Social Anxiety2018-09-27T13:16:11+00:00

Social Anxiety

Social Anxiety

Social Anxiety

Feelings of shyness or discomfort in certain situations aren’t necessarily signs of social anxiety disorder, particularly in children. Comfort levels in social situations vary, depending on the individual’s personality traits and life experiences. Some people are naturally reserved and others are more outgoing.

In contrast to everyday nervousness, social anxiety disorder includes fear, anxiety and avoidance that interferes with your daily routine, work, school or other activities.

Emotional and behavioral symptoms:

Signs and symptoms of social anxiety disorder can include persistent:

  • Fear of situations in which you may be judged
  • Fear that others will notice that you look anxious
  • Worrying about embarrassing or humiliating yourself
  • Concern that you’ll offend someone
  • Intense fear of interacting or talking with strangers
  • Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling or having a shaky voice
  • Avoiding doing things or speaking to people out of fear of embarrassment
  • Avoiding situations where you might be the center of attention
  • Having anxiety in anticipation of a feared activity or event
  • Spending time after a social situation analyzing your performance and identifying flaws in your interactions
  • Expecting the worst possible consequences from a negative experience during a social situation

For children, anxiety about interacting with adults or peers may be shown by crying, having temper tantrums, clinging to parents or refusing to speak in social situations.
Performance type of social anxiety disorder is when you experience intense fear and anxiety only during speaking or performing in public, but not in other types of social situations.

Physical signs and symptoms can sometimes accompany social anxiety disorder and may include:

  • Upset stomach or nausea
  • Trouble catching your breath
  • Dizziness or lightheadedness
  • Confusion or feeling “out of body”
  • Fast heartbeat
  • Diarrhea
  • Muscle tension

Avoiding normal social situations that may be hard to endure when you have social anxiety disorder include, for example:

  • Using a public restroom
  • Interacting with strangers
  • Eating in front of others
  • Making eye contact
  • Initiating conversations
  • Dating
  • Attending parties or social gatherings
  • Going to work or school
  • Entering a room in which people are already seated
  • Returning items to a store

Social anxiety disorder symptoms can change over time. They may flare up if you’re facing a lot of stress or demands. Although avoiding anxiety-producing situations may make you feel better in the short term, your anxiety is likely to persist over the long term if you don’t get treatment.

Causes

Like many other mental health conditions, social anxiety disorder likely arises from a complex interaction of environment and genes. Possible causes include:

  • Inherited traits. Anxiety disorders tend to run in families. However, it isn’t entirely clear how much of this may be due to genetics and how much is due to learned behavior.
  • Brain structure. A structure in the brain called the amygdala (uh-MIG-duh-luh) may play a role in controlling the fear response. People who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations.
  • Environment. Social anxiety disorder may be a learned behavior. That is, you may develop the condition after witnessing the anxious behavior of others. In addition, there may be an association between social anxiety disorder and parents who are more controlling or protective of their children.

Risks

    Social anxiety disorder is one of the most common mental disorders. It usually begins in the early to mid-teens, although it can sometimes start earlier in childhood or in adulthood.
    Several factors can increase the risk of developing social anxiety disorder, including:

  • Family history. You’re more likely to develop social anxiety disorder if your biological parents or siblings have the condition.
  • Negative experiences. Children who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to social anxiety disorder. In addition, other negative events in life, such as family conflict or sexual abuse, may be associated with social anxiety disorder.
  • Temperament. Children who are shy, timid, withdrawn or restrained when facing new situations or people may be at greater risk.
  • New social or work demands. Meeting new people, giving a speech in public or making an important work presentation may trigger social anxiety disorder symptoms for the first time. These symptoms usually have their roots in adolescence, however.
  • Having a health condition that draws attention. Facial disfigurement, stuttering, Parkinson’s disease and other health conditions can increase feelings of self-consciousness and may trigger social anxiety disorder in some people.

Complications

    Left untreated, social anxiety disorder may run 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

Other anxiety disorders, major depressive disorder, substance abuse problems and certain other mental health disorders can often occur with social anxiety disorder.

Treatment:

The two most common types of treatment for social anxiety disorder are medications and psychotherapy. These two approaches may be used in combination.

Psychotherapy
Psychological counseling (psychotherapy) improves symptoms in most people with social anxiety disorder. In therapy, you learn how to recognize and change negative thoughts about yourself and develop skills to help you gain confidence in social situations.
Cognitive behavioral therapy is the most common type of counseling for anxiety. In exposure-based cognitive behavioral therapy, you gradually work up to facing the situations you fear most. This therapy can improve your coping skills and help you develop the confidence to deal with anxiety-inducing situations. You may also participate in skills training or role-playing to practice your social skills and gain comfort and confidence relating to others.

