How To Deal With Social Anxiety

Mental Health

Dr. Happy


Hello again and thanks so much for reading my HIF Healthy Lifestyle Blog. I assume, that is, that someone out there is reading what I write. But sometimes I get anxious that there really is no one there and that my words just disappear in to an empty, black hole of cyber-nothingness!

I’m (partially) joking of course; but I’m not joking when I note that anxiety is extremely common. Along with depression, the anxiety disorders are the most common form of psychological disorders and mental ill-health. It’s normal to experience some stress and anxiety, but unfortunately there are some (in fact, many) people whose anxiety becomes overwhelming and unmanageable, for whom the impact on their daily lives is extreme and distressing.

It should be noted, however, that anxiety is not actually a psychological disorder. Rather, to be more correct, there are a number of “Anxiety Disorders” including Obsessive Compulsive Disorder, Panic Disorder (with and without Agoraphobia), and the Simple Phobias (such as the fear of spiders or the fear of heights or anxiety associated with small, closed spaces), to name but a few.

Among these, another of the more common is Social Anxiety (or social phobia).

Anxiety in social situations is also, as noted earlier in relation to anxiety more generally, a completely normal (and in some cases appropriate) experience. But again, for some people this distress can become debilitating and for many it can have a significant impact on their social and occupational functioning and success in life.

The most common example of social anxiety is a fear of public speaking; but it can also be experienced as extreme anxiety associated with eating or drinking in public, signing one’s name under scrutiny, and even using public toilet facilities. At the heart of social anxiety for everyone, however, is a fear of negative evaluation.

In summary, then, social anxiety tends to include unpleasant emotions such as fear and anxiety, in certain situations such as public speaking or where one is the centre of attention. At these times, people who experience social anxiety report significant physiological arousal (including increased heart rate, sweating, blushing, light headedness and even shaking) associated with unhelpful, negative thoughts such as “I’m so embarrassed to be seen blushing and trembling”, “people will think I’m stupid”, or “I must look so weird”. As a result of these thoughts and feelings, those who’re socially anxious tend to avoid situations they perceive to be difficult.

The good news is that treatments for social anxiety are relatively effective for most people, most of the time, and relatively quickly. The intervention with the most evidence, and therefore the one that’s typically recommended most often, is Cognitive Behaviour Therapy (CBT); a practical, relatively short-term psychological approach that focuses on the instruction of practical coping strategies to help those who’re suffering to gain more confidence and to function more effectively in anxiety provoking situations.

More specifically, CBT includes the following strategies that you might like to try for yourself if any of the above scenarios seem familiar to you:

  • Calming techniques – one of the simplest and most effective ways to break the vicious cycle of negativity that can turn normal anxiety into distress that’s disabling is to reduce the physiological arousal with applied relaxation and/or meditation strategies. There are a wide variety of styles, and different things work for different people, but in simple terms if you can find a way to slow your breathing down, the range of physical symptoms described above will reduce in intensity
  • Challenging Unhelpful Thoughts – the other factor that tends to turn mild stress in to major anxiety is unhelpful thinking. Thought patterns like “catastrophizing” (thinking the worst and making mountains out of molehills) do nothing to help and everything to exacerbate distress. More often than not, such concerns are simply unwarranted and so learning to question them, and then to think more realistic and helpful thoughts can also act as a circuit breaker.
  • Confronting fears – and finally, research has clearly shown that avoiding anxiety provoking situations makes things worse; whereas facing up to fears indubitably helps. So make a plan to do that which you’re afraid of, slowly and gradually and while practicing the tips described above, and you’ll find your confidence grow as you achieve more and larger goals.

Final note: although the strategies described above might sound simple and although they might be useful and applicable and helpful for someone with mild to moderate levels of social anxiety, just like any other type of problem, if your distress is more severe or if it’s long standing it would well be worth considering seeing a professional. So if you need some expert help, please ask your local GP for a referral to, or just search for an appropriately qualified Clinical Psychologist.

Dr Happy

Please note: Dr Happy's blog is general advice only. For further information on this topic, please consult your healthcare professional.

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