Social Anxiety Explained
Most of us feel nervous in certain social situations, especially when meeting new people or engaging in an unfamiliar activity. These feelings are common and are often of no concern. But what is social anxiety and when do nerves become this?
In contrast, social anxiety disorder can lead to feelings of fear and discomfort in everyday interactions and this can have a profound effect on your life. Self-consciousness and embarrassment can lead to the complete avoidance of any kind of social situation.
For those with social anxiety, seemingly common social interactions can quickly become overwhelming. Maintaining eye contact or attempting small talk can seem like an insurmountable hurdle, making you less inclined to engage with others.
The Anxiety and Depression Association of America (ADAA) estimates that 15 million American adults have social anxiety disorder. Despite this, it may be difficult for you to differentiate the disorder from shyness.
Warning Signs and Symptoms
Symptoms of social anxiety disorder typically begin around the age of 13, although it can sometimes start in children or adults. Emotional and behavioral symptoms include, but are not limited to:
- An intense fear of speaking to or interacting with strangers
- Avoiding situations that would place you at the center of attention
- Fear of physical symptoms that cause embarrassment, like blushing, sweating, or a shaky voice
- Continually worrying about embarrassing or humiliating yourself
- Fearing that other people will notice that you look anxious or uncomfortable
- Expecting the worst possible outcomes or negative experiences in social situations
- Avoiding participation in activities or speaking to others out of fear of embarrassment
- Fearing situations in which you may be negatively judged
- Analyzing your performance and criticizing the flaws in your interactions following an event
There are also physical symptoms that accompany social anxiety disorder, including:
- Fast heartbeat
- Nausea or upset stomach
- Dizziness or lightheadedness
- Trouble catching your breath
- Muscle tension
- Shaking or trembling
These signs and symptoms appear in different situations depending on the person experiencing them. Some common social interactions that may trigger such a response include:
- Attending parties or social gatherings
- Meeting new or unfamiliar people
- Using a public restroom
- Going on dates
- Attending school or work
- Eating in front of other people
- Maintaining eye contact
It is important to distinguish social anxiety disorder from shyness. If you are finding it difficult to endure even common, everyday social situations, you may want to discuss your symptoms with your doctor.
How Social Anxiety is Diagnosed
Although there is no test you can take to diagnose social anxiety disorder, your doctor will be able to diagnose you based on the symptoms you are experiencing and after ruling out another physical or mental health disorder.
A physical exam will help determine if your anxiety may be caused by another medical condition or a medication that you are taking.
Most doctors will ask for a description of your emotional and physical symptoms, where you experience these symptoms, and may examine certain behavioral patterns to make a diagnosis. There are criteria many doctors look out for, such as:
- Intense anxiety or panic prior to or during social interactions
- Fearing or avoiding social situations that may lead to embarrassment or humiliation
- Persistent or continual anxiety that disrupts your daily life
- Excessive anxiety or panic that is out of proportion to the situation
For most people, some situations will be more difficult than others. While you may be comfortable sitting in a crowded classroom, others may feel anxious attending a party.
You may spend a significant amount of time stressed out before an event has even occurred, or you could use up a lot of mental energy afterwards just worrying about how you acted.
Regardless of the impact social anxiety has on your life, there are treatments available that will make it easier for you to manage.
Treatments for Social Anxiety
Anxiety disorders, like many mental health conditions, can be more difficult to treat if you wait to seek treatment. Reach out to your doctor as soon as you notice that your anxiety is causing you to avoid social situations in your life.
The most common treatments for social anxiety disorder include psychotherapy, medications, or both.
Therapy for Social Anxiety
Psychotherapy, or talk therapy, is common in the treatment of social anxiety disorder, as it teaches you how to recognize and change negative thoughts as they appear. Therapy allows you to develop the skills to help you gain confidence in social situations.
The most common and effective form of therapy for anxiety is cognitive behavioral therapy (CBT), which can be done individually or in a group setting. You will slowly learn how to improve your coping skills and practice exposing yourself to various social interactions in a safe setting.
Medications for Social Anxiety
Medications are often prescribed in conjunction with therapy, as they help to lessen your symptoms, but do not give you the skills that you develop in therapy.
The most common medications prescribed for anxiety are selective serotonin reuptake inhibitors (SSRIs), with some doctors choosing to prescribe serotonin and norepinephrine reuptake inhibitors (SNRIs). Both are effective in treating social anxiety, although it may take weeks or months before you notice an improvement in your symptoms.
The most important thing to remember is take your time and do not give up if treatment does not work quickly. Learning new skills and finding the right medication is often a process of trial and error that can take months.
Discuss any changes in your condition with your doctor and give yourself the space to grow and challenge yourself as you learn to manage your disorder.