May people may feel anxious about different social situations, such as going to university for the first day or meeting for a job interview. These feelings of worry are transient and subside during or after the stressful social situation.
Social anxiety disorder is among the most common mental disorders. A person who suffers social anxiety disorder experiences continuous, excessive and unreasonable fear of being criticized and watched by others. As a result, this person ends up in social isolation and his daily routine will be severely impaired, including his school, work, social skills, and relationships.
1. What does social anxiety disorder feel like?
The diagnosis of social anxiety disorder is confirmed after a persistent fear, anxiety, and avoidance of social situations.
- Dreading every social activity, such as meeting strangers, talking in public, talking over the phone, working, shopping, and socializing
- Low self esteem
- Insecurity about relationships
- Fear of being criticized
- Avoiding eye contact
- The anxiety is associated with rapid heart rate, sweating, blushing, dry mouth, trembling, and muscle twitching
- The person is aware that their fears are not reasonable and excessive. S/He long to make friends and socialize, but perceives social situations to be dreadful.
2. What puts a person at risk of developing social anxiety disorder?
- Genetics; social anxiety disorder runs in families
- Changes in brain chemistry; as in different anxiety disorders, there is over-activity in the danger-sensing zone of the brain, called locus ceruleus, which stimulates the amygdala, the region of the brain that is responsible for controlling thinking and emotions. As a result, the physical symptoms are initiated.
- Having parents who are over protective, not affectionate, criticizing and over-judgmental, over-emphasizing manner and grooming, and exaggerating the danger of approaching strangers.
The use and withdrawal of drugs, alcohol, or nicotine may worsen the symptoms of anxiety
3. What are the treatment modalities at LWHCC for social anxiety disorder?
- Psychotherapy plays a important role in the treatment of social anxiety disorder. Psychotherapy will help you understand your illness and guide you into coping with the symptoms. It aims at modifying your thinking process and provides techniques that help you control your behaviors and emotional responses. One “side effect” of psychotherapy is temporary discomfort during behavior modification sessions. The psychotherapist will help you through this process to keep discomfort to a minimum level, and will provide you with a safe environment.
- Antidepressants, which are usually prescribed when patients have been suffering with social anxiety disorder and interfering with daily activities and when the client excepts an improvement before he/she could concentrate on therapy. You may start sleep better and feel less anxious after a few days of starting antidepressants, but your overall improvement will probably not show until 2-4 weeks later.
- Benzodiazepines, which are used with extreme caution, since they may develop dependency. These medications are strictly for short-term use and acute anxiety relief.
- Beta- Blockers, which are usually prescribed for use when needed to relieve symptoms such as racing heart rate, sweating, and shaking voice and limbs.
Which treatment modality is better for me?
At LWHCC, we will provide you with free triage service with a professional mental health nurse who will carry on a brief mental health assessment, either over the phone or during a face-to-face interview, and guide you to the appropriate service based on your mental health status and individual needs.
4. What can you do to help yourself?
- Overcoming social anxiety is a process that takes time and efforts. Take it one step at a time
- Challenge your negative thoughts, which underlie your social anxiety. It may help you to write them down and analyze each thought
- Focusing on yourself and your anxiety in social situations will only worsen your anxiety. Remember that your anxiety is not as visible to others as you think. Try to focus on others and actually listen to them
- Learn how to breathe. Take a deep breath through your nose and keep it in for four seconds, hold it for 2 seconds, and then release your breath slowly over 6 seconds
- Face your fears gradually. For example, if you are anxious about being around strangers, accompany a friend/ close person to a party or gathering. Once you are comfortable with this step, you might try introducing yourself to a stranger.
- Limit caffeine
- Avoid alcohol and drugs
- Get enough sleep
- Quit smoking
- Follow your treatment plan, including psychotherapy sessions
5. What can you do to help a close one who has social anxiety disorder?
Social anxiety disorder develops over years, and it may be long before it is diagnosed. During this time, you may have developed habits to help your close one in anxiety provoking situations. For example, you may have developed a habit of avoiding certain places or talking on your close one’s behalf in public.
- Learn about social anxiety disorder. You may want to discuss your concerns with the patient’s mental health team. Please do not hesitate to contact us any time you have a question.
- Empathize with your spouse/ relative
- Do not criticize irrational fears; rather show positive reinforcement of positive behaviors
- Encourage treatment
- Listen to their fears and worries. Do not assume that you know their thoughts or needs
- Ask how you can help
- Gradually help your close one face their fears. For example, if they want to run away from a social gathering, ask them to stay for few more minutes. Praise their progress
- Measure your close one’s progress based on their own improvement rather than absolute standards.
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