Social Anxiety Disorder

According to the Statistical Manual of Mental Disorders, DSM-5, Social Anxiety Disorder consists of fear and anxiety about a future threat and the emotional response to a real or perceived threat. Social anxiety disorder is the most prevalent anxiety disorder. It occurs when the person is exposed to possible scrutiny by others in social situations when meeting unfamiliar people and performing in front of others. As a result, the person fears being humiliated or embarrassed, leading to rejection or offending others.

In many cases, social situations are handled with intense fear or anxiety or by simply avoiding the situation through isolation and distancing themselves. This fear or anxiety is inconsistent or out of proportion to the actual threat posed by the social situation. Nevertheless, it is persistent and causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The person may even hear a little voice telling them they have false deficiencies, which feeds into their feelings of inferiority and incompetence. I have told my previous patients to say to that voice to stop and “shut up”!

In teaching college classes in psychology, I encountered some students avoiding certain classes where they would be required to speak in front of the class. They avoided the situation even when the requirement to graduate was taking a speech class, and they would postpone that class until the final semester just before graduation.

Social anxiety can easily be observed in the cafeteria and on the playground. These are the kids that are not with other students staying hidden from the attention of others. Granted, there are cliques in social situations, but to see someone isolate themselves like this is sad and painful.

Using cognitive-behavioral therapy, a psychologist can change how a person perceives the situation by not putting so much pressure on themselves. However, one needs to find a method that works for them. Overlearning material to be presented in front of a class helps, as does practicing in front of a mirror. Feedback from a friend or family member on a presentation is also helpful.

Learning social communication skills in introducing oneself to another can be helpful. For example, just extending one’s hand and telling someone their name is helpful. Perhaps extending their hand to someone in their class, introducing themselves, and talking about the class is another method. Finding a common theme helps communication, especially with someone with similar interests.

If the situation does not go “right,” “brush yourself off and start all over again,” as practice does make it better. I remember a graduate student in psychology who had the problem of asking a girl out on a date because he was concerned with failure, but with practice, he got that date! A therapist can help one gain confidence also.

The organization Toastmasters helps people with social anxiety because the members are required to give a speech in front of the group once a week. Initially, it is very difficult, but it becomes less and less stressful and has been shown to help social phobia.

I also spoke with a friend, and she said her job forced her to overcome this anxiety by talking one-on-one with customers. As a result, she said it got easier over time, and she gained confidence going forward.

It can be difficult at first, but trying to overcome this fear can relieve stress. And remember, you are not alone!