Anxiety is a condition defined as too much, continuous worrying over an imminent event such as death or illness of oneself or the others, or maybe even small events such as being late for an appointment or other uncertain outcomes.
What is social anxiety disorder/ social phobia?
Social anxiety disorder (also called social phobia) is a mental health condition and a common type of anxiety disorder. It is a severe, continuous fear of being watched and judged by others.
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It is normal to feel edgy/tensed/uneasy in some social situations. However, for people with this disorder, everyday interactions cause significant anxiety, fear, self-consciousness and embarrassment because they fear being scrutinized or judged by others.
The fear/stress that people with social anxiety disorder have in social situations is so overwhelming that they feel it is beyond their ability to control.
This gets into the way of their everyday life. Severe stress can affect their daily routine, work, school or other activities. For them, facing people and doing interactions and small tasks in front of other people such as eating or drinking etc also causes anxiety or fear. Generally, they tend to avoid and dread being centre of attraction at any place.
They tend to continuous worry about attending social events or facing public often for weeks and may even end up staying away from places or events where they think they might have to do something that will humiliate them.
Social anxiety disorder usually begins in the early to mid-teens, though it can sometimes start in younger children or in adults.
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Social situations which are generally avoided by social anxiety disorder patients:
Talking to and being around with people might be easy for you but not with patients who suffer from this disorder. For them, common everyday experiences also might become troublesome and can be a reason for stress like:
- Talking and interacting to strangers or unknown people
- Going to parties or social gatherings
- Entering a room in which people are already seated
- Returning items to a store
- Speaking in public
- Making eye contact
- Using public restrooms
- Eating in front of other people
- Going to school or work
- Starting conversations
The symptoms might start immediately before an event and you may start getting anxious. It is also possible that you might spend weeks worrying about it. Afterward, you could spend a lot of time and mental energy worrying about how you behaved in that social situation.
What are the symptoms of social anxiety disorder?
When interacting with others or performing in front of others, or in social situations, people with social anxiety disorder tend to exhibit following symptoms:
- Feel nauseous or sick to their stomach
- They may show a rigid body posture, make little or no eye contact, or speak with more than usually soft voice.
- It is difficult for them to be with other people, especially those they don’t already know, and have a hard time talking to them even though they wish they could.
- They tend to be very self-conscious in front of other people and feel embarrassed and awkward
- Be very afraid that other people will judge them.
- Stay away from places where there are other people
Physical signs and symptoms can sometimes accompany social anxiety disorder and may include:
- Blushing, sweating, trembling, a rapid heart rate, or feeling of the “mind is going blank”
- Muscle tension
- Dizziness and lightheadedness
- Stomach trouble and diarrhoea
- Inability to catch breath
- “Out-of-body” sensation
What are the causes and triggers behind social anxiety disorders?
Like many other mental health conditions, social anxiety disorder is likely to develop from a complex interaction of several biological and environmental factors. Some of the causes behind this disorder include:
- Inherited traits: Several studies have found that social anxiety disorders tend to run in families. However, the research has been unable to prove that why some family members have it while others don’t.
Also, it is not entirely clear how much of this may be due to genetics and how much is due to learned behavior.
- Brain structure: Researchers have found that several parts of the brain are involved in fear and anxiety. A structure in the brain called the amygdale may have a role in controlling your response to the fear. People who have an overactive amygdala may have a heightened fear response which therefore causes increased anxiety in social situations.
- Environment. Social anxiety disorder may be a learned behavior which suggests that some people may have developed this condition after an unpleasant or embarrassing social situation in life. This might have impacted them a lot and they started worrying about it excessively and later on developed this disorder.
- Also, there may be an association between social anxiety disorder and parents who either model anxious behavior in social situations or are more controlling or overprotective of their children. Children who are not allowed to express themselves more freely which in future might impact their response and their behavior in social situations.
- Some researchers have proposed that misinterpretation of others’ behavior may play a role in causing or worsening social anxiety. For example, you may think that people are staring or frowning at you when this might not be true.
- Underdeveloped social skills are another possible contributor to social anxiety. You may lack understanding of how to response in social situations which might discourage you after talking with people and you may worry about doing it in the future.
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How is social anxiety disorder treated?
