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Social Anxiety Disorder

Put simply, anxiety is the body’s hardwired response to danger or stress. Anxiety can be described as an emotion, but the medical journal Dialogues in Clinical Neuroscience considers it a “psychological, physiological, and behavioral state” that helps people cope with the unexpected.

An ever-growing share of young people is reporting anxiety issues. In 2007, about 36% of American college counseling center clients cited anxiety as their reason for seeking help. Six years later, in 2013, that share grew to 46%, according to the Association for University and College Counseling Center Directors.

Feeling self-conscious is normal. Being nervous before a big speech or job interview is also normal human behavior. However, if you regularly feel anxious around others or in unfamiliar situations, you might have social anxiety disorder. Also known as social phobia, this mental health disorder can make you rationalize things like skipping class, missing work, and avoiding social engagements with lifelong friends.

The basis of social anxiety disorder is formed by fearing embarrassment, judgment, or scrutiny around others. You might fear not stacking up to your peers or people looking down on you. Many people who suffer from this condition know their fears are irrational, yet they still feel anxious no matter what they tell themselves.

Fortunately, overcoming social phobia is possible.

 

What Causes Social Anxiety Disorder?

Before reading any further, know that you’re not alone in facing social anxiety disorder. According to the National Institute of Mental Health (NIMH), 7.1% of American adults and 9.1% of U.S. adolescents were diagnosed with social anxiety disorder in 2019. NIMH also estimates that more than 12% of U.S. adults face social anxiety disorder at some point in life.

The causes of social anxiety disorder differ on a case-by-case basis. Identifying these causes, also known as triggers, can be difficult for people overcoming the mental health disorder. Some people feel anxious in most or all social situations. This is normal.

Common triggers of social anxiety include:

  • Job interviews
  • Meeting strangers
  • Walking past people
  • Being introduced to authority figures
  • Talking to your boss
  • Public speaking
  • Speaking up in class
  • Entering a crowded classroom
  • Calling others over Zoom or on the phone
  • Taking tests
  • Thinking about mounting responsibilities
  • Knowing others are watching you
  • Going to social events
  • Being singled out in class or meetings
  • Financial stress

 

If your triggers aren’t on this list, that’s okay. People diagnosed with social anxiety disorder often fear one or more social scenarios that are unique to them.

 

Children Also Suffer From Social Anxiety Disorder

As mentioned above, social anxiety disorder is more prevalent among children than adults. Kids who face this mental health condition suffer substantial stress when talking to teachers and other adults, reading aloud in class, and playing with peers at recess. Children with social phobia sometimes go to great lengths to avoid school.

Keep in mind that it’s normal for children to be shy or ask to stay home from school once in a while.

 

Social Anxiety Disorder Signs and Symptoms

You may wonder whether you have social anxiety disorder or not. The overarching problem with social anxiety disorder is interference with your obligations, daily routine, or well-being. People can still suffer from this condition and function at a high level.

One example of “normal” nervousness is an increase in heart rate when called upon to give a presentation. Failing to sleep well the night before a make-or-break presentation is also standard. Someone with social phobia might stay home from work the day of a scheduled presentation, worry about giving the presentation weeks ahead of time, or feel lightheaded while presenting.

Physiological indications of social phobia:

  • Increased heartbeat
  • Lightheadedness or fainting
  • Uncontrollable nausea or bowel movements
  • Shortness of breath
  • Rosy cheeks
  • Stuttering or shaky voice

Psychological symptoms:

  • Unbearable self-consciousness in run-of-the-mill social scenarios
  • Fear of people knowing you’re anxious
  • Fear of being humiliated or embarrassing yourself
  • Extreme worry of others watching you
  • Unresolvable dread about social situations days or weeks in advance

Behavioral signs:

  • Consuming psychoactive drugs (including alcohol) to calm your mind
  • Actively hiding from focal points at parties or social gatherings
  • Constantly coming up with excuses to avoid social situations
  • Inability to feel comfortable while alone in public
  • Losing old friends from avoiding them over and over

 

Self-Help for Overcoming Social Anxiety Disorder

People who have social anxiety disorder should seek professional treatment. Recommended forms of treatment include counseling and medication. Harvard Medical School suggests a combination of medication and counseling to overcome social anxiety disorder.

Without denying the proven efficacy of mental health treatment, you should adopt healthy changes like the ones below to help reduce the severity of your symptoms and improve your quality of life.

 

Tip #1: Breathe

Until it comes to mind, breathing is an involuntary bodily function. Studies show that breathing exercises can actually help decrease anxiety, improve sleep, regulate negative emotions, boost your attention, and reduce stress.

A widely used breathing exercise is four-square breathing, also known as box breathing:

  • Breathe in for four counts.
  • Hold your breath for four counts.
  • Exhale across four counts.
  • Do nothing for four counts.

Make sure each count is at least one second long. Feel free to slow this exercise down even more. You’re safe as long as you don’t become lightheaded. Research from the world-renowned Mayo Clinic suggests basic breathing exercises like this can improve your body’s self-regulation of the autonomic nervous system (ANS). The ANS is one-half of the peripheral nervous system and controls bodily functions you have no control over like blood flow.

 

Tip #2: Fight Your Negative Thoughts

Suffering from a mental health condition like social anxiety disorder will likely cause you to experience significant self-doubt. While feeling self-doubt is normal from time to time, people with anxiety disorders often let their negative thoughts grow out of control.

Examples of negative self-talk include:

  • “I’m so dumb. Why did I do that?”
  • “I know I won’t sound confident during my presentation.”
  • “They aren’t interested in me. Why should I ask them out?”
  • “If I try this, I’ll end up embarrassing myself.”
  • “I hate myself.”

