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Last Updated on October 12, 2018

How to Tell Symptoms of Social Anxiety And What to Do About It

How to Tell Symptoms of Social Anxiety And What to Do About It

Social Anxiety Disorder (formerly known as Social Phobia) can be a significant hurdle to your happiness, health, and ability to achieve your potential in relationships and at work

Here’s a common scenario:

You’re the kind of person that likes others. You want friends, you want to hang out with your co-workers for hors d’oeuvres after work, and you definitely don’t want someone to hang out with on Friday nights. You just can’t make your reality fit with your wishes.

Here’s one scenario that often happens: after wish you could be bold at work, make friends, and ask for that raise, the minute you’re invited to golf with your boss, do a presentation for the team, or come to a friend’s anniversary party…you bail out. You don’t feel smart enough, worthy enough, prepared enough…it is never enough…so you say “no’ to the very thing you wish you could do.

So, on one hand, you’re happy because you got to avoid the anxiety-provoking personal encounter, but you’re simultaneously miserable because – yet one more time – you didn’t go after what you want most. This can hurt your self-esteem even further, which only makes you less apt to try again the next time.

The vicious cycle can go on for years on end. Clearly, this disorder has the potential to rob you of your health or prevent you from meeting your goals at work and having positive, healthy relationships.

But here’s the good news about Social Anxiety Disorder – you don’t have to let it rob your future!

Is It Social Anxiety Disorder?

First, let’s figure out what we’re dealing with.

The Fancy Definition 

According to the National Institute of Mental Health, Social Anxiety Disorder (formerly known as Social Phobia) is an “intense, persistent fear of being noticed and judged by others” to the degree that it can prevent you from reaching your potential at work and other areas of your life.  

It’s not “just” being shy. The anxiety must last over six months and cause “considerable impairment” in your life, according to the Diagnostic and Statistical Manual (5th ed.).[1] In addition, the anxiety must be constant, intense, and disabling to qualify. 

You’re not the only one!

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According to Social Phobia org, social anxiety is the third- largest mental health issue in the world, and affects 7% of US citizens.[2] It often (not always) begins around middle school which is inherently a period of intense self-consciousness. 

The Theories

Research is still divided on the cause of Social Anxiety Disorder, but some theories indicate there is a genetic/inheritable component while others argue that it can be a learned behavior.

Others believe the problem is multi-determined and can be a combination of genetics, social learning, and other factors combined. 

10 Scenarios That are Potential Triggers 

The Social Anxiety Association lists several scenarios that can be triggers for your anxiety including these common ones:[3]

  • Being teased or criticized
  • Being the center of attention
  • Being watched or observed
  • Having to say something in a formal, public situation
  • Meeting people in authority (“important people/authority figures”)
  • Feeling insecure and out of place in social situations (“I don’t know what to say.”)
  • Feeling embarrassed (e.g., blushing, shaking)
  • Meeting other peoples’ eyes
  • Swallowing, writing, talking, making phone calls if in public
  • Being introduced to other people

3 Major Symptom Categories

When we encounter our triggers, sufferers tend to become symptomatic. According to Psycom, there are 3 main categories of symptoms for this disorder:

  1. Physical symptoms: racing heart, dizziness, stomach trouble, blushing, sweating, trembling, and dry mouth
  2. Emotional Symptoms: panic attacks, poor body image, nervousness, high levels of anxiety and fears.
  3. Behavioral Symptoms: Avoiding places/situations where you think you will be the center of attention; not pursuing activities for fear of embarrassment; becoming isolated, quitting school or a job, substance abuse.

NIMH adds that poor eye contact, mind going blank, speaking softly, self-consciousness, and feeling awkward are also commonplace. Remember: these symptoms can be “normal” – we are looking only for a situation where it is prolonged and a true hinderance to functioning!

What To Do About It

The important factor is to do something about your Social Phobia as it can become more self-perpetuating over time. Here’s are a few ideas of how to get started.

1. Ask a Doctor

Don’t self diagnose, ask a doctor. Reach out!

If you are concerned that social anxiety is preventing you from reaching your full potential, then seek consultation from a mental health professional or medical provider. Don’t suffer in silence!

