anxiety when you feel you might not be able to put up to a certain task. Anxiety typically occurs in high pressure situations such as when giving a speech, sitting a test or almost any other situation that puts public demands on you can make you feel anxious. These situations don’t have to be “negative” as anxiety can also occur in positive situations such as getting married, having a child and starting a new school or job.

As outlined in the Diagnostic and Statistical Manual of Mental Disorder, fifth edition (the manual used by clinicians and researchers to diagnose and classify mental disorders), anxiety disorders include:(1)

Separation Anxiety Disorder

Selective Mutism, Specific Phobia

Panic Disorder

Panic Attack (specifier)

Agoraphobia

Generalized Anxiety Disorder

Substance/Medication-Induced Anxiety Disorder

Anxiety Disorder Due to Another Medical Condition

Unspecified Anxiety Disorder

Social Anxiety Disorder (Social Phobia)

Social Anxiety Disorder (Social Phobia)

In this article we’ll take a closer look at Social Anxiety Disorder, also known as Social Phobia. Perhaps you know someone with social anxiety, you suffer from it yourself or you just want to learn more about it. So what is social anxiety?

Social anxiety is characterised by feelings of discomfort, or fear, of being negatively judged and evaluated in social interactions by other people.

In other words, if you suffer from social anxiety you fear being embarrassed or humiliated and you may experience feelings of inadequacy, inferiority, depression and it is not unusual to then avoid these social situations. You may very well be aware of the fact that your fears and feelings are excessive or unreasonable. But you will still experience a great deal of dread when facing a feared situation and will do everything in your power to avoid it.

When on occasions you do decide to confront your fears, you feel very anxious beforehand and highly uncomfortable throughout. Afterwards, uncomfortable feelings may continue, as you worry about what others were thinking about you or how you may have been judged.

There are two types of social anxiety:

Generalized: you experience symptoms in most social situations

Nongeneralized (or specific): you experience symptoms in specific social situations

People with Generalized Social Anxiety are nervous, anxious and uncomfortable in almost all social situations, while an individual with a Specific Social Anxiety disorder would be fearful of for instance speaking in public (only).

A person that suffers from social anxiety can feel significant emotional distress in (any of) the following situations:

Being teased or criticized

Being the focus of attention

Being watched while doing something

Being introduced to other people

Meeting other peoples’ eyes

Having to say something in public or formal situation

Circulating around the room (or table) and needing to say something

Interpersonal relationships, whether friendships or romantic

Talking or making phone calls if in public

Feeling out of place or insecure in social situations

Meeting “important people” (authority figures)

What Are Common Signs and Symptoms For Social Anxiety?

Although everyone will experience social anxiety in their own way, feeling stressed, worried and having anxious thoughts are some of the common symptoms. Other symptoms of social anxiety can include:

intense fear

quick heartbeat

problem concentrating

avoidance behaviour

turning red/ blushing

sweating (excessively)

dry throat & mouth

trembling

difficulty swallowing

feeling lightheaded/ faint

nausea

muscle twitches

The above list is definitely not a complete list of symptoms, other feelings and symptoms have been linked to social anxiety as well.

What Causes Social Anxiety?

Social Anxiety can affect individuals of any age and gender, but it usually starts in teens with a history of shyness (2). It affects as much as 7 percent of the population at any given time in the U.S (or 15 million people). Research in Europe estimates that the lifetime prevalance of Social Anxiety is also around 7% in the general population.(3)

There is no single known cause of social anxiety disorder (or anxiety disorders in general), but research suggests that geneticsmay play a role in combination with environmental and present day stresses. Bad or traumatic experiences, such as being bullied at school or similar extreme stressful experiences can also have a big impact. Any experience that makes you feel different, strange or unacceptable in the judgement of other people can make susceptible to social anxiety.

How Is Social Anxiety Best Treated?

The best treatment for social anxiety is different for everyone, but making simple lifestyle changes will already help you tremendously to lowerstressand anxiety. These lifestyle changes may include regular exercise, reducing or eliminating caffeine and alcohol intake, getting adequate sleep and a healthy diet can all help to lower anxiety and stress. Other self-help tools for dealing with anxiety are learning to control your breath, challenging negative thoughts and building better relationships.

If you tried all of the above lifestyle changes and other self-help strategies and your social anxiety is not eased then you may need professional help too:

Cognitive-behavioral therapy (CBT) has been considered to be the most effective treatment option for social anxiety. CBT is a form of psychotherapy that helps you to change negative or unhelpful thoughts and behavioral patternswhich may contribute to your anxiety. CBT combines two components:

Cognitive therapy: examines how any negative or unhelpful thoughts that you have contribute to anxiety

Behavior therapy: examines how you behave and react in settings that offset anxiety

CBT is based on the idea that your thoughts (and not the outside world) affect how you feel and that in turn your feelings affect your behavior. So it is not the situation that determines how you feel, but your perception if it. So, if you learn to change the way you think about social situations that give you anxiety through CBT, you’ll learn to control your anxiety levels and you will feel better.

Group therapy can be an important element too in your treatment plan if you suffer from social anxiety. There are two kinds of groups: therapy groups and social support groups. Therapy groups focus on the use of CBT in a group setting and they may use acting, mock interviews, videotaping & observing so that you can practice and prepare for situations you are afraid of. The other kind of group, social support groups, offer general social support.

Medicationin the form of beta blockers, antidepressants and benzodiazepines is sometimes used to ease symptoms from social anxiety. Although these medications can help ease the symptoms, they come at a cost. Most of these are highly addictive and they are no cure for social anxiety, they just manage your symptoms temporarily. When you stop taking medication, your symptoms will probably return. CBT, group therapy and other strategies that work on the root cause of your anxiety are much better ways to deal with your anxiety in the longer run.

References & Further Reading

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