Whether you only think these things or say them out loud, they hurt your well-being.

To address your negative thoughts, follow these steps:

Step 1: Take note of all thoughts that involve socially related fears or worries. Are they negative? If so, write them down.

Example: Assume you’re worried about your next shift at work. In this situation, a negative thought could be “I can’t believe I got six orders wrong yesterday. Everyone must think I’m dumb. I shouldn’t show up to my next shift.”

Step 2: Question these negative thoughts.

Example: Immediately after the thought above comes to mind, ask yourself, “Have my co-workers messed up orders before?” or “Since everyone makes mistakes, does that really mean I’m stupid?” Be reasonable in answering these questions.

Step 3: Directly challenge the self-doubt with statements.

Example: Next, you might say, “My co-workers have messed up orders, too,” or “All humans make mistakes.”

You may not immediately feel better after recording, questioning, and challenging your negative thoughts. It’s also normal to feel scared when you go toe to toe with your self-doubt. You should still perform this exercise regularly. Be aware this self-help measure takes lots of practice before it becomes natural.

4 Major Types of Self-Challenging Questions:

  1. Seeking other explanations
  • “How can I reframe my thinking positively?”
  • “Are there other conclusions I could reach?”
  • “Can I look at this from others’ perspectives?”
  1. Basing yourself in reality
  • “Can these negative thoughts objectively be proven true?”
  • “What reasoning led me to this interpretation?”
  1. Valuing your goals
  • “Are these thought patterns getting me anywhere?”
  • “What might help me solve this problem instead of making it worse?”
  • “Can I at least learn something from this?”
  • “What thoughts might direct me to my goals?”
  1. Taking a step back
  • “Will this situation end in my death? How certain am I?”
  • “How will I feel about this next year?”
  • “What are the most likely outcomes?”
  • “Are there any positive outcomes of this scenario?”

 

Tip #3: Change Your Lifestyle

Diet and exercise can make or break your mental health. Even though someone who follows a perfect diet and exercises regularly may still suffer from social anxiety disorder, they’re less likely to have severe symptoms. On the other hand, someone with bad diet and exercise habits is more likely to experience sleep issues, high stress levels, and attention problems.

Lifestyle changes should not be substituted for professional help. To improve your social anxiety disorder symptoms, you should unarguably adopt healthy lifestyle choices such as the following:

  • Exercise regularly. The American Heart Association recommends that you put in at least 150 minutes’ worth of moderate aerobic activity weekly. Aerobic exercise, also known as “cardio,” includes walking, running, dancing, hiking, and swimming.
  • Reduce or eliminate your caffeine consumption. It might help you wake up, but coffee could be worsening your anxiety. Soda, tea, and energy drinks are also common sources of caffeine. Although the U.S. Food and Drug Administration (FDA) reports most adults can comfortably consume up to 400 milligrams of caffeine daily, the equivalent of four cups of coffee, even small doses of caffeine are known to adversely affect some people’s anxiety.
  • Get better sleep. Improve your sleeping environment by using blackout curtains and comfortable bedding, avoiding screens at least one hour before bed, and welcoming light, pleasant scents into your bedroom. Falling asleep and waking up on schedule can help you get higher-quality sleep. Lastly, if you can’t fall asleep after 15 or 20 minutes, get up and do something for several minutes before returning to bed.

 

Tip #4: Think About Others

Social anxiety disorder warps your perception of social situations. For example, when walking into a packed classroom, you may fear tripping over a desk and falling in front of your classmates. In this situation, you focus exclusively on how you feel. You might try to control your feelings by paying close attention to obstacles you may encounter.

Paradoxically, by paying extra attention to yourself, you’re making your anxiety worse. People with social anxiety disorder can’t control their thoughts well enough to stop focusing on themselves instantaneously. Even if you practice extensively, thoughts about yourself will pop out of nowhere from time to time.

Try listening to other people or ambient noise in your immediate environment.

Know that your symptoms and feelings aren’t very noticeable to others. Try looking at others to see if you can sense their anxiety. Chances are, you won’t have a clue.

Think about the people you come across. Try making small talk with them. Whether you know it or not, you will encounter other people with social anxiety disorder or other mental health diagnoses and can have a positive impact on them.

Ponder the present. At first, you will only be able to clear your mind of future and past worries for a few seconds. Over time, your ability to focus on the present will improve.

 

Seeking Treatment for Social Anxiety Disorder

Cognitive behavioral therapy (CBT) is an effective treatment for social anxiety disorder. The practice is based on the connection of thoughts, emotions, and behavior.

CBT is administered by a licensed mental health counselor and may include:

  • Breathing methods
  • Relaxation exercises
  • Effective thought-challenging techniques
  • Gradual exposure to things you fear
  • Social skills training
  • Role play
  • Mock interviews

Medications may also prove useful in handling social anxiety disorder symptoms. Antidepressants are the most popular social anxiety medication. This class of drug includes selective serotonin reuptake inhibitors (SSRI), drugs that limit the reabsorption of the “feel-good chemical” serotonin. Higher serotonin levels improve mood regulation, thereby treating anxiety disorder symptoms and depression.

Beta-blockers and benzodiazepines also help treat social anxiety disorder. The former medication may limit the severity of physical symptoms like sweaty palms, shaky voice, and increased heart rate. Benzodiazepines quickly reduce anxiety but are a last resort due to their highly addictive nature.

At Granite Recovery Centers, our mental health program uses cognitive behavioral therapy, motivational interviewing, process groups, and other treatments for co-occurring mental disorders to help you address your social anxiety disorder. You’ll also encounter holistic therapies like meditation, physical exercise, and yoga to aid in your recovery.

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