Fewer than 5% of people with social anxiety seek treatment after their symptoms begin and, in fact, 1/3 of sufferers report having symptoms for ten years or more before reaching out for help. 

This is a needless impediment to your wellbeing, because studies indicate that this condition is highly treatable. In fact, one study claims an 85% improvement and sometimes full recovery after treatment! [4]

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A family doctor, internal medicine physician, psychologist, or psychiatrist are among the types of providers experienced in diagnosing and treating Social Anxiety Disorder. Be sure to check reviews and recommendations in your community.

Insider Tip!

Experienced mental health providers always ensure that other factors aren’t the cause of your problem before assigning a psychiatric diagnosis. Many medical issues, medications, and even substance abuse can mimic psychiatric issues so it is essential to rule these out first. 

Special note: Make sure your provider considers all angles without making any assumptions because some people truly do have both genuine psychiatric symptoms and a coincidental medical problems which can mimic it. 

Diagnostics can get complex, so this is why only a credentialed provider should diagnose your concerns! 

What Should You Expect?

Most providers will conduct an intake evaluation where they will take a thorough history, check your symptoms against the DSM-5 criteria, provide you with an anxiety checklist or other type of self-report test instrument, and review your medical records to name a few possibilities.

Be prepared to speak honestly about your history as the more data, the more accurate your diagnosis and recommendations will be. There are also resources, by Mayo Clinic and others, which provide some of the questions you might be asked. Preparation can certainly help with your anxiety about the interview. [5] 

2. Treatment Options

Here are some ways to try to regain your health!

Psychiatric Treatments

The most common types of treatment for social anxiety are psychotherapy, medication, or some combination thereof. 

If you elect to take medication, your doctor can help you decide which one is right for you. Be sure to ask about how long it will take to notice improvement, any potential side effects, and how to weigh the risks versus benefits of the medication.

As for psychotherapy, Cognitive Behavioral Therapy is a common option and NIMH found particularly good outcomes using cognitive therapy combined with a behavioral therapy group.[6]

While the prospect of a group treatment might seem terrifying, it is deemed important so you can work on your symptoms in real-life scenarios with other group members.

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What is the goal of psychiatric treatment? 

A good goal to aspire to in the treatment of Social Anxiety Disorder is to decrease symptoms, learn to reframe negative thoughts about yourself, developing confidence in social situations, which in the end should help you develop the type of friendships, relationships, jobs, and other opportunities that you previously could not negotiate on your own.

Alternatives

Some organizations are proponents of alternative medicine as an adjunctive treatment. Treatments such as massage, meditation, mindfulness, hypnotherapy, and acupuncture are common place. 

NAMI also suggests various self-management strategies (identifying one specific time to worry during the day, becoming an expert on your triggers, etc.); stress and relaxation techniques (e.g., breathing exercising, focused attention), and yoga (physical postures, breathing, and meditation). Exercise, like in many other areas, is also recommended but check with your doctor before starting an exercise plan.[7]

3. Community Support

Many churches, clubs, and local organizations provide support and healing opportunities for Social Anxiety Disorder. 

The National Alliance of Mental Health provides educational and support resources to those with mental illness including social anxiety at 1-800-950-NAMI or [email protected]

4. Help Yourself!

NAMI and other organizations provide many ideas for self-help as a first step or as an adjunct to formal treatment. Here are some  ideas for being proactive in your care:

  1. Become educated about medication and treatment options. 
  2. Know your personal triggers and stressors and plan ahead. 
  3. Actively participate in your treatment. 
  4. Don’t QUIT if it isn’t helping. Keep at it until something does.
  5. Live a healthy lifestyle – engage in exercise and de-stressors and watch your diet.
  6. Avoid drugs and alcohol as they affect emotional balance, sleep, and can interactive with medication. *This includes too much caffeine!
  7. Join online discussion groups.

Practice Makes Improvement (If Not Perfect)

Mayo recommends that sufferers participate in social situations by being with those you feel comfortable around.  Then, slowly increase the “risk” by branching out a bit more. Rather than throw yourself into a wild frat party, you might first want to take a small interesting class where the teacher does most of the talking.

