Social Anxiety disorder (SAD) is a new concept for most of us. Many of us take it lightly. But what it is and how can it impact our normal lives, this article explains this. So, continue reading to know more about it.
Obviously feeling nervous is normal in any kind of social situation, such as singing for the first time in front of an audience, giving a presentation or meeting someone for the first time, it is like the feeling of butterflies in the stomach.
But when being judged or scrutinized by others causes some significant fear, embarrassment, anxiety, or self-consciousness it may be alarming.
Social anxiety is a very common issue that appears during teenage and for many people it vanishes as they get matured. However, for some people it does create issues and need for treatment may arise.
Social Anxiety Disorder:
After Depression and Substance abuse, Social Phobia is the third common mental health disorder. Social Phobia is clinically termed as a social anxiety disorder; it is an enduring and immense fear of various kinds of social situations such as being judged, being rejected in performing or social situations, or negatively evaluated. Or you may say that social anxiety is an anxiety disorder that appears in the response to any public situations in the form of intense distress.
A person with social phobia becomes intensely anxious when the fear of being embarrassed in different kinds of social situations feels. If someone is suffering from a social anxiety disorder that person always remains worried that others will notice their anxiety because of shaking, blushing, and sweating.
Symptoms of Social Anxiety Disorder (SAD):
Everyone has his/her comfort level to react in social situations depending upon their nature, experiences of life and personality traits. Some people are mostly reserved but some are naturally out-spoken that is why every time a feeling of discomfort or shyness is not necessarily mentioned the social anxiety.
Symptoms of Social anxiety appear in generally three ways:
Behavioral Symptoms of Social Anxiety Disorder:
SAD symptoms are persistent. Variety of behavioral and emotional changes appears during social phobia such as:
- Exceptional fear of interacting with unfamiliar or strangers
- Always worried about humiliation or embarrassment
- Always avoid becoming the center of attention
- After every socialization, spending time to inspect personal performance and flaws in interaction
- Always expecting the worst possible consequences after a negative encounter with social situations
Physical Symptoms of Social Anxiety Disorder:
In the case of severe social phobia physical symptoms or signs also may appear:
- Maximum pulse rate
- Twitching or trembling
- Muscles Strain
- Feeling like mind gone black/in dark
- Nausea or upset stomach
- Light headedness
Resistance towards Social Situations
SAD makes it endure to experience common everyday social interactions:
- Going to the job or school
- Attending any sort of social gatherings like parties, wedding events, picnic, etc.
- Starting or joining a conversation
- Meeting with strangers
- Using a public washroom or restroom
- Even eating in front of people
- Using the telephone
- Expressing personal opinion
Symptoms of social phobia may flare up in demanding and stressing situations. That is why the symptoms of social anxiety disorder change according to the situations. The person suffering from social phobia feels better in the condition of avoiding social interactions but for a short period and getting treatment is the right solution.
What causes social anxiety disorder?
SAD is similar to the other mental health conditions that develop from complicated reciprocity of biological factors and environmental happenings. Collectively there are 3 possible factors of social anxiety:
- BRAIN ANATOMY:
Amygdala is a structure in the brain that plays an important role in controlling the conditions of fear and in generating the fear response. Hyperactivity of the amygdala can be the reason for social phobia.
- INHERITED ATTRIBUTES:
Although there is no clarification of inheriting social anxiety disorder but social phobia runs in families. It might be due to genetics and may be due to the learning behavior,
Social phobia can be a learned behavior also. After facing embarrassing, unpleasant, or painful social experiences, people may go through social anxiety.
Factors enhancing the risk of social anxiety disorder:
There is not a single risk factor that can increase the risk of causing a social phobia. Several factors are involved in developing the possibility of social anxiety disorder such as:
If anyone has a family history of social phobia, he/she is more at risk of experiencing this disorder. Medically it can also be linked with an overactive part of the human brain that regulates every kind of fear response.
People can indeed spend a lifetime trying to forget the bad experiences of their childhood. Bullying, teasing, humiliation, or rejection may be susceptible to social phobia. In addition to these, some bitter experiences in life like trauma, abuses or family conflicts can also become the reasons for social anxiety disorder.
PHYSICAL DEFICIENCIES THAT CAN DRAW ATTENTION:
Trembling due to Parkinson’s disease, stuttering, any physical disability, or facial disfigurement generally creates a feeling of self-consciousness and sometimes it may lead to social anxiety disorder.
PECULIARITY OR TEMPERAMENT:
People who were timed, shy, or reserved in their childhood are at the risk of being prone to social phobia when they meet unfamiliar people or experience new situations.