Medications

Your doctor or mental health provider may also prescribe other medications for symptoms of social anxiety, such as:

  • Other antidepressants. You may have to try several different antidepressants to find one that’s the most effective for you with the fewest side effects.
  • Anti-anxiety medications. Benzodiazepines (ben-zoe-die-AZ-uh-peens) may reduce your level of anxiety. Although they often work quickly, they can be habit-forming and sedating, so they’re typically prescribed for only short-term use. If your doctor prescribes anti-anxiety medications, try taking them before you’re in a social situation so you know how they’ll affect you.
  • Beta blockers. These medications work by blocking the stimulating effect of epinephrine (adrenaline). They may reduce heart rate, blood pressure, pounding of the heart, and shaking voice and limbs. Because of that, they may work best when used infrequently to control symptoms for a particular situation, such as giving a speech. They’re not recommended for general treatment of social anxiety disorder. As with anti-anxiety medications, try taking them before you need them to see how they affect you.

Stick with it
Don’t give up if treatment doesn’t work quickly. You can continue to make strides in psychotherapy over several weeks or months. And finding the right medication for your situation can take some trial and error.

For some people, the symptoms of social anxiety disorder may fade over time, and medication can be discontinued. Others may need to take medication for years to prevent a relapse.
To make the most of treatment, keep your medical or therapy appointments, take medications as directed, and talk to your doctor about any changes in your condition.

Coping

These coping methods may help ease your anxiety:

  • Reach out to friends and family members
  • Join a local or Internet-based support group
  • Join a group that offers opportunities to improve communication and public speaking skills, such as Toastmasters International
  • Do pleasurable activities, such as hobbies, when you feel anxious

Over time, these coping methods can help control your symptoms and prevent a relapse. Remind yourself that you can get through anxious moments, that your anxiety is short-lived, and that the negative consequences you worry about so much rarely come to pass.

Emotional and behavioral symptoms:

Signs and symptoms of social anxiety disorder can include persistent:

  • Fear of situations in which you may be judged
  • Fear that others will notice that you look anxious””]Worrying about embarrassing or humiliating yourself
  • Concern that you’ll offend someone
  • Intense fear of interacting or talking with strangers
  • Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling or having a shaky voice
  • Avoiding doing things or speaking to people out of fear of embarrassment
  • Avoiding situations where you might be the center of attention
  • Having anxiety in anticipation of a feared activity or event
  • Spending time after a social situation analyzing your performance and identifying flaws in your interactions
  • Expecting the worst possible consequences from a negative experience during a social situation

For children, anxiety about interacting with adults or peers may be shown by crying, having temper tantrums, clinging to parents or refusing to speak in social situations.
Performance type of social anxiety disorder is when you experience intense fear and anxiety only during speaking or performing in public, but not in other types of social situations.

Physical signs and symptoms can sometimes accompany social anxiety disorder and may include:

  • Upset stomach or nausea
  • Trouble catching your breath
  • Dizziness or lightheadedness
  • Confusion or feeling “out of body”
  • Fast heartbeat
  • Diarrhea
  • Muscle tension

Avoiding normal social situations that may be hard to endure when you have social anxiety disorder include, for example:

  • Using a public restroom
  • Interacting with strangers
  • Eating in front of others
  • Making eye contact
  • Initiating conversations
  • Dating
  • Attending parties or social gatherings
  • Going to work or school
  • Entering a room in which people are already seated
  • Returning items to a store

Social anxiety disorder symptoms can change over time. They may flare up if you’re facing a lot of stress or demands. Although avoiding anxiety-producing situations may make you feel better in the short term, your anxiety is likely to persist over the long term if you don’t get treatment.

Causes:

Like many other mental health conditions, social anxiety disorder likely arises from a complex interaction of environment and genes. Possible causes include:

  • Inherited traits. Anxiety disorders tend to run in families. However, it isn’t entirely clear how much of this may be due to genetics and how much is due to learned behavior.
  • Brain structure. A structure in the brain called the amygdala (uh-MIG-duh-luh) may play a role in controlling the fear response. People who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations.
  • Environment. Social anxiety disorder may be a learned behavior. That is, you may develop the condition after witnessing the anxious behavior of others. In addition, there may be an association between social anxiety disorder and parents who are more controlling or protective of their children.

