What is Social Anxiety Disorder?

Previously referred to as Social Phobia, Social Anxiety Disorder is a condition in which people feel intensely uncomfortable in social situations. For many individuals, the idea of meeting new people, speaking in public, being in unfamiliar surroundings, or going on a first date can cause things like butterflies in the stomach, brain fog or a racy heart, but for people with social anxiety disorder, these interactions can trigger far stronger reactions.

Intense anxiety, self-consciousness, fear, and feelings of shame and embarrassment are common symptoms of social anxiety.  These more intense feelings can lead people to avoid triggering situations, and this could impact on work, study and day to day functionality.

 The fears associated with social anxiety disorder vary from person to person, but some of the more common fears or anxieties include:

  • Fear of being judged as inadequate, boring, quiet, uninteresting or unwelcome
  • Fear that others may notice the symptoms of anxiety (such as excessive sweating, body odour, shaking, stammering, anxious talking or the like)

The more we try to hide the symptoms, the stronger our anxiety becomes.

While social anxiety disorder is commonly triggered by social situations and interactions, the anticipation of such events can also be triggering, and deepen the anxiety .  Post-event worrying may also deepen the anxiety,  where mental obsessions of replaying and analysing what was said and done is magnified, The cycle of anticipatory, actual and post event anxiety may heighten the desire to avoid social situations in the future.

Social Anxiety Disorder is commonly triggered by a few specific situations. If the actual triggers remain unknown, the anxiety is referred to as Generalised Social Anxiety Disorder  

Symptoms of Social Anxiety Disorder

People with social anxiety disorder feel heightened symptoms of anxiety and fear, including:

  • Difficulty concentrating
  • Fixation on the physical sensations of anxiety, rather than the social interaction. 
  • Fixation on negative thoughts or feedback from others
  • Self-doubt and uncertainty
  • Feelings and thoughts around inadequacy or appearing foolish
  • A feeling of needing to flee the situation
  • Accelerated heart rate
  • Blushing and/or excessive sweating
  • Trembling or shaking
  • Nausea and the urge to vomit
  • Feeling light-headed or faint
  • Fast, shallow breathing
  • Muscle tension and aches
  • Dry throat
  • Stomach pain/indigestion

 In addition to common symptoms, social anxiety disorder has a number of common complications if the condition is left untreated. 

  • Difficulty forming and maintaining relationships
  • Difficulty finding and maintaining education or employment
  • Social isolation from family and friends
  • Reluctance or inability to leave the house
  • Depression
  • Suicidal ideation
  • Self-medication through drugs and alcohol, prescription and non-prescription drugs
  • Higher addiction tendencies including porn, gambling, gaming, online shopping.


Causes of Social Anxiety Disorder

While the exact cause of social anxiety disorder is unknown, it is believed that a number of factors, including genetic, environmental and lived experience could contribute to the development of the condition. 

- Family History : People with a direct family member living with social anxiety disorder are more likely to develop the condition

- Personality: Shy, highly sensitive, reserved, withdrawn or timid children with a slow to warm temperament may have a higher chance of developing social anxiety 

 - Lived Experience: Children who experience developmental trauma , prolonged or serious bullying, teasing, rejection or humiliation may have a higher risk of developing the condition. People that experience family trauma, grief and loss, abuse and other significant difficult life events that have not been worked through, may also have an increased chance of developing social anxiety disorder.

 - Appearance or Presentation: Having a condition that affects appearance or interaction, such as a large birthmark, orofacial clefts (cleft palate or lip), shakes due to Parkinson’s disease, a stutter or tic may increase feelings of self-consciousness, which may potentially contribute to the development of social anxiety. 

If you find yourself avoiding social situations or constantly worrying that you’re making a fool of yourself, you may have social anxiety disorder.  To help you work through this from the safety and comfort of your own home, seek a therapist that you resonate with on MyHealth1st .

Working through, and Living With Social Anxiety Disorder

Approaches to Social Anxiety Disorder vary from person to person, and need to be tailored to suit an individual’s needs. 

Understanding Social Anxiety Disorder on an intellectual level helps bring a conscious awareness to what is happening.  However, being with the fear, and sometimes terror, long enough to unlock its hold can be difficult.  Being in a good therapeutic relationship creates the right conditions to explore these areas.   With the help of a good therapist, a person living with Social Anxiety Disorder can come nearer to themselves, and gently look at what is happening underneath the behaviour.

There are a range of therapeutic approaches that can include: 

  • Acceptance and Commitment Therapy (ACT).
  • Dialectical Behavioural Therapy (DBT).
  • ACT and DBT provide plenty of psychoeducation around how to manage anxiety. Much of it is practical and can be folded into our day to day realities.
  • Psychodynamic Approach

Once stabilised, a psychodynamic approach can help explore the root cause of extreme anxiety. 

  • Cognitive Behavioural Therapy (CBT): CBT is a form of therapy designed to modify unhelpful thoughts and behaviours that may contribute to stress and anxiety.  CBT provide skills to manage anxiety symptoms, helps people to learn to identify and challenge their negative or anxious thoughts and replace them with more helpful ways of thinking. Relaxation strategies (e.g., relaxation breathing and muscle relaxation techniques) are commonly used. CBT has been found to be an effective treatment for anxiety disorders.
  • Exposure Therapy: As part of CBT, clients may be slowly exposed to situations that provoke anxiety, helping them to better identify and confront possible triggers as well as learn techniques to cope with or alleviate stress.

Lifestyle changes and paying attention to symptoms can also help to manage the effects of social anxiety. Maintaining good sleep hygiene, maintaining a healthy diet and regular exercise can also help alleviate and manage anxiety symptoms, as can managing stimulants like coffee, energy drinks or over the counter medications that contain caffeine. 




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