Many of our minds gravitate toward shyness when we hear the term social anxiety. However, this mental health concern – known in professional circles as social phobia or a type of anxiety disorder – can be more serious than many people think.
Social anxiety is characterized by an intense, excessive, and irrational fear of social situations. This fear can surround common social situations, such as being judged or rejected.
More than 15 million American adults (totaling about 7% of the population) are living with social anxiety. As with many conditions, social anxiety can look different from person to person, as there is a spectrum of symptoms that people may or may not experience. Some people demonstrate more mild symptoms of social anxiety, while others experience what are called “panic attacks” in response to social situations.
People with social anxiety may demonstrate some of the following symptoms when they are in social situations:
- Stammering speech, or speaking in a very low voice
- Difficulty forming coherent sentences
- Rapid heart rate
- Muscle stiffness or rigid, inflexible posture
- Limited eye contact
- Difficulty breathing
- Fear of being judged, rejected, or ridiculed
- Avoiding contact with other people, especially those they do not know
Individuals who are living with social anxiety may naturally have a shy temperament, which started when they were a child and continued as they grew. Based on the severity of their condition, individuals with social anxiety may have extreme difficulty engaging in daily activities, such as grocery shopping, working, attending school, or spending time with friends and family. The absence of formative relationships and the inability to cope with feelings of anxiety can have a long-lasting impact on individuals who may never overcome their condition without appropriate treatment.
Some individuals have a more specific type of social anxiety that surrounds their ability to stand in front of a group of people. This may be referred to as performance anxiety and can severely impact a person’s ability to perform, present, speak, or do anything in front of large crowds whose attention is focused solely on them.
There are several types of evidence-based, scientific treatments that are recommended for the care of social anxiety (and other phobia disorders). Most treatments involve some sort of talk therapy, as this is a good way for individuals to discuss their feelings at the root of their anxiety.
One particularly helpful treatment is cognitive-behavioral therapy or CBT. CBT is a talk-based therapy that individuals use to help shift negative, limiting thought patterns to those that are more positive and enable participation. Individuals use sentences that express their current beliefs regarding social anxiety and social situations and then create new statements that reflect a more realistic and healthy perspective.
For example, individuals with social anxiety may express the belief that “Everyone thinks I look bad today.” Trained therapists and mental health professionals can guide individuals to explain how and why they came to that conclusion while helping them understand that there is little to no evidence that supports that statement. Therefore, individuals slowly work to add and change words in the statement that express a more realistic viewpoint.
Over the course of therapy, individuals use CBT to tackle all of the negative beliefs they hold that pertain to their social performance in an effort to improve their function and decrease anxiety surrounding their social life.
Another way to treat social anxiety is through medication. Psychiatrists or other prescribing mental health professionals can recommend anti-anxiety medication (also known as anti-anxiolytics) to lower an individual’s tendency to experience anxiety in response to triggers. Because of the powerful nature of anti-anxiety drugs, it is recommended that individuals typically take these for only a short period of time.
Doctors may also prescribe antidepressants, which may be taken long-term by individuals who exhibit certain other symptoms of social anxiety. Due to the nature of this medication, individuals will not see a difference in their anxiety right away since it takes several weeks for the medication to build up in the body.
Additionally, some doctors may recommend that individuals take beta-blockers to decrease the uncomfortable physical symptoms of anxiety, such as increased heart rate and sweating. By lowering the likelihood of these symptoms occurring, it keeps the body calm. If the body is calm during stressful social situations, individuals may also feel more emotionally calm and relaxed.
Individuals living with social anxiety may also find solace in support groups, which is when people with similar concerns meet in an informal setting and discuss their anxiety. Support groups are usually led by a peer, but in some instances, they are moderated by a mental health professional. This is not the same thing as group therapy, and the discussion is meant to be among peers who share advice to assist others with similar problems.
As with any mental health condition, individuals should seek assistance from a qualified mental health professional, such as a counselor, therapist, social worker, psychologist, or psychiatrist. Psychiatrists are the only ones of that cohort who can prescribe medications, but the others can offer both individual and group therapy. It is important to remember that there are a variety of treatment options for individuals with social anxiety. Seek assistance from your primary doctor to get referred to any of the above treatment professionals for the treatment of social anxiety and other anxiety disorders.