Anxiety, in general, is a normal part of life. It’s normal to feel uncomfortable in some of our interactions with other people. All of us may experience occasional palpitations, sweating, or butterflies in the stomach during job interviews, class presentations, and performing in public. It’s a whole new ball game if you have a social anxiety disorder (SAD)—formerly referred to as social phobia—the third most common psychiatric disorder after depression and substance abuse.
SAD makes you skip a job interview, decline a promotion, leave a party early (and quietly), stop doing groceries, or avoid public restrooms. A person with social anxiety has an extreme fear of being scrutinized, judged, or humiliated even in everyday situations.
According to Science…
The DSM-5 describes social anxiety disorder as “fear of or anxiety about social situations, including situations that involve scrutiny or contact with strangers. Individuals with this disorder typically fear to embarrass themselves in social situations, such as while speaking in public
or meeting new people.” A social encounter often triggers physical symptoms such as increased heart rate, blushing, dry mouth, and upset stomach. Some of the situations that can trigger social anxiety include:
- Speaking with someone of authority
- Speaking to a group of people
- Talking to strangers
- Eating in public places
- Being watched while they are doing something
- Being criticized or being praised
- Any performance-based activity
- Interpersonal relationships
- Being put on the spot
The anxiety in SAD exists in a series or progression, ranging from zero anxiety to commonplace shyness and performance anxiety, and ultimately to social anxiety disorder. Because of the nature of the disorder, SAD can negatively affect multiple aspects of an individual’s life.
Social anxiety disorder is quite challenging to treat as clinical interviews, which are essential for the diagnostic process and management, require social interaction. In a 2007 survey, ADAA (Anxiety and Depression Association of America) found that 36% of SAD sufferers experience symptoms for more than 10 years before seeking medical help.
Development of self-protective strategies
SAD persists throughout a person’s life and the sufferer develops self-protective behavior to cope with the intense anxiety, which can be counterproductive later on. Anxious people adopt these actions to conceal their perceived shortcomings and increase their sense of security. Therapists analyze social anxiety by these safety behaviors, as well as its intensity and impact on your life.
Self-protective interpersonal patterns:
- You seek security in being liked, to the point of smiling, nodding, and making yourself agreeable. You would take the blame to minimize friction.
- You let others take charge and boss you around. You easily give in to pressure or intimidation.
- You attempt to lead a “perfect” or blameless life to eliminate the possibility of making mistakes.
- You stay out of the limelight. You would rather be “invisible” than be the center of attention. Being criticized (or even praised) in front of many people feels like an ordeal.
- People often say that you are passive, uninvolved, or reserved. You are afraid of imposed changes (e.g. moving to a new place). The possibility of making mistakes (e.g. stuttering or blushing) is more dreadful than missing out on opportunities (e.g. high-paying job).
Dealing with social anxiety through cognitive behavioral therapy (CBT)
CBT alone is considered an excellent treatment for social phobia. Prescription medications can also help but not without some side effects. A 2014 study revealed that CBT or talk therapy for SAD is more effective than medication and can have lasting effects even after treatment cessation. But what if you do don’t have access to a certified therapist? Or you’re just not ready to commit to a psychological treatment?
Claire Eastham, author of We’re all Mad Here, shares some doable tips on how to deal with social anxiety:
- Relaxation and breathing exercises. Some people with SAD benefit from deep breathing exercises, others don’t. But there are different types of relaxation techniques; one of them is progressive muscle relaxation (PMR). It is done by alternately tensing and relaxing your major muscle groups in the body. Because social phobics are most likely to have tense muscles, PMR can help induce full body relaxation.
- Thought records (thought diaries) is a pen and paper exercise and one of CBT’s tested instruments for increasing rationality, something that is assumed to contribute to a more pleasant emotional life. The purpose of this tool is to pay attention to your thoughts and recognize the unhelpful ones so you can change them.
- Good ol’ exercise. We have been reminded time and again about the wonders of exercise. For Eastham, moderate exercise is the right intensity level for anxiety management. Why? Because low intensity is not enough to make a difference and high intensity can aggravate your anxiety symptoms. So, do moderate exercises for at least 30 minutes three times a week to reduce stress and anxiety.
- Anti-anxiety diet. Healthy eating can do wonders for anxiety sufferers. When it comes to anxiety disorders, the most important aspect of eating healthier is removing certain foods that contribute to your anxiety symptoms. These are fried food, caffeine (coffee and soda), dairy, acid-forming food (eggs, wine, pickles), and refined sugar. You don’t need to eliminate all of these in your diet; just cut down the amount you eat and observe if your symptoms improve.