Social Anxiety

What is it?

Social anxiety refers to feelings of anxiety and fear that occur in response to social situations. Even though we all feel a little nervous before a presentation or meeting new people, social anxiety can cause overwhelming feelings of distress and a fear of being unable to cope. This is usually in response to anxiety about being watched while doing something, being the centre of attention, being introduced to new people, talking with people in authority, public speaking, or within an existing friendship group where you might worry about people thinking negatively about you. For some people, the anxiety can be present across a few key situations, and for others the anxiety may be present for most of the time when engaging socially.

What are the signs and symptoms?

Social anxiety is often a persistent worry about saying or doing something that will lead to humiliation, embarrassment, or social rejection. This can lead to a number of compensatory behaviours, negative thoughts and emotions, and physiological responses.

Someone who struggles with social anxiety may begin to avoid situations that cause distress, including social withdrawal, decreased work performance, or limiting eye contact or speaking softly. For some, when faced with social situations that are unavoidable, they might use alcohol or nicotine to cope with the experience. These are compensatory behaviours that are intended to decrease the likelihood of negative evaluation from others.

Often social anxiety can lead to negative self-evaluation, including rumination about past social situations or fear of upcoming situations where you feel you are likely to be judged or criticised by others. More often than not, the negative criticism is self-inflicted due to feeling inadequate, embarrassed, or worried about something you said or did. This can lead to feeling sad or depressed, particularly with increased social withdrawal. Over time, social situations cause anxiety but also low mood and depression.

Social anxiety can cause a physiological fear response like that which we experience when facing real danger. This can include:

  • Heart palpitations, increased heart rate, or pounding heartbeat
  • Sweating, trembling, shaking, numbness or a tingling sensation
  • Shortness of breath, heavy pressure or tightness in your chest
  • Lightheadedness, dizziness, feeling faint, tunnel vision or foggy feeling
  • Nausea
  • Dry throat, mouth, difficulty swallowing, talking or eating
  • Blushing, hot and cold chilss

How do we treat Social Anxiety?

Research in the area has indicated that medications and psychological treatment, particularly Cognitive Behavioural Therapy (CBT) is highly effective in treating and managing the symptoms of social phobia. Working with a psychologist, the key components of CBT for social phobia involve providing you with tools to understand and manage your experience of social anxiety. Some of these tools include relaxation training, and strategies to help you identify your triggers for social anxiety and learning and developing more adaptive interpretations of social situations. Treatment for social phobia also incorporates exposure to a variety of social situations with varying degrees of difficulty, to enable you to face your fears, and social skills training to help you gain confidence in social situations.


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