Anxiety- What is anxiety? Is anxiety normal? 

These are the two frequently pondered upon questions that an individual dealing with anxiety might engage in. Let’s simplify anxiety to develop a better understanding and identify if our anxiety is something normal or a sign of something serious.

Anxiety is a typical feeling. It’s your brain’s method of responding to stress and warning you of impending danger. Everyone experiences anxiety from time to time. You may feel concerned when confronted with an issue at the workplace, before a test, or even before making a major decision. Anxiety is normal on occasion. 

Anxiety disorders, on the other hand, are distinct. They are a set of mental diseases that produce extreme anxiety and terror. Excessive anxiety might cause you to avoid going to work, school, family gatherings, and other social settings that could trigger or aggravate your symptoms.

Are there different types of anxieties and anxiety disorders?

The answer is YES! There are several types of anxiety disorders including generalized anxiety disorder, panic disorder, social anxiety disorder, specific phobias, agoraphobia, separation anxiety, selective mutism, and medication-induced anxiety disorder. Let’s look at Social anxiety and social anxiety disorder quite briefly in this article. 

Social anxiety– Oh! The term sounds tricky yet simplistic. Social anxiety is anxiety that occurs when anticipating or engaging in some type of social situation, such as public speaking, meeting new people, or going to a party. Social anxiety deals with anxiety-infused bouts of emotions/feelings with respect to social situations. Now that we understood what social anxiety is, let’s look at social anxiety disorder and draw the thin line between the two.

Ponder- Are you terrified of being evaluated by others? Are you self-conscious in ordinary social situations? Do you avoid meeting new people out of fear or anxiety? If you’ve been feeling this way for at least 6 months and it’s making it difficult for you to accomplish ordinary chores like chatting to people at work or school, you may have a social anxiety disorder.

Social anxiety disorder is characterized by an acute, persistent dread of being seen and assessed by others. This dread might interfere with work, school, and other daily activities. It might even make it difficult to make and retain friends. 

Let’s look at Bob and the story of his life:

Bob, a 19-year-old, tells his therapist that he is miserable and under a lot of stress because of school and that he will “definitely fail out.” He struggles to think of anything nice about a regular day because he spends much of it playing video games in his dorm room. He seldom ever shows up for class, and he hasn’t approached his teachers to try to improve his marks this term. Bob has always identified as timid and has only ever had a small, close-knit circle of friends throughout elementary school and high school. Notably, starting college markedly increased his level of stress. He emphasizes that he struggles to focus during interactions with strangers because he is preoccupied with thinking about their opinions of him; he worries they would think he is “stupid,” “boring,” or a “failure.” When he loses focus, he stutters, stumbles over his words, and begins to perspire, which only helps to increase his unease. After the conversation, he repeatedly plays it back, concentrating on the “dumb” things he said. Similar to this, he has a long history of feeling uneasy around people in positions of power and has struggled to speak up in class and approach professors. Since starting college, he has been isolating himself more, turning down invitations from his roommate to go eat or hang out, ignoring his cell phone when it rings, and habitually skipping class. His concerns about how others view him are what drives him to engage in these avoidance behaviors. 

This story of Bob highlights what living with social anxiety is like, and how an individual dealing with social anxiety and social anxiety disorder go about social situations in their lives. A person suffering from social anxiety disorder experiences anxiety or fear when confronted with situations in which they may be scrutinized, analyzed, or critiqued by others (like in the story of Bob), such as speaking publicly, encountering new people, dating, being interviewed for a job interview, responding to a question in class. Daily activities, such as dining or drinking in public or using a public bathroom, can also generate anxiety or panic owing to fears of being embarrassed, criticized, or rejected. Individuals with social anxiety disorder experience such severe worry in social situations that they believe it is beyond their control. 

This fear may prohibit some individuals from heading to work, school, or doing daily duties. Some people may be able to perform identical acts, but they do them with great anxiety or worry. People with social anxiety may worry about social situations for days before they occur and they may end up avoiding places or activities that cause them pain or embarrassment. Some people with the condition may suffer anxiety during performances rather than social interactions. They experience nervousness when giving a speech, competing in a sporting event, or playing a piece of music on stage.

