Social Anxiety

Social Anxiety Disorder is an intense fear of social situations that could result in negative judgments by other people. Situations that may cause anxiety for people with this disorder include meeting new people, starting a conversation, and eating or drinking in front of others. While many people feel worried in some social situations, when someone has Social Anxiety Disorder, the anxiety is very strong, and may lead to avoiding situations that cause anxiety, or experiencing very high anxiety during them. Often after a social situation has ended, a person with Social Anxiety Disorder will replay the situation over and over in their minds, thinking about all the possible ways they might have embarrassed themselves.

Other common situations that people with Social Anxiety Disorder may find difficult include:

• Being the centre of attention
• Being assertive
• Being watched by others
• Dealing with people in authority
• Calling someone who isn’t known to the person
• Speaking up at a meeting
• Entering a room when others are already seated.

Causes

Genetics and temperament

Anxiety disorders, including Social Anxiety Disorder, tend to run in families. It is unclear how much is due to genetics and how much is due to learning from observing other family members. Children who are born with a shy and timid personality style or temperament appear to be more likely to develop Social Anxiety Disorder.

Parental factors

Parents who have Social Anxiety Disorder themselves are more likely to have children who develop this disorder, through their child observing their parents’ anxiety in social situations, and learning from it. Parenting styles that are controlling and overprotective have been linked to Social Anxiety Disorder in their children.

Thinking (cognitive) style

Certain styles of thinking have been linked with social anxiety disorder. A “looming” cognitive (or thinking) style is a tendency to think about and pay attention to thoughts about upcoming dangers and risks. This thinking style has been linked with Social Anxiety Disorder. People with Social Anxiety Disorder also tend to interpret social information, such as others’ responses to them, in negative ways, and frequently think about what others think of them.

Learning experiences and negative life events

Children who experience bullying and rejection by other children their age are at more risk of developing Social Anxiety Disorder. Sometimes social anxiety disorder will develop in adolescents after a particularly embarrassing event.

Seeking help

If you experience high anxiety in social situations and the anxiety is significantly affecting your life, there are effective treatments available. You can seek help at:

Your GP. Your GP can refer you to a mental health professional, such as a psychologist or psychiatrist. Your GP is the best person to start with when looking for effective treatment for Social Anxiety Disorder.

Like all anxiety disorders, Social Anxiety Disorder is highly treatable.

Treatment

Psychological therapies

People with anxiety disorders, including Social Anxiety Disorder, should be offered psychological therapies first, before medication. Cognitive behaviour therapy (CBT) has been developed to treat anxiety disorders, including Social Anxiety Disorder. CBT is a practical treatment, and involves teaching practical skills to deal with anxiety symptoms. CBT focuses on understanding the thoughts, feelings, and behaviours that keep anxiety going, and strategies to gain more control over symptoms. Often people with Social Anxiety Disorder will avoid situations they fear, or do things when in those situations to try to reduce their anxiety, such as trying to make sure they don’t say anything embarrassing. However, these strategies often lead to increased anxiety and “social mistakes”, making the anxiety worse. CBT helps people to begin to change these behaviours, and reduce their anxiety.

Online treatment programs for some anxiety disorders, including Social Anxiety Disorder, have recently been developed. Online treatment programs are based on CBT. Online treatment programs may involve some contact with a therapist over the Internet.

Medication

A type of anti-depressant medication known as selective serotonin reuptake inhibitors (SSRI) has been found to be effective in treating Social Anxiety Disorder over the short-term and the long-term. Your GP or psychiatrist will need to prescribe this medication to you.

How family and friends can help

• Avoid telling the person with Social Anxiety Disorder to just “snap out of it” or to get over it
• Try to understand what situations the person with this disorder finds difficult
• Remember that although you might not find the situation hard, for the person with Social Anxiety Disorder, the fear of a particular social situation can be extremely intense
• Encourage the person to seek professional treatment, and to persist with it

⬇️ Download this information as a fact sheet

Have a look at WayAhead’s Understanding Anxiety website

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