Social anxiety disorder, also called social phobia, is a mental disorder where a person experiences a severe and persistent fear of being judged and watched in social situations, with intense feelings of anxiety triggered by social events or the possibility of interacting with new people, or performing in front of others.

Feeling shy and nervous before going on the stage, or meeting someone new, or giving an interview, or participating in a work-related meeting is quite normal. People may have personality traits which make them a little shy by nature, and such traits are quite common. However, the difference between such nervousness and social anxiety is the intensity of the symptoms. The symptoms of social anxiety severely affect the occupational, emotional and undeniably the social functioning of a person. Even simply things like walking in a public place, or eating in a public food-court or just being among  friends,  can provoke anxiety for a person with social anxiety disorder. Thus, this illness interferes with their daily-life activities and causes a lot of distress. According to the World Health Organization (WHO), one in thirteen persons globally suffer from social anxiety disorder.

However, this disorder can be managed with a proper treatment. 

Signs And Symptoms of Social Anxiety

It is important to yet again highlight the fact that reserved behaviour in social events and other social situations  is normal for those with an introverted personality. Even extroverted people experience a certain level of nervousness before presenting themselves on the stage or in an interview. Social anxiety disorder typically manifests in avoidance-based behaviour which really disrupts a person’s day-to-day functioning. The condition typically starts in the teenage years, however it is not uncommon for it to begin during childhood or adulthood.

Here are some of  the signs and symptoms of social anxiety disorder: 

Emotional & Behavioural Symptoms:

  • Persistent fear of being judged in social situations
  • Fear of such anxious behavior to be noticed by someone
  • Fear of feeling embarrassed or humiliated, or causing embarrassment or humiliation to someone else
  • Catastrophizing i.e expecting the worst possible outcome in a situation
  • Over-analyzing one’s own performance and interaction or judging one’s own imperfections after a social event 
  • Anticipatory anxiety due to a social event that’s about to happen
  • Avoiding the spotlight in any situation
  • Avoiding social interactions

Physical Symptoms

  • Breathlessness
  • Pounding heart beat
  • Visibly shaking and trembling
  • Blushing
  • Motor tension
  • Upset stomach 
  • Nausea
  • Dizziness, feeling lightheaded and drained
  • Feeling as if you’ve gone blank and do not know what to say

Causes of Social Anxiety Disorder

The exact causes of social anxiety disorder haven’t been identified, however some linkages can be drawn with some factors. It may run in the family, as in, if you have a close relative with social anxiety disorder then the chances of having the illness are considerably high. Underdeveloped social skills or not being naturally empathic can be possible contributors. If your social interactions with most people are challenging, then you might unintentionally develop avoidance-based approaches. This in turn may  isolate yourself further and possibly even become quite an asocial person. All of this may contribute to developing social anxiety. Another fact is that not having good social skills leads to us not being able to respond well to others, and we may end up misreading other people’s actions. Our poor social skills add to the obstacles in good communication. This may worsen the condition. Scientists are still looking for more biologically-based and environmental factors contributing to the development of social anxiety disorder.

Treatment for Social Anxiety

You must see a doctor or a health-care professional if you think you’ve been feeling the symptoms above for over 6 months. A physical examination will ensure the symptoms aren’t due to any physical ailment. Where no physical issues are highlighted then a visit to  a mental health professional will be recommended. You may contact our Incontact  team of mental health professionals and book your appointment.  If social anxiety disorder is suspected,then a visit to a psychiatrist may be recommended.  After this  a treatment plan can be decided based upon symptoms and their intensity. Treatment for social anxiety disorder involves: 

Psychotherapy: 

CBT or cognitive behavioural therapy is typically considered useful for social anxiety disorder as well as for many other psychological disorders. It equips you with many tools and techniques which help you manage your symptoms. It also  addresses the core of the problem, which according to CBT principles, is the cognitive distortions and unhealthy behavioural and mental habits that ultimately cause a lot of disruption in one’s life. Another therapy that we at Incontact are specialized in is EMDR or eye movement desensitisation and reprocessing therapy. EMDR has a proven track record for the treatment of anxiety based disorders. It helps activate the brain’s natural capacity for healing and process the traumatic memories from the past that affect us today. EMDR thus helps us target the early experiences that made us develop social anxiety in the first place. We also recommend a systemic approach to see origin of the social anxiety and its roots from a psychodynamic and systemic perspectives.

The anxiety and fear is therefore reduced to a considerable extent due to the therapy. 

Support Groups: 

In support groups, there is an environment of unconditional acceptance and positivity, and everyone is driven by the same goal as you are. It helps to learn from them and their journey, and receive a lot of unbiased, helpful feedback. Social support from such a source is crucial for someone going through social anxiety disorder as they have trouble maintaining good relationships with people in the real world. Such support groups provide a safe space for them to interact.

Medication: 

The medications used for social anxiety disorder are: 

  • Antidepressants
  • Anti-anxiety medication
  • Beta-blockers

Frequently Asked Questions

Q. Isn’t social anxiety just a form of introversion?

No. People with social anxiety have an extreme fear of being judged and scrutinized by the people around them in social and/or performance situations. This fear is excessive and unreasonable and affects people with social anxiety disorder in their day-to-day activities and has a detrimental impact on all spheres of their lives. There are significant physical symptoms associated with social anxiety as well.

Q. What can I do on my own to reduce the symptoms of social anxiety?

Follow these tips:

  1. See someone ASAP: visit a mental health professional as early as possible. 
  2. Read up on your illness and mental health in general. 
  3. Keep a journal.
  4. Avoid substance abuse.
  5. Develop healthy habits like eating a well balanced diet, going to bed on time and sleeping for 8 hours every single night, working out regularly, etc. Such habits are a must for everyone, and impact our mental health in positive ways.
  6. Be as honest as possible with your therapist and discuss every single issue with them. Take your medication, if any, on time and regularly. Follow your treatment plan very, very seriously.
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