Do you often feel embarrassed or even humiliated in social situations?
Do you hate small talk and giving presentations?
Are you afraid of meeting strangers? Do you avoid unfamiliar situations and do you often feel judged by others? Do you feel anxious when you need to speak in public, do you spend a lot of time analyzing your “performance” after interacting with others, do you blush, sweat, or tremble when you feel overwhelmed in unstructured social environments like large parties or public gatherings? Are you afraid to make new friends, ask someone out on a date, or even approach a stranger for information?
If you have experienced several of these symptoms, you may suffer from Social Anxiety Disorder, one of the most common current mental health issues, affecting an estimated 7% of the US population at any given time.
Social Anxiety Disorder and Shyness
Social Anxiety Disorder is not the same as being shy. Shyness, and also being an introvert, is a personality trait that can be experienced in a positive way. Social Anxiety Disorder has quite severe symptoms that interfere with social and professional functioning. It is not a personal choice, and it is not possible to “just get over it” or outgrow it. Unfortunately, because Social Anxiety Disorder is poorly understood in the general population and was under-diagnosed until recently, those who suffer from it often have to deal with a lot of unhelpful and condescending advice. Which, in turn, contributes to their anxiety.
Symptoms
In addition to the symptoms above, you may also experience nausea, diarrhea, palpitations, dizziness, and hot flashes. Every uncontrollable social situation will cause you severe anxiety and may lead to avoidance of the social interactions that cause these symptoms, such as voicing your opinions, dating, joining clubs, trying out new hobbies and traveling.
Diagnosis
As a serious mental health disorder, Social Anxiety Disorder needs to be diagnosed by a licensed mental health professional according to nationwide diagnostic criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Causes
Many factors can contribute to developing Social Anxiety Disorder.
There may be a genetic component (the disorder seems to run in families). SAD is probably related to childhood trauma that undermines your sense of self-worth and confidence, and that also can affect your stress response. As a result, the part of the brain called the amygdala may become chronically overactive, causing a heightened fear response.
Another cause can be maladaptive learning. For example: when children or adolescents are bullied or if they have role models who themselves suffer from social anxiety.
Treatments
Social Anxiety Disorders can be treated both with medication and with psychotherapy. Group therapy has also been proven to be very effective.
Drugs include anti-depressants, anti-anxiety medication, and beta-blockers.
Psychotherapy approaches include Cognitive Behavioral Therapy that teaches you new coping strategies, and psychodynamic therapy that investigates and heals the toxic childhood patterns that generated the disorder. Role play and drama therapy are also very helpful in re-training your social interaction skills.
In addition, organizations like the Social Anxiety Institute provide both psycho-education for patients and their families and peer led connections, forums, and groups.
Many people with Social Anxiety Disorder try to self-medicate with alcohol or illegal drugs in an attempt to lower their inhibitions and “take the pressure off.” Unfortunately, this often leads to more embarrassment and negative exposure, which in turn leads to worsened symptoms of the disorder.
Treatment may take some time to be effective, and learning new coping skills involves some effort, but it is very much worth it.
Prognosis
The outcome of treatment is often very positive, depending on the severity and the exact cause of the disorder.
Try to get treatment as early as you can, and see the process as a journey towards a more relaxed and enjoyable life.