Social anxiety disorder often appears in late childhood, with symptoms including extreme shyness or aversion to situations or social interactions. Also, Social anxiety disorder may endure for many years, maybe for a lifetime, if not treated.

Watch our video to understand why you are anxious

What are some common triggers that may give rise to anxiety in individuals dealing with social anxiety?

People who suffer from social anxiety frequently experience severe anxiety and suffering in the following situations:

• Eating in front of others
• Being the center of attention when speaking in public
• conversing with strangers
• Having dates
• Getting to know new people
• Looking for another job?
• Leaving for work or school
• Maintaining eye contact
• Making public phone calls
• Making use of public washrooms

What are the signs and symptoms of Social anxiety disorders? 

People dealing with social anxiety may face physical as well as psychological symptoms-

Physical symptoms:  

• Blushing 
• Nausea 
• Excessive sweating 
• Trembling or shaking 
• Difficulty speaking 
• Dizziness or lightheadedness 
• Rapid heart rate

Psychological symptoms:

• Worrying intensely about social situations 
• Worrying for days or weeks before an event 
• Avoiding social situations or trying to blend into the background 
• Worrying about embarrassing yourself in a social situation 
• Worrying that other people will notice that you are stressed or nervous 
• Needing alcohol to face a social situation 
• Missing school or work because of anxiety

How to Diagnose social anxiety disorder?

Look for the signs and symptoms and refer to the diagnostic criteria such as DSM-5 or ICD-10. The criteria for social anxiety disorder include:

• Constant fear of social situations due to fear of humiliation or embarrassment 
• Feeling anxious or panicky before a social interaction 
• A  realization that your fears are unreasonable 
• Anxiety that disrupts daily living 
• The symptoms related to social anxiety disorders must be evident for 6 months and must occur in presence of peers as well and not just adults

According to DSM-5, the patient must have a significant and persistent dread or worry around one or more social settings in which they may be assessed by others. The symptoms must last at least six months. Fear of shame, discomfort, rejection, or offensiveness must be present. In addition, all four of the following elements must be present:

• Almost invariably, the same social settings cause anxiety or panic.
• These scenarios are carefully avoided by the sufferer.
• When typical sociocultural influences are included, the anxiety or panic is out of measure to the real threat.
• Anxiety, dread, and/or aversion create severe suffering or hinder social or professional functioning significantly.

The fourth diagnostic element is that anxiety and dread are more accurately classified as distinct mental diseases, such as agoraphobia or panic disorder.

Onset and etiology

According to the DSM-5, the median age of onset of social anxiety disorder is age 13, with 75% of those with social anxiety disorder experiencing the onset at a range of ages 8-15. The onset can either be insidious, or sudden onset triggered by a specific event (American Psychiatric Association, 2013). It is believed that the causes of social anxiety disorder involve genetic factors- in first-degree relatives; Parent communication, attachment, and parenting styles; Behavioral aspects such as children who have behavioral inhibitions

Prevalence

The prevalence rate of Social anxiety disorder is alarming. 3% to 13% of individuals in the total population are clinically diagnosed with Social anxiety disorder and the majority of cases remain undiagnosed. The prevalence is comparatively slow in children- 1% to 2% and it is found that 27% of children with GAD and 5% of children with separation anxiety disorder have social anxiety disorders. Children dealing with social anxiety disorder are more likely to be depressed later. Children with behavioral inhibitions demonstrate elevated reactions to novel stimuli. Social anxiety disorder is mostly linked with adolescence- peer pressure, peer acceptance, and peer victimization 75% onset between 8-15 years in and is also linked with an increased rate of dropout and decreased quality of life. 

Risk Factors

According to the DSM-5, temperamental characteristics such as anxiety of inadequate social judgment and avoidance are factors that increase the likelihood of social phobia/social anxiety. Child maltreatment, especially peer abuse, is a hazard trigger for social phobia, although its causality cannot be established. There appears to be a hereditary component, yet it is possible that social anxiety is also a taught trait. (2013) (American Psychiatric Association). Obesity has been highlighted as a risk factor in adolescents (ADAA, 2013), since obese adolescents may suffer peer rejection and social anxiety as a learned habit.