Risk Factors:

    Social anxiety disorder is one of the most common mental disorders. It usually begins in the early to mid-teens, although it can sometimes start earlier in childhood or in adulthood.
    Several factors can increase the risk of developing social anxiety disorder, including:

  • Family history. You’re more likely to develop social anxiety disorder if your biological parents or siblings have the condition.
  • Negative experiences. Children who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to social anxiety disorder. In addition, other negative events in life, such as family conflict or sexual abuse, may be associated with social anxiety disorder.
  • Temperament. Children who are shy, timid, withdrawn or restrained when facing new situations or people may be at greater risk.
  • New social or work demands. Meeting new people, giving a speech in public or making an important work presentation may trigger social anxiety disorder symptoms for the first time. These symptoms usually have their roots in adolescence, however.
  • Having a health condition that draws attention. Facial disfigurement, stuttering, Parkinson’s disease and other health conditions can increase feelings of self-consciousness and may trigger social anxiety disorder in some people.

Complications:

    Left untreated, social anxiety disorder may run 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

Other anxiety disorders, major depressive disorder, substance abuse problems and certain other mental health disorders can often occur with social anxiety disorder.

Treatment:

The two most common types of treatment for social anxiety disorder are medications and psychotherapy. These two approaches may be used in combination.

Psychotherapy
Psychological counseling (psychotherapy) improves symptoms in most people with social anxiety disorder. In therapy, you learn how to recognize and change negative thoughts about yourself and develop skills to help you gain confidence in social situations.
Cognitive behavioral therapy is the most common type of counseling for anxiety. In exposure-based cognitive behavioral therapy, you gradually work up to facing the situations you fear most. This therapy can improve your coping skills and help you develop the confidence to deal with anxiety-inducing situations. You may also participate in skills training or role-playing to practice your social skills and gain comfort and confidence relating to others.

Medications:

Your doctor or mental health provider may also prescribe other medications for symptoms of social anxiety, such as:

  • Other antidepressants. You may have to try several different antidepressants to find one that’s the most effective for you with the fewest side effects.
  • Anti-anxiety medications. Benzodiazepines (ben-zoe-die-AZ-uh-peens) may reduce your level of anxiety. Although they often work quickly, they can be habit-forming and sedating, so they’re typically prescribed for only short-term use. If your doctor prescribes anti-anxiety medications, try taking them before you’re in a social situation so you know how they’ll affect you.
  • Beta blockers. These medications work by blocking the stimulating effect of epinephrine (adrenaline). They may reduce heart rate, blood pressure, pounding of the heart, and shaking voice and limbs. Because of that, they may work best when used infrequently to control symptoms for a particular situation, such as giving a speech. They’re not recommended for general treatment of social anxiety disorder. As with anti-anxiety medications, try taking them before you need them to see how they affect you.

Stick with it
Don’t give up if treatment doesn’t work quickly. You can continue to make strides in psychotherapy over several weeks or months. And finding the right medication for your situation can take some trial and error.

For some people, the symptoms of social anxiety disorder may fade over time, and medication can be discontinued. Others may need to take medication for years to prevent a relapse.
To make the most of treatment, keep your medical or therapy appointments, take medications as directed, and talk to your doctor about any changes in your condition.

Coping:

These coping methods may help ease your anxiety:

  • Reach out to friends and family members
  • Join a local or Internet-based support group
  • Join a group that offers opportunities to improve communication and public speaking skills, such as Toastmasters International
  • Do pleasurable activities, such as hobbies, when you feel anxious

Over time, these coping methods can help control your symptoms and prevent a relapse. Remind yourself that you can get through anxious moments, that your anxiety is short-lived, and that the negative consequences you worry about so much rarely come to pass.

Emotional and behavioral symptoms:

Signs and symptoms of social anxiety disorder can include persistent:

  • Fear of situations in which you may be judged
  • Fear that others will notice that you look anxious””]Worrying about embarrassing or humiliating yourself
  • Concern that you’ll offend someone
  • Intense fear of interacting or talking with strangers
  • Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling or having a shaky voice
  • Avoiding doing things or speaking to people out of fear of embarrassment
  • Avoiding situations where you might be the center of attention
  • Having anxiety in anticipation of a feared activity or event
  • Spending time after a social situation analyzing your performance and identifying flaws in your interactions
  • Expecting the worst possible consequences from a negative experience during a social situation

For children, anxiety about interacting with adults or peers may be shown by crying, having temper tantrums, clinging to parents or refusing to speak in social situations.
Performance type of social anxiety disorder is when you experience intense fear and anxiety only during speaking or performing in public, but not in other types of social situations.

Physical signs and symptoms can sometimes accompany social anxiety disorder and may include:

  • Upset stomach or nausea
  • Trouble catching your breath
  • Dizziness or lightheadedness
  • Confusion or feeling “out of body”
  • Fast heartbeat
  • Diarrhea
  • Muscle tension

Avoiding normal social situations that may be hard to endure when you have social anxiety disorder include, for example:

  • Using a public restroom
  • Interacting with strangers
  • Eating in front of others
  • Making eye contact
  • Initiating conversations
  • Dating
  • Attending parties or social gatherings
  • Going to work or school
  • Entering a room in which people are already seated
  • Returning items to a store

Social anxiety disorder symptoms can change over time. They may flare up if you’re facing a lot of stress or demands. Although avoiding anxiety-producing situations may make you feel better in the short term, your anxiety is likely to persist over the long term if you don’t get treatment.

