Social anxiety

1. Social Anxiety Disorder (SAD)

Social anxiety disorder is characterized by extreme fear of social situations, including public speaking, meeting new people, eating out, shopping, and being observed by others. People who have SAD often avoid these situations and may even feel anxious before they occur. Social anxiety disorder affects about 1% of adults in the United States.

2. Social phobia

A person with social phobia experiences intense anxiety in social situations. He or she may experience panic attacks, sweating, trembling, shortness of breath, nausea, dizziness, or feeling faint. These symptoms may make him or her want to escape from the situation.

What helps???

Practice public speaking

For those who have mild-to-moderate social anxiety disorder — for example, maybe it’s not causing you panic attacks — finding ways to practice public speaking is a good approach. Dr. Potter suggests joining a group such as Toastmasters, which is for specifically practicing public speaking and rehearsing.

Try cognitive behavioral therapy

Among the different kinds of psychotherapy available, cognitive behavioral therapy — which involves making changes to the way you think and feel about a situation, which, in turn, can help you modify your behavior — is a helpful way to approach social anxiety. “With social anxiety specifically, you want to identify patterns of thinking that cause you to avoid social situations — like if a person’s always expecting the worst outcome, or a person is fixated on the fact that someone might see them blushing, or sweating or stammering,” says Dr. Potter. “You want to help them learn to challenge those expectations and adopt more positive self-talk rather than negative self-talk.”

Gradually introduce yourself to anxiety-inducing situations

Dr. Potter recommends what she calls “situational exposure.” Identify certain social situations you’re afraid of, and work your way up from easier to more difficult scenarios while practicing relaxation techniques so you can tolerate anxiety. “For example, if you have a fear of large groups, and you’ve been mostly avoiding group activities, start by going out with a friend one on one,” she explains. “Then work your way up to going out with a small group of friends.” Repeat as needed until you feel more comfortable before attempting to go to a restaurant, a bar or a party where there would be more people. You can also work on situational exposure with the support of a therapist, Dr. Potter says. “Like cognitive behavioral therapy, exposure therapy is a type of treatment a trained psychologist can provide.”

Ask your support system for a helping hand

It can be embarrassing or humbling to admit to people in your life that you’re anxious in social situations and might need help. However, letting a friend or loved one know you might need some extra support can be a major boost. “Many times, people are going to feel more comfortable if they’re in a social situation with somebody that they’re close to,” Dr. Potter says. “Especially if somebody has been fairly isolated in recent times, it can be helpful at first to have a buddy when you go back into a social situation.”

The key to this support is helping an anxious person become more independent over time. “Eventually, people with more generalized social anxiety will find it uncomfortable to go shopping or order food by themselves,” Dr. Potter explains. “You want to balance supporting a person and encouraging them to do it themselves.”

If you’re a friend or family member of somebody anxious in social situations, one way to offer support is to bring them into the conversation. “You might be like, ‘Oh, I think Sara has something she would probably like to say on that subject. She’s really interested in that,’” Dr. Potter says. “You can support them by bringing them out of their shells.” Before doing that, however, be sure to ask the person if that’s OK. “If you’re a person with social anxiety, you may not like being put on the spot to say something. Talk to that person in advance about how they want to handle certain things.”

Check in with yourself

When you’re out in public and start feeling anxious, it’s easy to spiral and become fixated on everything that appears to be going wrong, even if you’re the only one feeling that way. “In the moment, you need to focus outside of yourself and remind yourself, ‘This is probably anxiety. I can’t read their mind. I do not know what they’re actually thinking of me,’” Dr. Potter says.

This is easier said than done, of course, so she suggests using a technique called “five senses” that can help you regain perspective and stay in the moment. “Do a check-in with yourself of all of your five senses to get yourself more externally focused. Distract yourself from unpleasant internal sensations and negative thoughts,” says Dr. Potter. “Then you can try to refocus on: ‘What are they actually saying to me? What else is going on right now? What can I see? What can I hear? What can I feel?’”

Look for silver linings — and be kind to yourself

If your social anxiety isn’t going away as fast as you’d like, that’s perfectly normal. “It might be that you moved too fast and need to spend more time practicing other social encounters before you’re up for the one you’re stuck on, or you need to work more on relaxation techniques and distraction techniques so you can tolerate that situation next time,” says Dr. Potter.

Analyzing after the fact what triggered a reaction, whether a panic attack or something else, can also help. “Try to break down, ‘How can I think about that differently?’ or ‘How can I change the situation next time?’” Dr. Potter suggests. “Let’s say you go to a concert and start to have a panic attack because you’re enclosed in by a lot of people. Maybe next time, you might sit in the back or on an aisle, or stay somewhere where you feel like there’s an exit route if you feel anxious or closed-in.”
Dr. Potter adds that other people are generally way more focused on themselves than they are on others. “They are most likely not scrutinizing your behavior in social situations, because they are busy thinking about what they are going to say or do next,” she says. “Your anxiety usually magnifies the negative and minimizes the positive — so the things you’re acutely aware of about yourself may not be particularly noticeable to others.”