You might find that these are “safe” settings to meet people since it is highly structured and there is inherently a reason to speak with your peers. It also levels the playing ground as all of you are “new” in this social setting. [8]

Mayo further suggests that you actually practice socializing, just as you might practice piano. Here are some examples they suggested:

  • Eat with a close relative, friend or acquaintance in a public setting.
  • Purposefully make eye contact and return greetings from others, or be the first to say “hello”.
  • Give someone a compliment.
  • Ask a retail clerk to help you find an item.
  • Get directions from a stranger.
  • Show an interest in others — ask about their homes, children, grandchildren, hobbies or travels, for instance.
  • Call a friend to make plans.

While these might seem like basic tasks to our more extroverted friends, this can be seemingly unsurmountable to our friends with Social Anxiety Disorder!

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Be Kind (To Yourself)

Learning these new social skills is taxing. Remember to be kind to yourself along the way. Mayo suggests that you spend some time with people you already know and feel comfortable with such as long-term friends and family. 

Another idea is to engage in pleasurable activities and hobbies when you’re anxious. 

Remind yourself that anxiety doesn’t last forever and that you have survived it before and will survive it again. 

Never, Ever Give Up

As you begin your treatment strategies, don’t give up. Don’t ever, ever give up. 

Social Anxiety Disorder, as we stated earlier, is a treatable disorder, so every single small step gets you further to your end goal.

Remember: As you practice, you will invariably fail and have set-backs. It is normal so just expect it! Progress isn’t linear– it occurs with step-by-step small gains over time. 

The Future You

Remember that the best time to start is now. Be a strong, stubborn, tenacious self-advocate. Get help if needed to take the step toward wholeness and healing now!

No matter whether your goal is having close friends, being more effective at work, or even finding a new relationship partner, being able to successfully connect with others can indeed transform a lonely, frustrating life into a more fulfilling one.

Take the step.

Featured photo credit: Eric Ward via unsplash.com

Reference

More by this author

Jodie C.

An experienced psychologist who has worked with people of all ages and socioeconomic backgrounds.

How to Tell Symptoms of Social Anxiety And What to Do About It

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Last Updated on February 18, 2019

13 Tips to Face Your Fears, Grow with It and Enjoy the Ride

13 Tips to Face Your Fears, Grow with It and Enjoy the Ride

Fear. I spend my life talking about fear — fighting fears, fixing fears and understanding fears. And yet I doubt I get 10 calls a year from people saying “Mandie can you help me fix my fear?”

Why is this so critically important to you?

The realization for me is that fear is not the fundamental driving force in your life it’s what regardless of whether I’m talking to a doctor, a teacher, a CEO’s, a senior citizens or teenager – every single one of those conversations has a direct correlation with your world.

Fear can range from the overwhelming desire to look away or stop in your tracks to literally fleeing your country and the life you knew. In this article, I will share you with 13 tips to face your fears and enjoy the ride.

1. Know That Fear Is Real, but Can Be Overcome

Right now around the world people are facing fear — real fear. Fear that I pray my children and I will never experience. Does that lessen my fears or your fears in your relativity safe 21st century life?

When I look at the world we all live in, I find that fear like so many other emotions can mean so many different things to so many different people:

  • The child who has to be physically dragged to their first day of school.
  • The man facing the judge.
  • The woman with her hand poised over the buttons over her phone because she has to walk down a dark corridor late at night alone.
  • The man as the surgeon says “count backwards from 10 Mr Smith.”
  • The woman that’s told “We are sorry, we can’t help you.”
  • The man that faces the empty circle of a gun and prays for his very existence.

These and a million more (Portrayed in every kind of movie, book or song you could imagine) are what make us human. We face fear and somehow move forward or are stopped in our tracks.

Like the rabbit in the headlights of the car that veers off through the field away from the tyres of the car or stays still praying for salvation. Like someone will save them. Sound familiar?

Fear is huge. Fear is everywhere and yet fear can be overcome, controlled and can even be a power for good.