In order to get this disorder treated, the first step is to seek a professional help. You need to talk to your doctor or health care professional about your symptoms. Your healthcare professional might ask you a series of questions and check your health history to rule out any unrelated physical diseases which might be causing you these symptoms.
As per his diagnosis and understanding, your healthcare professional may refer you to a mental health specialist, such as a psychiatrist, psychologist, clinical social worker, or counselor. The first step to effective treatment is to have a diagnosis made, usually by a mental health specialist. Various methods, techniques and medications which are helpful in treating/ preventing this disorder are given below for your understanding and reference:
A type of psychotherapy (sometimes called as talk therapy) known as cognitive behavioral therapy (CBT) is especially useful for treating social anxiety disorder. This therapy helps you in learning different ways of thinking, behaving, and reacting to situations which in turn will lessen your anxiety level. In case, if you are lacking social skills, this therapy also helps you in learning them.
People who are suffering from this disorder have also given feedback that support groups have been really helpful in treating this disorder. They meet and talk and interact with people having this same disorder.
In a support group who all has this social anxiety disorder, you can receive fair and honest feedback about the way you are reacting in social skills and how the others see you in the group.
This way, you will get a fair idea about whether or not your judgment and thoughts about yourself and others are true or not. While interacting with others, you may also learn how they have overcome this disorder and share tips in how to approach social situations.
There are three types of medications used to help treat social anxiety disorder:
- Anti-anxiety medications
Anti-anxiety medications are really helpful and they start working right away in lessening your anxiety and fear level. However, since these medications are powerful; they are generally not advised for a longer period of time. They are once started so that you can meanwhile look for other methods of treatment.
Patients have reported to develop tolerance towards this drug and the same dose might not work for them. In order to get the same effect of less anxiety; they have been given higher and higher doses of this medicine. Some people may even become dependent on them. In order to avoid these situations, generally healthcare professionals advise these anti-anxiety medications for short periods.
Though antidepressants are mainly used to treat depression, but they have also proved to be helpful for reducing the symptoms of social anxiety disorder. These medications do not start working right away and may take several weeks to show their effect.
There are also some side effects of this medicine like headaches, nausea, or troublesome sleeping. If you have started on low dosage of this medicine, the chance of getting these side effects is low and they may not be severe also. You may gradually increase the dose.
Incase if some side effects are intolerable, you should inform your doctor about the same.
Beta-blockers are medicines that can help block some of the physical symptoms of anxiety on the body, such as an increased heart rate, sweating, or tremors. Beta-blockers are commonly the medications of choice for the “performance anxiety” type of social anxiety.
It is quite possible that you may not see an immediate effect of these therapies and medications and become quite disheartened. However, we will advise you to continue with the treatment and talk to your doctor about it.
Your doctor will work with you to find the best medication, dose, and duration of treatment. Many people with social anxiety disorder obtain the best results with a combination of medication and CBT or other psychotherapies. They can help you gain confidence and improve your ability to interact with others. A good emotional support system of family and friends is also helpful in combating this disorder.
Left untreated, social anxiety disorder can ruin your life. Anxieties can interfere with work, school, relationships or enjoyment of life. Social anxiety disorder can cause:
- Low self-esteem
- Trouble being assertive
- Negative self-talk
- Hypersensitivity to criticism
- Poor social skills
- Isolation and difficult social relationships
- Low academic and employment achievement
- Substance abuse, such as drinking too much alcohol
- Suicide or suicide attempts
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It cannot be predicted what will cause someone to develop an anxiety disorder. However, there are certain home remedies as well as lifestyle related things which will help you in reducing the impact of these symptoms:
- Get help early. The sooner the better. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
- Maintaining a positive attitude towards life and in general. Try to warden off negative thoughts from your life.
- Keep a journal. Keeping track of your personal life can really help you and your mental health professional to identify what’s causing you stress and what seems to help you feel better. Know what the stressors in your life are. Try to manage or reduce these stressors.
- Try to keep your mind busy. At the same time, take out some time to do activities which you enjoy. This cheers both the body and the mind.
- Avoid unhealthy substance use. You should try to limit alcohol and caffeine intake in your body. Alcohol and drug use and even caffeine or nicotine use can cause or worsen anxiety. You may seek professional help in quitting or reducing their intake.
- Try to sleep continuously at a stretch for 8 hours in night. Having a good sleep relaxes your body and prepares your body for the coming day.
- Exercise every day.