Beyond Shyness: When Social Anxiety Threatens to Take Over Your Life

Shyness… or social anxiety? Until recently, these terms were used interchangeably. It was thought that most socially awkward people had quirks that could be overcome with individual effort; otherwise, they were just “unfriendly,” with no interest in normal social activity.

Today, however, researchers in psychology and neuroscience recognize social anxiety as a disorder that can affect a person’s behavior and interactions. It’s also more common than once thought – in fact, it’s the 3^rd most common psychiatric disorder in America.

So, what is the difference between normal shyness and being socially anxious, and what can you do about it? The issue poses many problems, but just as many solutions.

What is Social Anxiety?

People experiencing social anxiety are uncomfortable in situations where they feel they’re being evaluated; they worry about being judged or embarrassing themselves.

Without help, a socially anxious person may have trouble being assertive, as well as low self-esteem, underdeveloped social skills, and hypersensitivity to criticism. As a result, they may do poorly at work and school and struggle with forging relationships; they are also at higher risk for substance abuse, alcoholism, and suicide.

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Socially anxious people tend to stick closely to a daily routine and avoid interacting with strangers. Like most people, they have friends and loved ones; however, these connections are much harder to make and maintain.

When forced into a new or unfamiliar situation, socially anxious people may begin shaking, blushing, or sweating uncontrollably; they can even experience arrhythmia or panic attacks. Others show no external symptoms – outwardly calm, but inwardly nervous. They may rely on coping mechanisms instead, like drinking, smoking, flirting, or overeating.

Causes of Social Anxiety

Many different factors can contribute to social anxiety. Some cases are inherited. Often individuals with social anxiety have family members who also have some level of anxiety. Because of this, it is quite common for some anxiety symptoms to be learned from other family members making often difficult to determine if the symptoms are organic or modeled in the environment.

Brain chemistry also plays a role.

For some, anxiety is triggered by low levels of the neurotransmitter serotonin which helps to regulate mood and emotions. Without serotonin, our brains cannot respond normally to social situations, causing us to feel confused and stressed.

Serotonin imbalance is also linked to mood disorders such as depression and bipolar disorder, which have many of the same symptoms as social anxiety; in fact, many people suffer from a combination of these disorders.

Finally, in the brain, a structure in the brain called the amygdala (uh-MIG-duh-luh) can play a role in controlling the fear response. People who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations.

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Though social anxiety usually manifests during the teen years, it can also develop later in life if an individual experiences a negative or traumatic event. For instance, those who experience teasing and bullying or types of rejection and humiliation may be more prone to social anxiety disorder. Family discord or sexual abuse are also strongly associated with developing social anxiety disorder.

Treatments Available

Though social anxiety has long gone unrecognized, it can now be managed with a number of different treatments.

Medication

Anxiety medications help people feel relaxed and calm, so they have the clarity of thought to challenge their unrealistic fears. Patients can now take anti-anxiety medications to restore their serotonin balance, such as Zoloft and Prozac; people with mild symptoms, meanwhile, can take beta blockers to suppress the physical effects of nervousness (like blushing, sweating, and shaking).

These drugs do have a number of serious side effects, such as headaches, nausea, insomnia, and mood swings. Zoloft, meanwhile, has been linked with a number of sexual problems, including diminished sex drive and erectile dysfunction. Benzodiazepines and antihistamines are also very common medication treatments that may help treat social anxiety.

As with any medication, consult a doctor and obtain a prescription before using them.

Therapy

Others respond better to therapy and life coaching, which allows them to practice normal social interaction without the fear of criticism or rejection.

With a psychologist’s help, patients can identify past experiences that may have contributed to their condition, giving them closure; they can also learn helpful stress management techniques through Cognitive Behavioral Therapy (or CBT). In this treatment, patients learn to challenge their negative thinking, face their fears and change their lifestyle. They engage in many new social situations, gradually gaining self-confidence and sociability.

A patient who is extremely nervous around women, for example, may start by creating a profile on a dating website or having dinner in public with a close female friend; with time and effort, they may be expected to ask out someone who they’re secretly attracted to.

These treatments can also be supplemented with medication, depending on your needs and symptoms.

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With the help of medication and therapy, most socially anxious people can easily manage their symptoms and lead happy, healthy, productive lives; however, they are never completely “cured.” Even after years of therapy, a socially anxious person may sometimes feel overwhelmed, suffering from “off” days or caving under especially stressful circumstances.

With a supportive network of friends and family, however, they can keep these setbacks to a minimum and take control of their social lives.

The Takeaway

Social anxiety can impact your life in many ways; it can limit your opportunities, place strain on your personal relationships, and negatively affect your self-image. However, with strength, dedication, and a little extra help, a person can transform this into a positive experience. They will truly appreciate the benefits of socialization and friendship and gain sympathy and sensitivity to the social needs of others.

Being socially anxious can be serious and life-changing, but for the millions of people which it affects, the outlook has never been better.

Concerned that you or a loved one might have social anxiety? You can start by taking a survey like this one, offered by the Anxiety and Depression Association of America (ADAA). If you are experiencing symptoms or would like to learn more about it, discuss it with your doctor – he or she may be able to recommend medication, therapists, or other treatments.

This article was reviewed and approved by Dr. Kimberly Williams.

Sources

1. “Prozac.” emedicinehealth.com.
2.  “Social Anxiety Disorder (Social Phobia).” Mayo Clinic. mayoclinic.com. 23 August 2011.
3. “Social Anxiety Disorder.” Web MD. webmd.com.
4. “Zoloft (Sertraline).” emedicinehealth.com.
5. Cleland, Sue. “Living with Social Anxiety Disorder.” Anxiety Disorders Association of Victoria. adavic.org. 2003.

Photo by seanmcgrath