Understanding Social Anxiety Disorder
Does the thought of going to a party where you don’t know many people make your stomach churn? Do you worry for days before having to give a presentation at work? Do you find yourself replaying social interactions in your head, analyzing every little thing you said or did? While most people get a little nervous in some social situations, for some, this fear is so intense and persistent that it gets in the way of their life. This is known as Social Anxiety Disorder.
At Televero Health, we help patients understand the important difference between normal shyness and a clinical anxiety disorder. Shyness is a personality trait. Social Anxiety Disorder is a treatable medical condition characterized by an overwhelming fear of being judged and scrutinized by others.
More Than Just Being Shy
A person who is shy might feel uncomfortable in a social situation but can usually warm up over time. A person with Social Anxiety Disorder experiences an intense, out-of-proportion fear in social settings. The focus of the fear is almost always on the possibility of embarrassing themselves or being negatively evaluated by others. They might worry that people will think they are awkward, stupid, or boring.
This fear is so intense that it often triggers a strong physical “fight-or-flight” response. The physical symptoms of social anxiety can include:
- Blushing
- Sweating
- Trembling or shaking
- A rapid heart rate
- Nausea or an upset stomach
- Difficulty speaking or feeling like your mind has gone blank
The fear of these physical symptoms showing can then become another source of anxiety. You might worry that people will notice you are blushing or that your hands are shaking, which you believe will lead to even more judgment.
The Vicious Cycle of Avoidance
Because social situations cause such intense distress, the natural response is to avoid them. You might turn down invitations to parties, avoid speaking up in meetings, or eat lunch alone at your desk. While this avoidance provides temporary relief from the anxiety, in the long run, it is the fuel that keeps the disorder going.
Every time you avoid a feared situation, your brain learns two things:
- The situation is, in fact, dangerous and should be avoided.
- The only way to cope with the anxiety is to escape.
This creates a vicious cycle. The more you avoid, the more your world shrinks, and the more your fear grows. This can have a devastating impact on your life, making it difficult to make friends, advance in your career, or pursue your interests.
How Is Social Anxiety Treated?
The good news is that Social Anxiety Disorder is a highly treatable condition. You do not have to live with this level of fear. The most effective treatments help you to break the cycle of avoidance and challenge the negative thought patterns that drive the anxiety.
- Cognitive Behavioral Therapy (CBT): This is considered the gold-standard therapy for social anxiety. A therapist helps you to identify your fearful thoughts about social situations and to evaluate how realistic they are. You learn to challenge these negative automatic thoughts and replace them with more balanced and helpful ones.
- Exposure Therapy: This is a key component of CBT. It involves gradually and systematically facing the social situations you fear in a safe and controlled way. You might start with something small, like making eye contact with a cashier, and work your way up to more challenging situations, like making small talk with a coworker. This process, called habituation, helps your brain to learn that the feared situations are not actually dangerous and that the anxiety will naturally decrease on its own.
- Medication: Antidepressants, particularly SSRIs and SNRIs, are often very effective at reducing the underlying anxiety, which can make it much easier to engage in the work of therapy.
If the fear of judgment is controlling your life, please know that there is a path to feeling more comfortable and confident. With the right treatment, you can learn to quiet the anxious voice in your head and start living the life you want to live.
Key Takeaways
- Social Anxiety Disorder is not just shyness; it’s an intense, persistent fear of being judged or scrutinized in social situations.
- The condition often involves strong physical symptoms like blushing, sweating, and a racing heart.
- Avoiding feared social situations provides temporary relief but ultimately makes the anxiety worse over time, creating a vicious cycle.
- Social Anxiety Disorder is highly treatable with evidence-based approaches like Cognitive Behavioral Therapy (CBT), exposure therapy, and medication.
Ready to take the first step? We can help. Get started with Televero Health today.