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Social anxiety

Social anxiety disorder is a kind of panic disorder where people get so anxious and distressed in social situations that they try to avoid those situations altogether. People can have social anxiety in any situation where they might become the focus of attention, and worry about what other people are thinking about them. This feeling can relate to any one specific situation (like speaking up in a meeting at work), or lots of different situations (like giving a speech, being watched while writing or eating in front of people).
This section deals with the complex issue of social anxiety, the different types, why it happens and most importantly, what you can do about it.

Social anxiety

What is Social Anxiety?

Social anxiety is very common; so don’t feel like you are alone here. It’s actually the third biggest mental health condition. It is commonly the fear of social situations that involve interaction with other people. You could say social anxiety is the fear and anxiety of being negatively judged and evaluated by other people.

There are three parts to social anxiety: physical sensations; actions and avoidance; thoughts and beliefs. Each of these is discussed in more detail below.

Physical sensations

When we are exposed to a physical threat, our bodies automatically gear up to fight or flight (called the fight-flight-freeze response). We become more alert, our heart starts racing, our muscles tense up, we sweat more, and breathe more quickly. These changes are designed to protect us from danger. They help us to run away quickly, fight the “enemy” or freeze to avoid observation.

But sometimes our fight-flight-freeze response is activated when it’s not actually helpful (that is, when there is no actual danger). When people with social anxiety find themselves in a situation where they are worried they will be judged, their fight-flight-freeze response is triggered, and they might have some or all of these sensations:

  • Racing heart
  • Blushing
  • Dizziness or feeling faint
  • Sweating or hot flushes
  • Trembling or shaking
  • Mind going ‘blank’
  • Nausea or butterflies in the stomach

Actions and avoidance

Because the feelings associated with the fight-flight-freeze response can be unpleasant, people’s usual impulse is to want to get away from the situation that is making them anxious.

A person with social anxiety might start making up excuses or reasons to avoid eating in public, making a speech or whatever the situation is that makes them anxious. While this might seem sensible, avoiding these situations is actually counterproductive, because it stops you from learning that they’re not really dangerous, and that even if you get anxious, you can handle it.

Thoughts and beliefs

People with social anxiety often have unhelpful thoughts about their own behaviour or how they are being judged by others. For example:

  • “They must think I look silly and sound pathetic”
  • “I am going to stuff this up”
  • “I won’t know what to say”
  • “Everyone can see how anxious I am”

Treatments and help

The gold standard treatment for social anxiety is a process called cognitive behavioural therapy (CBT) – In short, learning to recognise your thoughts, learning some tricks and then practising it in real situations. With the help of a therapist CBT can help in the following ways:

  • Helps you understand the symptoms, causes and effects of social anxiety
  • Challenges your fears and worries related to the social situations that bother you (e.g. worries that you might say the wrong thing during a job interview and the interviewers will think you’re an idiot)
  • Helps you face the situations that you’re afraid of and usually avoid, in a gradual and manageable way
  • Develops assertiveness and conversational skills (if necessary)
  • Introduces a range of relaxation activities, including breathing exercises and other strategies, to help you manage the physical symptoms of anxiety.

If you feel you need a little more help:

  • A doctor is always a good place to start when trying to overcome a panic disorder, as he or she can make referrals for specialists, and support your efforts with medications if necessary.
  • This website has information on a range of professional care options that are available.