What is Social Anxiety: Definition Symptoms, Treatment, and differences with Shyness. Social anxiety is an intense fear that some people experience in social situations. Although it is often confused with shyness, this disorder has serious consequences for those who suffer from it and can become disabling.
Each of us is different in our way of being and this affects our way of relating to others. Thus, some do not find it inconvenient to surround themselves with many people and interact with strangers, since they have an extroverted tendency that makes them seek out and enjoy social events.
However, some prefer to maintain a reserved and discreet attitude, as they do not feel very comfortable in large groups where it is necessary to interact with several people at the same time. In this case, we usually talk about shy people, who are characterized by being more inhibited in the presence of others around them.
Although shyness is not usually very popular, it is not a mental health problem at all. Simply, it is a personality characteristic that modulates how social relationships are carried out. Shy people do not see their daily functioning diminished or experience difficulties in their daily lives, they simply prefer to adopt a more restrained attitude when they are in public.
Shyness and Social Anxiety: Who’s Who?
However, it is important to differentiate shyness from a much more complex and problematic phenomenon: social anxiety. Although they are often considered synonyms, the truth is that the latter is recognized as a psychological disorder that can cause enormous suffering in the affected person.
Those who experience social anxiety have an intense and irrational fear of social situations, which leads them to avoid all those scenarios in which they must expose themselves to the observation and judgment of others. Since social relationships are necessary for our well-being, it is not surprising that this anxiety disorder is profoundly disabling.
Experiencing some anxiety when meeting a new person is healthy and normal. In the face of the unknown, it is adaptive to act cautiously, although it is expected that this initial activation will be reduced over time. However, sometimes the tension persists in all social settings, at which point we may be talking about this anxiety disorder.
Thus, the person cannot relate normally and enters a state of blockage by which he perceives others as hostile and threatening figures. Due to the impact that social anxiety disorder can have on people’s lives, in this article we are going to talk about its causes, symptoms, and the most appropriate treatment.
What is Social Anxiety?
Social anxiety disorder, also known as social phobia, refers to a persistent and clinically signiﬁcant fear that appears in those situations in which the person may be exposed to the assessment or scrutiny of others. In this way, the patient feels terrified at the possibility of making a fool of himself or becoming the center of attention.
Although the person suffering from social anxiety recognizes that his fear is not rational, it is so intense that he is not able to expose himself to the feared situations. For this reason, without professional help, it is common for avoidance behaviors to increase, which leads to more and more difficulties at various levels of life (school/work, family, social…) and a less and less social network of support.
Although the focus of fear is similar in all people with this disorder, there is some heterogeneity in terms of severity and the times when anxiety appears. In some cases, this will be reduced to very specific scenarios, while in others the fear is generalized to practically any situation that involves social interaction.
Thus, certain people may lead a relatively normal life except when they have to deal with their anxious situation (eg, speaking in public), while others will be unable to leave the house or make a phone call because social anxiety has conditioned them all their life.
Usually, social anxiety begins to appear during adolescence, being rare that it begins at later ages. Recognizing early when this is taking place is important, otherwise, the disorder can progress and become much more complex over time.
What is the cause of social anxiety?
As with most psychopathological disorders, social phobia can never be explained based on a single cause. In reality, it is a multifactorial phenomenon, and several possible risk factors have been proposed that make the development of this problem more likely.
- Family history: People who have relatives who suffer or have suffered from social phobia have a higher risk of developing this psychological disorder. However, in no case can this anxiety problem be explained solely by genetic factors.
- Traumatic experiences: Those who have had negative experiences of a traumatic nature may develop social anxiety. A common example is bullying since teasing, insults, and contempt can deeply mark the psychological development of a child or adolescent, making them acquire a vision of the world as an insecure and hostile place.
- Possessing some peculiar characteristics: People who move away from normativity due to some characteristic of their person usually have a higher risk of developing social anxiety. Getting out of the mold is often synonymous with receiving discriminatory treatment from others, which seriously hinders the ability to interact healthily with other people.
- Parental influence: Children who grow up in environments where the opinion of others is disproportionately valued may be more vulnerable to social anxiety.
- The deficit in social skills: Not everyone is skilled when it comes to relating to other people. Those who have deficiencies in this sense can block themselves in social settings and develop anxiety and fear of what others may think about them.
What are the symptoms of social anxiety?
Anxiety is characterized by manifesting itself at three levels: behavioral, physiological, and cognitive. Thus, we can identify some symptoms that allow us to know if a person may be suffering from social phobia.
- Cognition :
At a cognitive level, people who suffer from anxiety experience intrusive and ruminative thoughts. Thus, they “turn their heads” and almost obsessively consider the possibility of being judged and criticized or of making a fool of themselves in front of others. When someone with social anxiety knows that she will have to face a certain situation imminently, there is marked anticipation.
Thus, he begins to think about what will happen, often putting himself in the worst possible scenario. The mere fact of imagining and mentally planning what may happen produces high levels of anxiety, almost as much as the actual event itself. In many cases, rumination does not stop when the social event has already been faced, but it is perpetuated afterward. In this way, the person reviews what he did and analyzes, again and again, possible mistakes that he could have made and for which others may have judged him.
- conduct :
At the behavioral level, people with social anxiety tend to avoid those situations that generate fear. In some cases, these can be very established and cause the total isolation of the person, who is unable to do such daily tasks as talking on the phone or going to work or to the supermarket due to the anguish caused by being exposed to others.
The problem with avoidance behaviors is that they are effective in the short term, as they provide a false sense of relief. However, in the medium and long term, these only make the initial problem worse, producing an increasingly pronounced limitation in daily life.
When the person with social anxiety does not receive adequate treatment, it is common for addictive behaviors such as drug and alcohol consumption to also appear, since these substances can serve to alleviate discomfort temporarily. It is also possible that self-harm behaviors and suicide attempts appear since desperation can lead to not seeing possible alternative solutions to the situation that is being experienced.
- Physiology :
On a physiological level, social anxiety produces symptoms that can be more or less obvious. In general, the person experiences an activation of their autonomic nervous system, which can cause an increase in heart rate, excessive sweating, dizziness, muscle tension, or difficulty breathing, among others.
What is The treatment of social anxiety?
The treatment of choice for social anxiety is cognitive-behavioral psychotherapy, which in some cases can be combined with the use of psychoactive drugs if the psychiatric professional considers it convenient.
Drugs can help control physiological symptoms, the most commonly used being selective serotonin reuptake inhibitors (SSRIs). However, therapy will be essential to modify dysfunctional thoughts, train social skills and gradually expose them to feared situations.
The technique used so that the patient can be exposed again to social scenarios is Systematic Desensitization, which allows starting from those less feared situations to those that generate more fear. In some cases, you can start with an exhibition imagined in session, and then jump to a live exhibition.