Sometimes to meet the social or work needs it is essential to meet new people, visit new places or deliver a speech/presentation or conduct a workshop. All these situations and conditions may trigger a social anxiety disorder in a person.
In some cases, kids with overprotecting or controlling parents and with overbearing of some situations and conditions also face the trouble of having social phobia. Sometimes a person with a social anxiety disorder may also have other mental health issues such as body dysmorphic disorder, depression or generalized anxiety disorder (GAD).
COMPLICATIONS WITH UNTREATED SOCIAL ANXIETY:
Social phobia is not a condition to be neglected because left untreated social anxiety can simply ruin anyone’s life. It can affect or interfere with your relationships, career, or precious moments of your life. Social phobia can cause:
- LOW-SELF ASSURANCE
- SUBSTANDARD SOCIAL SKILLS
- NEGATIVE SELF-TALK
- IGNORANCE FOR ASSERTIVENESS
- JUMPING TO THE WORSE CONCLUSIONS
- SUICIDE TENDENCIES
- ABUSE OF SUBSTANCES LIKE ALCOHOL & SMOKING
- DIFFICULT SOCIAL RELATIONSHIP
- SENSITIZED TO CRITICISM
WHEN IS THE TIME TO GET HELP FOR SOCIAL ANXIETY DISORDER?
If a person experiences some of the above mention conditions or symptoms he/ she should contact a general practitioner (GP). A general practitioner diagnoses a person facing SAD based on the following points.
- By discussing the symptoms, how often the symptoms appear and in what situations these symptoms occur.
- By analyzing the conditions of the person by a list of situations to observe anxiously.
- By providing a self-report questionnaire.
To help in assessing whether any kind of medication, physical appearance or medical condition may trigger social phobia GP can also conduct a physical examination.
TIPS TO AVOID SOCIAL ANXIETY:
Make it clear that probably no one can cure SAD by self-help but it may reduce or can consider as a first step towards the proper social phobia treatment.
- UNDERSTANDING TO SELF ANXIETY:
It is very important to understand that social phobia is a mental disorder. Neglecting personal conditions and avoiding social interactions is not the solution but it may increase the issue. Think about your behavior and thoughts in various social situations and try to find the root cause of anxiety.
- THINK POSITIVE:
Always try to see the positive aspects, even in the worse situations also. If the social situations turn worse don’t get depressed and never take it as the beginning of a mishap.
- BELIEVE IN YOURSELF:
Always be on your side never getting too much worried about people because people will judge you no matter what. Believing in you raises self-confidence and discourages depression and anxiety.
- FACE THE FEARS:
It could be the toughest step but facing your fears can automatically resolve the social phobia issue. Start from achieving the small targets and move towards the bigger ones.
- EXERCISE FOR COPING SAD:
When a person goes through social anxiety, the heart rate automatically started to increase as a part of the fight or flight response. By practicing “How to slow down the breathing rate” during anxious conditions can settle other anxious sensations and helps your mind to get focused and relaxed.
PROPER TREATMENTS FOR SOCIAL ANXIETY DISORDER:
There are three major treatments available for social anxiety:
GUIDED SELF HELP:
This treatment is recommended for Social anxiety, panic disorder, and depression. Guided self-help aims to equip you with techniques and various tools to overcome your social fears and anxiety during and after the treatment. A therapist helps you to understand your problems and motivates you to make confident decisions and positive changes in life.
Guided self-help includes more therapies such as:
- BEHAVIORAL ACTIVATION
- INTERPERSONAL THERAPY
- EYE MOVEMENT DESENSITIZATION & REPROCESSING
COGNITIVE BEHAVIORAL THERAPY:
A talking therapy that helps people to change their thinking and behaving approach to manage the problems related to anxiety, depression and social phobia. CBT is the most effective treatment of choice for social anxiety disorders. A course of CBT includes:
- CONTINUOUS ASSESSMENT: these are ongoing face to face or through internet assessments to identify the level of anxiety and social phobia in a person.
- ANXIETY AWARENESS: educate individuals about anxiety according to their conditions, fears, and symptoms.
- STRATEGICAL TRAINING: motivating the person to control the social anxiety issues step by step by making proper strategy in light of provided guidelines.
- BEHAVIORAL INTERVENTIONS: it is simply the classified revelation to the particular feared/anxious conditions. For instance, if a person is fearful of dealing with people in the crowd and would like to be able to make a friend at a party. The lower mentioned hierarchy could be adapted in response to how easy or difficult that person finds each step.
