Coming to Grips With Social Anxiety: Causes and Treatment

The last few years of social distancing have probably left most of us feeling out of sorts and a bit rusty when it comes to social interaction. It’s not uncommon to feel a bit of social anxiety when leaving the house or when interacting with large crowds of people.
Even without the pandemic to consider, it’s normal to feel a little nervous in social situations such as going on a date, an important job interview, or giving a public speech. That anxiety isn’t all bad, as it can help you focus and work hard. However, if those nervous feelings persist and take away from your enjoyment of day-to-day activities, then you might be dealing with social phobia or a social anxiety disorder.
Social anxiety or social phobia is more than simply feeling shy or a little nervous around people. When a person has social anxiety disorder, it makes everyday interactions such as meeting new people, attending social gatherings, and daily routines such as work or school anxiety-ridden experiences and sources of embarrassment. This extreme fear of social settings means that one feels like they are on stage and being scrutinized, making one feel very self-conscious.
Social anxiety can kick in during various situations where one may feel they are being observed by others, such as when they are eating in front of others, public speaking, using a public restroom, entering a room late to find others already seated, or being in a classroom or meeting with others.
It may also be present in situations of interactions with others such as expressing one’s opinions in a conversation, speaking on the phone, meeting strangers, working on a group project, making a return at the store, or while dating.

How does social anxiety affect a person?

When it becomes a serious enough problem to be called a disorder, social anxiety can have a wide-ranging impact on a person’s life, causing distress in many areas such as at work and school, in relationships, and in daily activities.
Regarding work and school, it can create difficulties by decreasing enjoyment in those areas. It can make job interviews nerve-wracking. Anxiety can make asking questions or expressing oneself feel troublesome. It can diminish opportunities because of avoiding certain career paths that would otherwise be open.
In relationships, making and maintaining relationships is more complicated with anxiety. In one’s daily life it can make tasks such as grocery shopping, asking for directions or eating out quite difficult. With social anxiety, it is very hard to try new things and expose yourself to new experiences, which means that life becomes somewhat limited in the things you can do.

What causes social anxiety?

It is not entirely understood what causes social anxiety, but there are several possibilities. Social anxiety disorder typically comes on around 13 years of age, though it can start in younger children or in adults. Research suggests that it is caused by the combination of one’s environment and experiences.
Anxiety disorders can sometimes tend to run in families. Whether this is due to genetics or through learned behavior is unclear. If one is raised in an overprotective or controlling environment, or experiences emotional trauma, those experiences could also contribute to the development of anxiety disorders.
Biologically, if one has physical abnormalities such as an overactive amygdala, the structure in the brain that plays a significant role in how we respond to fear, one may develop an anxiety disorder. Additionally, an imbalance in one’s levels of serotonin, the neurochemical that helps to regulate our moods can also have an impact on social anxiety.
Negative experiences such as family conflict, bullying, sexual and emotional abuse, as well as developing a health condition that draws attention to one’s voice or appearance, can trigger social anxiety. If one has negative experiences that one deals with through avoidance, that can reinforce patterns of thought and behavior that increase anxiety in those circumstances in the future.

Signs of social anxiety

All of us will find ourselves in situations where we feel a bit shy or embarrassed, but that doesn’t necessarily mean a social anxiety disorder or social phobia is at work. This is especially the case with younger children, who often are shy in new environments or around people with whom they are not familiar.
Because of our different personalities, some people will thrive and relish social situations, while others are a little more reserved. But social anxiety goes beyond shyness and being reserved.
To discern social anxiety, one needs to look out for telltale signs and avoidance of certain anxiety-inducing situations that interfere with one’s life. Some things to look out for include emotional, physical, and behavioral signs like the following:

Fear of interacting with strangers

• Avoiding doing things for fear of embarrassment, including avoiding situations where you might be the center of attention
• Blushing, sweating, upset stomach, muscle tension, feeling like your mind is blank, shaky voice, dry mouth, nausea, dizziness
• Concern over these physical signs of anxiety being seen by others

Spend time doing a ‘post-mortem’ of your performance.

• Try to identify the flaws in your interactions with others after a social situation.

Fear of situations with the possibility of being judged negatively

• Focus on your ‘performance’ during social situations, and being overly concerned about how others will react to you.
• Avoiding or escaping social situations by engaging in protective behaviors such as staying quiet, drinking alcohol, or avoiding eye contact to try and feel safe.

Treatment options

The outlook for social anxiety is good. That is because there are several treatment options available, including self-help methods, therapy, and medication.
With self-help, it is possible to reduce the symptoms of anxiety. Some of the things you can do to deal with anxiety include:

• Taking steps to understand your anxiety better, including what your triggers are and how you tend to react to them. Journaling can help you keep track of such things.
• In moments of anxiety, focus on what is being said rather than assuming the worst or focusing on your performance in the situation. Be present in the moment, with your attention firmly on the other person.
• Relaxation techniques such as breathing exercises can help you deal with anxiety and stress, and it also helps to break things down into small tasks so that you don’t feel overwhelmed.
• Avoid caffeine, as foods such as coffee, chocolate, and carbonated sugary drinks are stimulants and may increase your anxiety.
• Get plenty of good sleep, at least eight hours of sleep per night, because lack of sleep can increase anxiety and worsen the symptoms of social phobia.

In addition to these self-help methods, you can also seek out professional treatment for social anxiety. To be diagnosed with social anxiety disorder, your healthcare provider or doctor will ask about your symptoms and how you react in social situations.

Some of the criteria used to diagnose social anxiety disorder include anxiety that disrupts daily activities and living, recognition that the fears attached to your anxiety are unreasonable, and persistent fear of social situations.
If you are diagnosed with social anxiety disorder, several treatment options are available, including cognitive behavioral therapy, which helps you pick up on negative and unhelpful patterns of thinking, and replace those with positive ones. Exposure therapy gradually exposes you to the social situations you typically fear and helps you to face instead of avoiding them.
Doing therapy as part of a group will also allow you to interact with others who have similar struggles. This form of treatment not only helps you to feel less isolated but also gives you an opportunity to practice interacting with others.
Your doctor may also prescribe medications, and those could potentially include Luvox, Paxil, Zoloft, or Effexor. Medications such as these do not cure social anxiety disorder, but they are designed to help reduce your symptoms of anxiety, and they can also help you to function more fully in your daily life.
Your doctor will adjust the dosage to have maximum efficacy and minimal side effects, but the medication requires you to stick with it and be consistent as it can take several months for the medication to improve your symptoms.
God created us human beings as social creatures, and it can be particularly painful to feel isolated from others and find social interactions challenging and a source of fear. There are options available, and if you or a loved one struggle with social anxiety, it is important that you seek help for it so that the symptoms do not worsen, and you can begin work on managing your symptoms.