Comorbidity

According to the DSM- 5, comorbidity occurs with other anxiety disorders, depression, and drug addiction disorders (American Psychiatric Association, 2013). There may be more anxiety problems. Due to solitude, isolation, and the difficulty to form new social connections, social anxiety and social anxiety can also cause melancholy. Alcohol or drugs may be used by individuals to try and lessen their social anxiety (NIMH,2014).

How to cope with Social anxiety? What are the strategies to deal with social anxiety disorder?

Daily activities might be particularly difficult if you have social anxiety disorder. In social situations, you could have a great deal more self-consciousness and fear than most people do, and you might also have poor self-esteem.

But resist the urge to let fear prevent you from living fully. The disorder of social anxiety can be treated in a number of ways. For help feeling better and getting through the day, try these eight suggestions. Additionally, be aware that some people may require professional assistance to overcome their social anxiety.

In need of a cope-up plan? Consider reading our succinct article on a plan to cope with anxiety.

1. Regulate Your Breathing

Uncomfortable physical changes might be brought on by anxiety. For instance, you could start breathing quickly and shallowly. You may feel even more worried as a result.  You can control your breathing and other anxiety symptoms by using certain strategies. To start, try these:

• Straighten your back and choose a comfortable seat.
• Let your shoulders drop.
• Grasp your chest with one hand and your tummy with the other.
• Inhale gently for four seconds. Your hand on your stomach will rise, whereas the hand on your chest shouldn’t move much.
• Take a deep breath in for two seconds, hold it for six seconds, and then let it out gently.
• Repeat this a few times to induce relaxation.

Check out this informative video on “how to breathe” and try it out!

2. Try Workout or exercise

According to research, engaging in physical activity like running might help you manage your anxiety. Also useful is progressive muscular relaxation. This entails tensing and relaxing certain muscle groups in your body while focusing on the sensation of the release.

You may relax by doing yoga. According to studies, yoga practice for a few weeks at least can help reduce general anxiety.

Read our informative article on effective exercises for mindfulness to lace yourself with new tricks.

Want to know about therapist-recommended meditation, consider watching our video to enrich yourself!

3. Prep in advance

You might feel more secure if you prepare ahead of time for socializing that makes you uncomfortable. Some situations could make you feel want to stay away from them because they give you anxiety. Instead, make an effort to get ready for the future.

4. Take baby steps

Avoid rushing into important social encounters. To get acclimated to dining in public, plan restaurant dinners with friends or family. Make an effort to make eye contact and say hello to folks you meet on the street. As you become comfortable, you can progress to increasingly difficult tasks. Don’t be too hard on yourself. Fighting social anxiety requires patience and practice.

5. Get out of your own way

Instead of focusing on your thoughts, try to pay more attention to what is going on in the world around you. You can do this by paying attention to what is being said or by telling yourself that others probably can’t tell how worried you are just by glancing at them.

6. Respond to unfavorable thoughts

These ideas may even be spontaneous and may be related to certain persons or circumstances. They are typically in error. However, they could make you misinterpret things like facial emotions. You could come to believe that people are thinking things about you that they aren’t because of this.

To do this, you may just use a pen and a piece of paper:

• Consider all the unfavorable ideas you have about certain circumstances.
• Put them on paper.
• Confronting negative ideas with good ones should be written down.

7. Gather and respond to information from your environment

Your senses—sight, hearing, smell, touch, and taste—can help you relax when you’re feeling worried. Use your senses to help you feel comfortable.

8. Seek professional help

Seeing a therapist and taking professional help will help you understand your anxiety better and will result in effective coping. The therapist will help in making your life better by using certain therapeutic interventions and therapies such as ACT, CBT, or an elective approach.

Wish to read more about tips to overcome social anxiety, read our latest article!

Don’t forget to watch this super informative video on how to treat anxiety!

Check out our online course on How to Overcome Social Anxiety & Build Confidence to gain more knowledge and help yourself.

Download free worksheet on Social Anxiety!

Enroll in our Accredited CBT Therapy for Anxiety Online Course

• Cognitive Behavioral Therapy Practitioner (CBT) Udemy Course
• How to overcome excessive worry – CBT guide Udemy Course
• Managing OCD with Mindfulness & CBT Udemy Course
• CBT Counseling with Mindfulness for self-compassion Udemy Course
• CBT for Fear of Abandonment & People leaving you Udemy Course

Download Free worksheet of this article

Read more articles at psychologylearnonline.com