2. Accept Your Fear

Firstly if you aren’t facing the barrel of the gun, atrocities that make the news or impeding death, that’s a good start. However it doesn’t mean your fear is any less real.

We are quick to say “I can’t moan, my life is not as bad as X.” While in theory, that’s honorable your appreciation of Mr. or Mrs. X’s horrific life won’t change anything directly. So accept your fear is relative to you.

And here’s what can be done.

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3. Get Some Perspective

I found myself asking anyone that would answer “what is your worst fear”. The answer that intrigued me the most came from my daughter (15 years old and she usually has a copy of Fight the Fear – my book – in her school bag so she can help someone else be as positive and confident as her. No matter what life throws up.)

And her fear, surprised me — heights. I pointed out that we live in a sprawling bungalow (one storey) and the highest she goes is two storeys’ at school! She laughed but added, fear isn’t like that Mum. I know it’s not a real fear, but it’s like when you stand on a chair and feel unsafe.

That girl will go far. Because she truly gets fear.

We know something is scary and yet we still do it. Why? Because we have a perspective to the fear. When you lose perspective, it can feel too big, and too scary.

So look around you to get some perspective on your fear:

  • Are you really at risk?
  • Will this kill you?
  • Which leads us on to..
  • If the worse was to happen what would it be?

4. Hold a Hand

As a coach, it is my job to holds someone’s metaphorical hand and help them face a fear.

Like the child petrified of the thunder storm or the teen that can’t get back in a car again after failing their test, your job as a parent is to reassure, encourage, enable and motivate someone to face something that ideally they never would choose to again.

We know many of our fears aren’t real. However, it is only when someone guides us with love, respect, lack of judgement and safety are we able to get through fear. And trust me, you can get through your fears. I’ve seen it so many times.

Ask yourself:

  • If the worse were to happen, what would that be?
  • Could that really happen?
  • If the worse did happen, how would you recover?
  • If the worse were to happen, what would you need to do next?

By seeing fear as not the end destination but part of being human, you can see through it’s wily evil ways and move forward.

5. Know Whose Hand You Hold Either Physically or Emotionally

This helps with fears for the rest of your life.

Think of someone you can always rely on (and ideally you won’t just answer yourself because that adds a lot of pressure to your existence!) And you will find that you’ve already found a way to get through fear.

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The beauty of this is that it means that fear becomes part of life not something to be feared and shied away from.

It means you know you can turn to your friend, partner, colleague, parent, sibling and say “Right I need to deal with this, and I’m going to need you to help me.”

For one moment, think about it from the other person’s view point. When we get to help other people we feel valued, loved, respected and lots of other positive emotions and we get a good dose of positive chemicals setting off in our bodies too.

Your fear, and your determination to fight it, helped someone else too. Now that’s cool right?

6. Understand That There Are Some Things Fear Will Never Touch

I like to find role models in life — people who have faced heroism, history changing moments, war, atrocities, miracles, life saving inventions.

Not everyone was looking for greatness, however they all found it. And one of my favourite books to date is written about Alistair Urquhart, the forgotten highlander. If this doesn’t get turned into a film in the future, then no man’s story is likely to.

Alistair went through the most horrific experiences in the 2nd world war. If you think of one of the awful things that happened back then in our world, Alistair went through at least 3 of them! Asked afterwards how did you cope? He talked about how whatever they did to his body, no matter how they starved, tortured, threatened or mocked him, they couldn’t have his mind. In his mind he was free.

Of all the people’s voices I’ve heard in my head over the years, this is one of those statements that reminds me anything is possible if you have faith and hope.

Look for the things in life that fear can’t touch. They will create confidence and faith for the future, whatever you face. And they will give you a sense of why being you is awesome.

Of all the billions of people on this planet, no one will have an answer identical to yours!

7. Process Your Fears to Carry on with Life

Being brave is not about sticking your chest out and smiling regardless of what hell you endure. It is about finding a way to emotionally process your fears to be able to keep going.

I have a tool kit of things I can rely on – tools, strategies, techniques. They include people to hug or talk to, music. hobbies, walks on the beach and even my favourite food. It sounds mad but at the times where I have questioned “how will I get through this?” I’ve found immense joy in doing the most unlikely of thing that makes me smile.

