Social Anxiety

Social Anxiety

Social Anxiety

Social Anxiety Disorder (SAD) is a longstanding and excessive fear of social situations.

How we feel, think, and behave in social situations varies from person to person depending on our personality traits, upbringing, and life experiences. Some people are naturally reserved and shy whereas others might be more outgoing and extroverted, but anyone can have a SAD.

Beyond the typical sensation one might expect when speaking in public, meeting people for the first time, starting at a new job or school, or giving a performance, when the discomfort or feelings of shyness result in anxiety, fear, or avoidance and have an ongoing impact a person’s daily at work, in school then it could be SAD.

Prevalence

The average age of onset of SAD is between 10 to 13 years, and SAD is rarely diagnosed after the age of 25. SAD affects men and women equally at a male to female ratio of approximately 1:1.

Psychological and Physical symptoms:

SAD is a mental illness characterized by:

Psychological symptoms such as:

  • Fear of situations that you may be judged
  • Worrying that you will embarrass and humiliate yourself
  • Crippling fear of interacting with strangers
  • Avoiding and event or interaction where one could be the center of attention
  • Looking to find flaws in ones interactions after a social interaction
  • Fear of offending people
  • Anticipating the worst possible outcomes because of ones interactions with people
  • Fear of embarrassing physical symptoms like sweating, shaky voice or limbs, trembling or blushing,
  • Avoiding activities or people because of fear of anticipated embarrassment
  • Constantly being critical of and judging oneself

Refusing to talk, temper tantrums, crying or being clingy with their parents are all possible symptoms in children who are anxious about talking adults.


Physical symptoms such as:

  • Palpitations (an awareness of your heart beating faster than usual)
  • Shortness of breath
  • A churning sensation in your stomach / nausea
  • Diarrhea
  • Out of body experiences
  • Muscle Tension
  • Confusion
  • Lightheaded or dizzy sensations

Avoiding social interactions such as:

  • Eating in public
  • Looking people in the eye
  • Using public bathrooms
  • Walking into a room where everyone is seated
  • Returning purchases in person
  • Starting a conversation
  • Going on dates
  • Talking to strangers
  • Attending school
  • Going to a job
  • Going to large social events or parties

Avoiding social situations will manage the condition from the perspective of reducing potential triggers, but the individual is not getting any better, and it will have a profound impact on their quality of life and affect the relationships they have with family and friends.

There are two main groupings of disorder: specific, where fear is triggered by one or more situations, and generalized, which encompasses fear of multiple situations.


Progression of symptoms

Social Anxiety is an ongoing and intense fear that people are constantly watching you and judging you. The disorder typically surfaces in the very early teen years, and once symptoms are present for at least 6 months a diagnosis is made.

The ways in which the disorder affects people will vary, as will the severity of its impact, and if left untreated, it is only likely to worsen, and in some cases progress from fearing one type of interaction in one particular location to fearing any interaction in any location with any number of people. In extreme cases some people elect to live in isolation which can lead to, or worsen existing depression or the development of additional phobias.

While there is no particular pattern the disorder follows, it does have a number of typical steps or phases in which people may find themselves including:

  • Initial Indications: In early childhood, those who eventually developed social anxiety disorder displayed timid personality traits.
  • Age When First Symptoms Appear: Research shows that for people who have social anxiety disorder, the vast majority started developing or exhibiting symptoms at age 13. Given that this is an age when a person can start experiencing a lot of changes, it can be easy for families to dismiss the symptoms. Once recognised, a diagnosis can be made when the symptoms persist for longer than six months.
  • Things Get Worse: Over time it can be seen that everyday life nas not returned and the severity and frequency of the triggered symptoms have increased.
  • Other Disorders: Prior to diagnosis and treatment, each person will handle the disorder differently, but the anxiety, and increasing isolation can be linked to the development of substance abuse, depression, and additional anxiety disorders.
  • Outlook: Over time, untreated social anxiety disorder can increasingly limit almost all aspects of one’s life, and become a chronic condition. As with most conditions, the longer it is left before getting help, the potential exists that treatment may take longer and be a bit more difficult, but it is treatable and typically the outcome is extremely positive.

Causes

The cause of SAD is not fully understood, but many professionals suspect:

  • The part of the brain that regulates emotions
  • Local weather patterns — such as few daylight hours and constant rain

Those with an increased risk of developing SAD include those with:

  • A shy temperament
  • A health condition that attracts attention such as facial disfigurement
  • A family history of SAD

SAD often coexists with other mental health conditions such as clinical depression and avoidant personality disorder. In addition, evidence shows that anxiety disorders often run in families but it is unclear if this is because of learned behaviors or because of genetics. Children observing behaviors such as the actions of overprotective or controlling parents will often learn that behavior and understand it to be what normal looks like.

Another possible element that could cause or significantly contribute to social anxiety is when a part of the brain called the amygdala becomes overactive and enters a state referred to as ‘amygdala hijacking’. This is a response to fear, and as a protection mechanism the brain prepares the body to immediately pursue safety in what is called ‘Fight or Flight response’. Similar amygdala activity is observed in people with PTSD.

Social Anxiety complications

SAD can have a profoundly negative effect on a person’s quality of life and can cause severe impairment in other important areas of functioning — social skills, learning, and job performance. People with SAD often cope by drinking excessive amounts of alcohol. SAD is also associated with an increased risk of suicidal behavior.

