Feeling Overwhelmed Among People? How to Deal With Social Anxiety

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Alice is a 19 year-old college student. She has been skipping classes, and her grade is dropping. She is afraid she may end up dropping out of the school. She is able to attend the big lecture classes, but can’t attend the small group discussions. The few times she went to the small group discussion, she hid at the back of the classroom and didn't speak. She doesn’t interact with her peers for fear of being laughed at. She remembers the pain and humiliation she felt in high school. People think she is shy and sensitive. Her situation is getting worse. Alice suffers in silence and she doesn’t know what to do. Talking to a stranger has never been easy for Alice. She is in constant fear of offending somebody she doesn’t know. 

Alice may appear to be merely shy, but actually she is suffering from social anxiety disorder. Social anxiety disorder (also known as social phobia) involves intense fear or anxiety of being judged and evaluated negatively by others in social situations. Social anxiety disorder is very common among children, adolescents and young adults. In the United States, about 7% people suffer from social anxiety. 

What are the signs & symptoms of social anxiety disorder?

People with social anxiety disorder have difficulties in following social situations:

  • Having conversations with someone
  • Meeting strangers or unfamiliar people
  • Eating or drinking in public
  • Performing in front of others
  • Being the center of attention
  • Having to say something in a circle
  • Going to a party or meeting
  • Entering a room
  • Dating
  • Making friends


When we are suffering from social anxiety disorder, we tend to think others judge us in a very negative way.

We often believe some of the following ideas:

  • I’m going to say something stupid and I will offend this person.
  • I’m so disgusting, and this person is going to reject me.
  • I’ll be bullied or tormented by others.
  • I’m stupid and boring, and nobody likes me.
  • I’m nervous and my hands are trembling, and other people are going to laugh at me.
  • I walk funny and everybody in the classroom will see it.


We are afraid that others will judge us as anxious, weak, crazy, stupid, boring, intimidated, dirty or unlikable.


Physically we may have some of the following symptoms: 

  • Rapid heartbeat
  • Muscle tension (trembling or shaking)
  • Dizziness and light-headedness
  • Stomach trouble and diarrhea
  • Inability to catch breath
  • Sweating
  • “Out-of-body” sensation

We may start having symptoms and getting anxious immediately before an event, or might spend weeks worrying about it (such as, worrying every day for weeks before attending a social event, or repeating a speech for a work assignment every day for days in advance). Afterwards, we could spend a lot of time and mental energy worrying about how we acted.

Things that other people consider “normal” -- like making small talk and eye contact -- make us so uncomfortable. These social situations are so stressful for us to handle, we may try to avoid all social contact. All aspects of our life, not just the social, could start to fall apart. 

What are the causes & risk factors of social anxiety disorder? 

There are no clear-cut answers as to why some people develop social anxiety disorder. Like most mental health problems, social anxiety disorder appears to be caused by a combination of biological and psychological factors and challenging life experiences. Genetics likely has something to do with it. If you have a family member with social phobia, you’re more at risk of having it, too. It could also be linked to having an overactive amygdala -- the part of the brain that controls your fear response.

Social anxiety disorder usually comes on at around 13 years of age. It can be linked to a history of abuse, bullying, or teasing. Shy kids are also more likely to become socially anxious adults, as are children with overbearing or controlling parents. If you develop a health condition that draws attention to your appearance or voice, that could trigger social anxiety, too. 

How does it affect your life?

Social anxiety disorder prevents you from living your life. You’ll avoid situations that most people consider “normal.” You might even have a hard time understanding how others can handle them so easily. 

You may end up dropping out of school, having trouble to maintain employment, being single (unmarried or divorced), not having enough money to live a better life. 

When you avoid all or most social situations, it affects your personal relationships. It can also lead to:

  • Low self-esteem
  • Depression
  • Sensitivity to criticism
  • Poor social skills that don’t improve

 

Treatment for social anxiety disorder

Psychological treatments, such as relaxation training, meditation, biofeedback and stress management, can help with social anxiety disorder. Many people with social anxiety disorder also benefit from supportive counselling or couples or family therapy. Some experts agree that the most effective form of treatment for social anxiety disorder is cognitive-behavioural therapy (CBT). 

Medications have also been proven effective, and many people receive CBT and medication in combination. However, it is the combination of cognitive and behavioral therapy that changes the brain and allows you to overcome social anxiety. Medications can only temporarily change brain chemistry and can be useful in some cases. You must consult with your psychiatrist when it comes to medications.  

Social anxiety, as well as the other anxiety disorders, can be successfully treated today. Studies repeatedly indicate that treatment compatibility is the key element in success. Repetition and reinforcement of rational concepts, strategies, and methods (and their implementation) is the key to alleviating social anxiety disorder on a long-term basis.