The ABCs of Dealing with Social Anxiety

Have you ever felt an intense fear of:

• Being judged?
• Making a mistake or embarrassing yourself?
• People looking at you or scrutinizing you?
• Specific situations, like ordering at a restaurant or talking in front of a crowd?

Then you’ve experienced some degree of social anxiety.

What is social anxiety?

There are 3 important things to understand about social anxiety.

1. Social anxiety is more nuanced and challenging than shyness.

Shyness is usually short-term and isn’t seriously disruptive to your life. Social anxiety is persistent and debilitating.

Social anxiety disorder can cause:

• Emotional symptoms, like excessive worrying and panic attacks
• Physical symptoms, like sweating, a rapid heartbeat, and nausea
• Feelings of judgment and shame from others, which are usually unfounded

All of these symptoms can affect your ability to lead a normal life of school, work, and developing close friendships.

2. Social anxiety happens on a spectrum. 

You can experience low, moderate, or severe levels of discomfort in regular, everyday social situations. 

3. It’s important not to ignore social anxiety.

According to the National Institute of Mental Health (NIMH), Social anxiety disorder usually starts during youth in people who are extremely shy. Social anxiety disorder is not uncommon; research suggests that about 7 percent of Americans are affected. Without treatment, social anxiety disorder can last for many years or a lifetime and prevent a person from reaching his or her full potential. 

According to the Anxiety and Depression Association of America (ADAA) approximately 15 million American adults have social anxiety disorder. Symptoms of this disorder may start around the age of 13.

Is social anxiety common among teens?

Although you may feel like you’re the only one who experiences social anxiety, it’s actually quite common.Teen anxiety is a rising problem. The National Institute of Mental Health (NIMH) reports that nearly 32 percent of all U.S. teens have suffered from an anxiety disorder in the last year. In addition, adolescent girls (38 percent) are more likely to develop anxiety disorders than adolescent boys (26 percent).

Anxiety can be made worse when adding in external pressures like academic pressure, constant exposure to negative events on the news, and social media.

When it comes to teen anxiety, it’s important to get help early. It’s not necessarily “just a phase.” If left untreated, it could lead to co-occurring disorders, including substance abuse.

A mental health professional can teach you about tools and techniques to manage your anxiety.

What is social anxiety disorder?

Social anxiety disorder, also called social phobia, is characterized by a fear of being around others. People with social anxiety disorder have trouble with things like:

• Talking to people
• Meeting new people
• Attending social gatherings

Normal social situations become difficult when you have an intense fear of being judged or scrutinized by those around you. Even if you understand that your fears are irrational or unreasonable, you may still feel powerless to overcome them.

If you’ve felt an extreme fear in social situations, you also aren’t alone: more than 15 million Americans suffer from social anxiety disorder. 

Those with social anxiety disorder experience symptoms that interfere with their daily lives:

• Strong physiological stress responses
• Paralyzing fears
• Frequent avoidance of social interactions of all types

The good thing is, social anxiety disorder is highly treatable! With the help of mental health professionals and a supportive social circle, those with social anxiety disorder can gradually work toward living a normal, high-functioning life.

What are the symptoms of social anxiety disorder?

Those who suffer from social anxiety disorder may experience the following symptoms in social situations:

Physical symptoms

Blushing

Nausea

Excessive sweating

Trembling or shaking

Difficulty speaking

Dizziness or lightheadedness

Rapid heart rate

Muscle tension

Feeling that your mind has gone blank

Psychological symptoms

Worrying intensely about social situations

Worrying for days or weeks before an event

Avoiding social situations or trying to blend into the background if you must attend

Worrying about embarrassing yourself in a social situation

Worrying that other people will notice you are stressed or nervous

Needing alcohol to face a social situation

Missing school or work because of anxiety

Behavioral symptoms

Engaging in safety behaviors that limit your experience of a situation (e.g., avoiding eye contact)

Leaving a feared social or performance situation (e.g., hiding in the restroom during a party)

Avoiding all social or performance-related situations (e.g., dropping a class to avoid giving presentations)

Self-medicating through alcohol or drugs

Social anxiety disorder symptoms can change over time. If you’re under a lot of intense pressure, such as during the college application process, your symptoms may flare up.

For those with a milder case of social anxiety, symptoms may only occur in certain situations. For example, you may only feel lightheaded while shopping in a crowded mall, or you may avoid eye contact while eating in public.

Symptoms can occur in all social settings if you have an extreme case.

What causes social anxiety disorder?

The jury is still out on what causes social anxiety disorder. However, experts believe that it’s caused by a combination of nature and nurture factors.