Causes:

Like many other mental health conditions, social anxiety disorder likely arises from a complex interaction of environment and genes. Possible causes include:

  • Inherited traits. Anxiety disorders tend to run in families. However, it isn’t entirely clear how much of this may be due to genetics and how much is due to learned behavior.
  • Brain structure. A structure in the brain called the amygdala (uh-MIG-duh-luh) may play a role in controlling the fear response. People who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations.
  • Environment. Social anxiety disorder may be a learned behavior. That is, you may develop the condition after witnessing the anxious behavior of others. In addition, there may be an association between social anxiety disorder and parents who are more controlling or protective of their children.

Risk Factors:

    Social anxiety disorder is one of the most common mental disorders. It usually begins in the early to mid-teens, although it can sometimes start earlier in childhood or in adulthood.
    Several factors can increase the risk of developing social anxiety disorder, including:

  • Family history. You’re more likely to develop social anxiety disorder if your biological parents or siblings have the condition.
  • Negative experiences. Children who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to social anxiety disorder. In addition, other negative events in life, such as family conflict or sexual abuse, may be associated with social anxiety disorder.
  • Temperament. Children who are shy, timid, withdrawn or restrained when facing new situations or people may be at greater risk.
  • New social or work demands. Meeting new people, giving a speech in public or making an important work presentation may trigger social anxiety disorder symptoms for the first time. These symptoms usually have their roots in adolescence, however.
  • Having a health condition that draws attention. Facial disfigurement, stuttering, Parkinson’s disease and other health conditions can increase feelings of self-consciousness and may trigger social anxiety disorder in some people.

Complications:

    Left untreated, social anxiety disorder may run 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

Other anxiety disorders, major depressive disorder, substance abuse problems and certain other mental health disorders can often occur with social anxiety disorder.

Treatment:

The two most common types of treatment for social anxiety disorder are medications and psychotherapy. These two approaches may be used in combination.

Psychotherapy
Psychological counseling (psychotherapy) improves symptoms in most people with social anxiety disorder. In therapy, you learn how to recognize and change negative thoughts about yourself and develop skills to help you gain confidence in social situations.
Cognitive behavioral therapy is the most common type of counseling for anxiety. In exposure-based cognitive behavioral therapy, you gradually work up to facing the situations you fear most. This therapy can improve your coping skills and help you develop the confidence to deal with anxiety-inducing situations. You may also participate in skills training or role-playing to practice your social skills and gain comfort and confidence relating to others.

Medications:

Your doctor or mental health provider may also prescribe other medications for symptoms of social anxiety, such as:

  • Other antidepressants. You may have to try several different antidepressants to find one that’s the most effective for you with the fewest side effects.
  • Anti-anxiety medications. Benzodiazepines (ben-zoe-die-AZ-uh-peens) may reduce your level of anxiety. Although they often work quickly, they can be habit-forming and sedating, so they’re typically prescribed for only short-term use. If your doctor prescribes anti-anxiety medications, try taking them before you’re in a social situation so you know how they’ll affect you.
  • Beta blockers. These medications work by blocking the stimulating effect of epinephrine (adrenaline). They may reduce heart rate, blood pressure, pounding of the heart, and shaking voice and limbs. Because of that, they may work best when used infrequently to control symptoms for a particular situation, such as giving a speech. They’re not recommended for general treatment of social anxiety disorder. As with anti-anxiety medications, try taking them before you need them to see how they affect you.

Stick with it
Don’t give up if treatment doesn’t work quickly. You can continue to make strides in psychotherapy over several weeks or months. And finding the right medication for your situation can take some trial and error.

For some people, the symptoms of social anxiety disorder may fade over time, and medication can be discontinued. Others may need to take medication for years to prevent a relapse.
To make the most of treatment, keep your medical or therapy appointments, take medications as directed, and talk to your doctor about any changes in your condition.

Coping:

These coping methods may help ease your anxiety:

  • Reach out to friends and family members
  • Join a local or Internet-based support group
  • Join a group that offers opportunities to improve communication and public speaking skills, such as Toastmasters International
  • Do pleasurable activities, such as hobbies, when you feel anxious

Over time, these coping methods can help control your symptoms and prevent a relapse. Remind yourself that you can get through anxious moments, that your anxiety is short-lived, and that the negative consequences you worry about so much rarely come to pass.