What is social anxiety?

It’s a feeling most are familiar with: that nervous, uneasy sensation of walking into a room and all eyes are on you. It’s that moment before you have to make a presentation at school or in the boardroom. It’s the nausea you might feel before a big first date, or having to introduce yourself to a room full of strange new faces.


Because that feeling is definitely something we can all describe as having been through before, most of us can also probably describe how we got through it. Some might say, “Once I got up on that stage, it wasn’t that hard,” while others might shrug off the fear, saying “I hate public speaking as much as the next guy, but what are you going to do? It’s part of my job.”


But it’s not that easy for everybody.


Those who’ve been diagnosed with social anxiety disorder can attest to that. The stress of public speaking, or meeting new people, or registering for a new class can be too much to handle for a person with social anxiety. That person may avoid social contact at all costs because it’s just too hard, and that might include merely making eye contact with a person, or having a short conversation with someone.


Social anxiety disorder, suffered by approximately 15 million Americans, is also referred to as social phobia. It’s a common mental disorder, one characterized by the inability or unwillingness to do the following:


  • Meeting or talking to new people
  • Speaking in public
  • Making eye contact
  • Walking into a room
  • Dating
  • Using public restrooms
  • Attending parties or other social functions
  • Eating in front of others
  • Attending classes
  • Going to work
  • Beginning or maintaining conversations


Not all people with social anxiety have difficulty with everything listed above. For example, one person with social anxiety may not have a hard time speaking on a panel in front of a few hundred people, but might resent or fear meeting new romantic prospects. Another may excel in intimate, one-on-one conversations, but may bristle at the idea of having to present something to a large crowd.


The different voices of social anxiety


Kade, 26


“My name is Kade, and I’m 26. I just started teaching at a community college. My class sizes aren’t very big – they’re not like the classes I was used to when I was in school, with hundreds of kids in every lecture. In a way having these smaller classes is actually more intimidating. My social anxiety isn’t claustrophobic… I don’t get freaked out by big crowds or anything like that, even though I’m sympathetic to people who are scared by things like that. For me, the fewer people there are, the more scared I get. It’s almost like I feel that the bigger the crowd, the less attention there is on me. The smaller the crowd, the fewer distractions for people. I’m not sure if that makes sense to anyone else, but that’s what scares me.


Gain control of your public speaking anxiety.


“I’ve worked pretty hard to keep it under control, so I don’t think my students have any indication that I work up a pretty good sweat before starting every class. I owe a lot of it to a great therapist who I see once a week, because she helped me figure out how central my social anxiety was to everything in my life. I figured out how to accept that I have social anxiety without letting it be a continual barrier in my life. I’m so thankful for that because I really do love teaching, as I think all educators do, but if I didn’t get control over my anxiety I wouldn’t be able to do what I love and contribute the way I do.”


David, 47


“I’m 47, but sometimes I feel like I’m going to be in high school the rest of my life! You know that feeling, when you’re a freshman and you’re the little fish and you walk in to this huge high school of thousands of kids and you don’t know where you’re going? That’s scary, right? That’s how I feel most of the time.


“I work at a job that’s pretty solitary, so I don’t have to deal with the general public and I really don’t have to have much interaction with a lot of people at the office either. I don’t know if that makes it better or worse. It’s better because I don’t really stress over going to work every day, but it’s probably worse because I don’t get to exercise getting out of my cave, which is what my brother calls my disorder.


“My symptoms are clammy hands. My knees shake when I talk to new people. I also feel the back of my head getting hot. I have this lump in the pit of my stomach like I’m getting ready to drop on a rollercoaster.


Anxiety at work or school -- what you can do about it.


“It’s gotten significantly better over the years, and I’m not scared of the name anymore. I’m actually eager to talk about it when I get comfortable with a person, because I feel like I’ve got kind of a life raft in that. When I say negative things out loud, I get to re-evaluate my beliefs – things sound different out loud than when you’re just saying them in your head. Even though I can’t say I’m free and clear of social anxiety – I’m definitely not – I’m in a place that I can recognize the feelings, accept them, but don’t have to be driven by them. That feels good.”