Without managing symptoms and getting treatment for the root of the condition, Social Anxiety Disorder will not just rectify itself, but instead cause increased stress and anxiety for the individual. It also has the potential to impact personal relationships with loved ones as well as impact school or a person’s job and their ability to earn income and thereby impact more than just the person with the disorder. Potential complications include:

  • Self-esteem issues
  • Trouble being self-assured or confident
  • Pervasive negative thoughts about oneself
  • Typically devastated by criticism
  • Lacking typical communication skills
  • Relationship issues
  • Isolation
  • Below average education results and career achievements
  • Alcohol and/or drug abuse
  • Thoughts of 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 for Social Anxiety:

The two most common types of treatment for SAD are

  • Medications – antidepressants such as selective serotonin reuptake inhibitors and sedatives such as benzodiazepines
  • Talking therapy – such as cognitive behavioral therapy

Psychological and Physical symptoms:

SAD is a mental illness characterized by:

Psychological symptoms such as:

  • Fear of situations that you may be judged
  • Worrying that you will embarrass and humiliate yourself
  • Crippling fear of interacting with strangers
  • Avoiding and event or interaction where one could be the center of attention
  • Looking to find flaws in ones interactions after a social interaction
  • Fear of offending people
  • Anticipating the worst possible outcomes because of ones interactions with people
  • Fear of embarrassing physical symptoms like sweating, shaky voice or limbs, trembling or blushing,
  • Avoiding activities or people because of fear of anticipated embarrassment
  • Constantly being critical of and judging oneself

Refusing to talk, temper tantrums, crying or being clingy with their parents are all possible symptoms in children who are anxious about talking adults.


Physical symptoms such as:

  • Palpitations (an awareness of your heart beating faster than usual)
  • Shortness of breath
  • A churning sensation in your stomach / nausea
  • Diarrhea
  • Out of body experiences
  • Muscle Tension
  • Confusion
  • Lightheaded or dizzy sensations

Avoiding social interactions such as:

  • Eating in public
  • Looking people in the eye
  • Using public bathrooms
  • Walking into a room where everyone is seated
  • Returning purchases in person
  • Starting a conversation
  • Going on dates
  • Talking to strangers
  • Attending school
  • Going to a job
  • Going to large social events or parties

Avoiding social situations will manage the condition from the perspective of reducing potential triggers, but the individual is not getting any better, and it will have a profound impact on their quality of life and affect the relationships they have with family and friends.

There are two main groupings of disorder: specific, where fear is triggered by one or more situations, and generalized, which encompasses fear of multiple situations.


Progression of symptoms

Social Anxiety is an ongoing and intense fear that people are constantly watching you and judging you. The disorder typically surfaces in the very early teen years, and once symptoms are present for at least 6 months a diagnosis is made.

The ways in which the disorder affects people will vary, as will the severity of its impact, and if left untreated, it is only likely to worsen, and in some cases progress from fearing one type of interaction in one particular location to fearing any interaction in any location with any number of people. In extreme cases some people elect to live in isolation which can lead to, or worsen existing depression or the development of additional phobias.

While there is no particular pattern the disorder follows, it does have a number of typical steps or phases in which people may find themselves including:

  • Initial Indications: In early childhood, those who eventually developed social anxiety disorder displayed timid personality traits.
  • Age When First Symptoms Appear: Research shows that for people who have social anxiety disorder, the vast majority started developing or exhibiting symptoms at age 13. Given that this is an age when a person can start experiencing a lot of changes, it can be easy for families to dismiss the symptoms. Once recognised, a diagnosis can be made when the symptoms persist for longer than six months.
  • Things Get Worse: Over time it can be seen that everyday life nas not returned and the severity and frequency of the triggered symptoms have increased.
  • Other Disorders: Prior to diagnosis and treatment, each person will handle the disorder differently, but the anxiety, and increasing isolation can be linked to the development of substance abuse, depression, and additional anxiety disorders.
  • Outlook: Over time, untreated social anxiety disorder can increasingly limit almost all aspects of one’s life, and become a chronic condition. As with most conditions, the longer it is left before getting help, the potential exists that treatment may take longer and be a bit more difficult, but it is treatable and typically the outcome is extremely positive.

Causes of Social Anxiety

The cause of SAD is not fully understood, but many professionals suspect:

  • The part of the brain that regulates emotions
  • Local weather patterns — such as few daylight hours and constant rain

Those with an increased risk of developing SAD include those with:

  • A shy temperament
  • A health condition that attracts attention such as facial disfigurement
  • A family history of SAD

SAD often coexists with other mental health conditions such as clinical depression and avoidant personality disorder. In addition, evidence shows that anxiety disorders often run in families but it is unclear if this is because of learned behaviors or because of genetics. Children observing behaviors such as the actions of overprotective or controlling parents will often learn that behavior and understand it to be what normal looks like.

Another possible element that could cause or significantly contribute to social anxiety is when a part of the brain called the amygdala becomes overactive and enters a state referred to as ‘amygdala hijacking’. This is a response to fear, and as a protection mechanism the brain prepares the body to immediately pursue safety in what is called ‘Fight or Flight response’. Similar amygdala activity is observed in people with PTSD.

Social Anxiety complications:

SAD can have a profoundly negative effect on a person’s quality of life and can cause severe impairment in other important areas of functioning — social skills, learning, and job performance. People with SAD often cope by drinking excessive amounts of alcohol. SAD is also associated with an increased risk of suicidal behavior.

Treatment for Social Anxiety:

The two most common types of treatment for SAD are:

  • Medications – antidepressants such as selective serotonin reuptake inhibitors and sedatives such as benzodiazepines
  • Talking therapy – such as cognitive behavioral therapy