- Just say hello to a person before the party starts when there are not many people around.
- Comment on the party decorations to the host.
- Just stay in the party till the end even if a person does not make any other attempt to interact with people.
- EXPOSURE TO WEIRD SITUATIONS: CBT exposes a person to “social mishap” conditions or weird situations where he embarrasses himself in public. This is a kind of general practice to make a person use to with the situations they normally go through in their daily life and minimize the risk of a social anxiety attack.
- COGNITIVE INTERVENTIONS: CBT trains a person to identify, challenge and overcome their fears.
- ATTENTION DIVERSION: when a person gets familiar with their no adaptive thoughts, that person should be motivated to target the existing situations and to be realistic about the entire scenario and stop thinking about feared future conditions.
SAD may need specific medication also with therapies and counseling sessions. Mostly the doctors suggest antidepressants to treat social anxiety. Doctors prescribe two kinds of drugs:
SSRIs (Selective Serotonin Reuptake Inhibitor) drugs and SNRIs (Selective Serotonin and Norepinephrine Reuptake Inhibitors)
SNRI drugs include:
- SERTRALINE (Zoloft)
- FLUOXETINE (Prozac)
- PAROXETINE (Paxil)
And SSRI drugs include:
- DULOXETINE (Cymbalta)
- VENLAFAXINE (Effexor)
Medication cannot quickly fix the social phobia but it needs a time of 2 to 6 weeks to deliver the required results. Doctors start with a low dose of medication and then gradually increase according to the conditions and effectiveness of the medication.
After observing the symptoms of SAD doctors may also prescribe some other medicines like:
- ANTI-ANXIETY MEDICATION:
In the case of severe anxiety conditions, doctors prescribe BENZODIAZEPINES, that reduces anxiety level quickly but it can be sedating or addicting. That is why this medication is typically used for a very short time.
Sometimes doctors try different antidepressant drugs rather than SSRIs & SNRIs to find the most effective antidepressant with minimum side effects.
- BETA- BLOCKER MEDICATION:
This is a special kind of medication that blocks the stimulating effect of adrenaline (EPINEPHRINE). This medication is not part of general anxiety treatments but it instantly controls the anxiety symptoms during particular conditions such as just before a presentation.
Beta-blockers reduce blood pressure, heart-pounding, heartbeat, shaking and trembling of voice and limbs.
There is another concept prevailing in people about the herbal medication of social anxiety disorder but there is no such proof of its effectiveness.
People use valerian or kava as an herbal supplement for the treatment of anxiety but it seriously damages the liver. Theanine or passionflower may provide a calming effect but still, the potency is unknown. It is better to stick only with the recommendations and prescriptions of your doctor and avoid any other kind of treatment or home remedies to treat the problem.
Support/interactional groups also may be helpful for people with social anxiety. A group with people who all have the same issue, the social phobic person receives honest and impartial feedback about how other people find you. By knowing how others with social phobia overcome their fears a person can get motivation, inspiration, and courage to deal with their anxiety disorder.
SOCIAL ANXIETY DISORDER IN CHILDREN:
Signs of social anxiety may also appear in children. Children with social anxiety disorder experience acute feelings of anxiety about various triggers including fear of awkwardness, fear of being evaluated, fear of offending others, speaking in front of others, and reading out loud.
Social anxiety in children harms self-confidence, academic achievements, social relations and other fields of functioning. Children with social anxiety cannot face confidentially various social situations (enhancement classes play teams, school events, family gatherings, and playdates) that provide a strong base to a successful and confident adult.
The signs to identify social anxiety in children include:
- Unusual crying
- Recurrent tantrums
- Fear of going to school, bad school performance, shy in classroom activities, and no participation in classroom and social events
- Never ask any question in class or not asking for any help in school
- Being susceptible to parents or carer.
HOW TO DEAL SOCIAL ANXIETY IN CHILDREN?
Treatments for SAD in kids are almost the same as for teenagers and adults but medicines are normally avoided. The therapies are designed according to the age of the child which also involves participation from the parental side.
It is really important to understand that almost every psychological experience survives on a continuum. The factor that distinguishes healthy people with a person with SAD is not the existence of extreme social anxiety but it is the disinclination to face anxious thoughts, sensations, and notions. Excessive SAD provokes other problems also including depreciates positive experiences, tendency to view affectionate and even casual social situations as threatening.
When social phobia becomes enormous, it is essential to get proper professional treatments that can easily improve one’s quality of life.