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It may be a short lived moment of happiness. However, it reminded that nothing stays the same and I can find away.

One client told me that it was crazy when it felt like their world was falling around their ears to run a bath to the brim (you don’t waste water) get the best bath oils, light too many candles, lock the door and drink a glass of bubbly (champagne is only for special occasions.)

Did that moment fix the disaster that my clients life felt? No, however it gave them a moment of calm and the brain is far quicker to find solutions, resolve and motivation to keep going when you do that.

It may feel like madness to do something you love, however it can be a powerful way to help you find solutions to the fears you face in life.

8. Assume the Worse

If you read the statement from the client above. Notice how they assumed it was wrong to fill the bath up to the top? How bubbly is only for special occasions?

Think how naughty they felt to be doing something that was not allowed?

  • Think about what age it may have made them feel?
  • Think about how they feel about champagne?
  • What special moments it’s been a part of in their lives?

And you can see how the assumptions they made about their “right” to have these things was not healthy.

When I drag the assumptions out of people’s words for them to see, they are often struck by how negative the words make them feel.

Don’t assume your words aren’t impacting on you. You can go through fear and actually enjoy the ride when you take the time to understand how you are letting words get to you.

9. Take a Fear That Feels Insurmountable Right Now.

If you were to repeat it to me out loud, what would you say?

Would you have blame on yourself in there? Would you assume others can do it and it’s just you? Would you feel small, unsuccessful, useless, unworthy?

Usually, when you do this exercise, you are able to spot the untruths that run wild in your head convincing you that you are doomed. And rarely when we are faced with our assumptions is there is a lot of evidence to them.

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10. You Are Not Defined by Your Fear

One fear does not define your life – be mindful of that. It is likely to lead you to thinking of all the times you’ve succeeded and bring a moment of calm, confidence and faith back to you.

11. Go with Fear

When you learn to go with fear, you could find yourself actually having fun, no seriously – having fun.

I have a few amazing clients I’m working with right now who would describe themselves as life long worriers, or pessimists. In the past that has served them well, enabling them to keep safe, steer clear of risks and even develop strategies in the event of disasters. However, now they find it’s becoming hard to break the cycle and they really want to because it’s holding them back.

Notice how they’ve found their hidden fears and want to face them?

One client said “I knew this was going to be tough, and I knew I couldn’t fight it alone and I knew you would be the one to help me.” Before I sat an incredibly successful, confident, capable business owner with a family and a social life to die for.

However, I’ve learned that the most successful looking lives can hide things that impact on life, success, love, happiness and business.

We didn’t start with the fear that they felt was holding them back, we broke the fear down, and found lots of little obstacles that had been deemed as “life” and “unchangeable” and “that’s just the way it is” by developing awareness to the little steps on the road to their obstacles to happiness and success they were able to tackle them in a different way.

12. Discover Great Skills in Your Scary Moments

And in that clients words “I came here to work with you to grow my company, and my own personal skills. I didn’t expect to get the children to be cleaning up after themselves and my partner being more attentive! It all feels a little magic.”

The moral is that out of the scariest of moments, we can find great skills we didn’t know we had. Find better, healthier, happier ways to live and find ways to enjoy life more. (And have a bit of magic!)

What a great place to be in ready for the next fear that thinks it’s going to get in the way of you, right?

13. Own Your Fear

Think back over these tips and come up with at least one example for each one. Write them down. Put them on your phone. Turn them into a piece of art. Turn them into a poem. Frame them. Go for a fast walk across the fields, beach, down town and repeat these things in your head to the sound of your feet on the ground.

We rarely take the time to appreciate how far we have come, how much we can achieve or what we are capable of – by really owning the tips in this article you will have given your brain a big fat dose of “Damn right I can do this!” and the motivation and accountability to say “Let’s find a way” through any fear.

You can’t help but feel good when you see that can you? And fear doesn’t stand a chance, does it?

More Resources About Fighting Fear

Featured photo credit: Ben White via unsplash.com

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