India, 30


“I was deeply, deeply depressed for a long time, and couldn’t really figure it out. I grew up in a nice house, with great parents, everything I ever wanted… it was really kind of idyllic. And yet I was in this persistent state of sadness, which everyone around me kind of like dismissed a lot, saying stuff like, ‘Oh, she’s just emo,’ or ‘Wow, she’s sensitive.’


“When I turned 18 or 19, my mom finally said, ‘Honey, you have got to get help.’ She took me to a therapist, this really warm and wonderful lady who, I feel like, took one look at me and breathed me in and just knew. She helped unearth some of my dark secrets, the biggest of which was the fact I had a lot of negative self-talk. In the privacy of my brain I called myself the worst names. I was a loser, I was ugly, I was stupid, no one liked me. It sounds poetic, but it was like I was looking at a funhouse mirror all my life and everything I saw in myself was distorted and just wrong.


“When I began to embrace who I was, all of me, the good and the bad, my social anxiety started to lift. I’ve come to realize that when your inner dialogue is nasty, you start to believe that everyone around you thinks those same things too. Whether it’s true or not isn’t the point. It’s about building up your own self-worth, validating yourself. I’m so relieved it’s not a life sentence.”


Symptoms of social anxiety


Just because you’re shy or uncomfortable in certain social situations, it doesn’t automatically mean you have social anxiety disorder. If, however, your fear and anxiety over social connections at work, school or elsewhere begin to disrupt your life, it’s a possibility.


Some of the symptoms of social anxiety disorder include:


  • Worrying about embarrassing yourself in front of others
  • Fear of interacting with new people you’ve never met
  • Concern that you’re being judged, physically or intellectually
  • You worry that people can tell you’re anxious because you’re sweating, blushing or shaking
  • You avoid doing things that might make you the center of attention
  • The closer the date of a big event, the more anxious you become
  • After participating in a social situation, you spend hours or days scrutinizing your performance and wondering what terrible things people were thinking or saying about you
  • You expect the worst possible outcome from a potential social interaction


In children, this kind of anxiety is revealed through temper tantrums, tears or a refusal to speak; in adults, it might manifest in sweaty palms, nausea, headaches and panic attacks.


Yes, there are physical symptoms too. They include:


  • Rapid heartbeat
  • Sweating
  • Shaking
  • Blushing
  • Upset stomach
  • Nausea
  • Dizziness
  • Muscle tension or pain
  • Breathlessness
  • Forgetfulness


Read more about the physical symptoms of anxiety.


Causes of social anxiety


Experts agree that not one single thing causes social anxiety. Social phobia likely stems from a number of factors, including biological and environmental.


For some, anxiety is inherited – perhaps you had a mother or grandfather who had an anxiety disorder as well. It could be genetic, or it could be learned, adopted behavior.


Studies have also shown that brain structure can be a contributor as well. According to The Mayo Clinic, the amygdala plays a role in controlling one’s response to fear, so if you have an overactive amygdala, you may be at risk for social phobia.


There are other risks too: it could be that you’ve had a history of bullying or abuse in your past, or you have a condition that brings attention to you, like stuttering or some other physical appearance that others might consider curious or strange. It could also be your temperament –if you’re just naturally shy or withdrawn, you may also be at greater risk for developing the disorder.


What can go wrong with social anxiety?


If you don’t recognize or acknowledge your social phobia, or find ways to treat it, it can disrupt your quality of life. You may have a hard time going to class, reporting in to work, or creating and maintaining long-lasting relationships, romantic or otherwise.


Your social anxiety may result in lower self-esteem. You may have challenges asserting yourself, or developing social skills that would permit you to grow your network or make new friends. You may find yourself isolated from the world, or even turn to substances like alcohol or other drugs to escape your discomfort. At its worst, social anxiety may contribute to thoughts of suicide.


How can social anxiety be prevented?


While there’s no way to predict, and therefore prevent, social anxiety or social phobia, if you’re already experiencing the symptoms, there are ways to minimize their negative impact. For one, you can seek the advice of a therapist, who will guide you through a personalized treatment program. You can also practice meditation and mindfulness, keep a journal, and exercise.


If you suffer from social anxiety and need guidance, visit us at www.hopetherapyandwellness.com.


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