Environmental factors

Environment. Social anxiety disorder may be a learned behavior. Some people may develop social anxiety after a particularly unpleasant or embarrassing social situation. Also, you may develop anxiety if you have parents who exhibited anxious behavior in social situations, or who were more controlling or overprotective when you were a child.

Negative childhood experiences. If you were teased, bullied, rejected, ridiculed, abused, or humiliated as a child, you may be more prone to developing social anxiety disorder.

Temperament. Children who are shy, timid, withdrawn or restrained when facing new situations or people may be at greater risk.

New social or work demands. Social anxiety disorder symptoms typically set in around adolescence. However, if you’re meeting new people, giving a speech in public or making an important work presentation, it may trigger social anxiety symptoms for the first time.

Having an appearance or condition that draws attention. For example, being unusually tall or having a speech disorder can make you feel extra self-conscious, and may trigger social anxiety disorder.

Biological factors

Family history. Anxiety disorders tend to run in families. However, it isn’t clear how much of this may be due to genetics and how much is due to learned behavior.

Brain structure. A structure in the brain called the amygdala plays a role in controlling our fear response. An overactive amygdala is more sensitive, leading to heightened fear responses, and causing more anxiety in social situations.

Moreover, traumatic experiences may contribute to the worsening of social anxiety disorder, including:

• Bullying
• Family conflict
• Sexual abuse

How is social anxiety disorder diagnosed?

There are no medical tests to check for social anxiety disorder. Depending on your symptoms and behavioral patterns, your doctor may diagnose social anxiety disorder. In general, your symptoms and behaviors must align with the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

• A constant fear of social situations for fear of being scrutinized, humiliated, or rejected
• Feeling fearful and anxious in any social situation
• Fear, panic, and anxiety that is out of proportion to the actual threat posed by the social situation
• Avoiding social situations entirely, to the point of impairing your daily functioning
• Fear, anxiety, or avoidance that lasts for 6 months or longer

How can I overcome social anxiety?

Luckily, social anxiety disorder is very treatable. Some people only need one type of treatment to manage their anxiety, while others may need to use a combination of techniques. Your doctor may refer you to a mental health professional for treatment. If your symptoms are especially debilitating, your doctor may suggest medication.

You may feel better if you try a variety of treatment options:

Change your diet

Coffee, chocolate, and soda are stimulants, and may increase anxiety. 

Try adding anxiety-busting foods that are high in magnesium (leafy greens, nuts, and seeds), zinc (cashews, oyster, and egg yolks), and omega-3s (wild Alaskan salmon).

Get enough sleep

Researchers have found that the relationship between sleep problems and anxiety is bidirectional: Sleep problems can cause anxiety, and anxiety can prevent you from falling asleep.

​And just like anxiety, sleep problems can impact how you function emotionally, mentally, and physically.

Keep a diary

When you check in with yourself regularly, you’ll begin to notice recurring patterns.

​Everyone experiences anxiety differently; some people feel especially anxious in the morning, while others may feel more anxious after missing a few workout sessions. Journaling helps you understand your triggers, cognitive distortions, and self-talk habits.

Be aware of cognitive distortions

Cognitive distortions give rise to destructive thinking patterns. 

They cause you to take things personally, focus too much on the negative aspects of a situation, and expect the worst.

Practice positive self-talk

Self-talk is your inner dialogue. When you have social anxiety, you tend to experience more negative self-talk.

To break the cycle of anxiety, try to train your mind to shift to positive self-talk.

Here’s an example of negative self-talk:

“I don’t want to learn how to skateboard because I know I’ll be bad at it.” 

And here’s an example of positive self-talk:

“This is an awesome opportunity for me to build a new skill and get some exercise.”

Focus on self-care

It’s easy to let self-care fall by the wayside, especially if your schedule is stacked with classes and extracurriculars. Think of daily self-care as a proactive way to manage your social anxiety. By keeping your “social battery” above 0%, you’ll be better-equipped to deal with normal social situations.

Try therapy

Cognitive behavioral therapy addresses negative patterns and distortions in the way we look at the world and ourselves. 

Exposure therapy helps you gradually face social situations, rather than avoiding them. 

Group therapy helps you learn social skills in a safe setting—among other people who also have social anxiety. It can help you feel less alone.

Closing Thoughts

The most important thing to remember is to get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.

The good news is that anxiety is totally treatable! Self-awareness, therapy, and medication can help you cope with your anxiety during social situations. It may take some time, but with regular treatment, you’ll begin to feel calmer and more confident during social interactions.