Social Anxiety Disorder
What is social anxiety disorder (SAD): Social anxiety disorder (also called social phobia) includes excessive worry related to social or performance situations. People with social anxiety experience severe self-doubt and self-judgment. They are intensely afraid of embarrassment or humiliation and assume they will be judged or rejected. People with SAD are overly concerned with how others view them and what they will look like in social situations, including fear of appearing visibly anxious. These worries can be debilitating and that often lead to avoiding social situations altogether or major discomfort and safety behaviors when in the situations, such as limited eye contact and engagement in conversation or hanging back in the group. There are often physical symptoms due to the discomfort, such as blushing, shaking, sweating, and crying.
Social anxiety versus shyness: Many people with SAD will say that they experienced shyness in childhood, but social anxiety is much more than being shy. Shyness is a personality trait that involves discomfort, and SAD is a mental health diagnosis that interferes in quality of life. SAD is more prevalent in everyday tasks, such as using the bathroom, ordering meals, and being in ordinary conversations, etc. The level of distress, avoidance, and impact on functioning is overall more severe with SAD versus shyness.
What causes social anxiety disorder (SAD): Social anxiety is the most common anxiety disorder. There is no known cause for it but it is said to run in families. Research shows that genetics influence how the parts of the brain that are involved with fear and anxiety function.
Who is affected by social anxiety disorder (SAD): Social anxiety disorder can develop at any age, and the most common onset is early adolescence. Approximately 15 million adults or 7% of the population experience SAD. The symptoms are equally common between men and women. 36% of people with SAD have symptoms for 10 or more years before getting help. SAD is very treatable with a trained professional!
Symptoms of Social Anxiety Disorder
- Persistent fear in one or more social situations in which one could be exposed to scrutiny or evaluation (speech or presentation, having a conversation, meals in front of others)
- Fear of being judged or negatively compared to others
- High self-criticism and assuming others are also thinking negatively of them
- Fear of showing anxiety symptoms (blushing, stumbling on words, etc.)
- Avoidance of situations
Treatment for Social Anxiety Disorder
The treatment for SAD: Cognitive behavior therapy (CBT)is the leading treatment for anxiety.
The components of CBT for SAD: Although CBT is the broadly research based treatment for all anxiety disorders, CBT has therapy strategies specific to each type of anxiety. To treat SAD, the following components are used.
- Psychoeducation on symptoms of social anxiety disorder and understanding how it presents for the person.
- Exposure therapy by facing avoided situations that are interfering with quality of life and maintaining anxiety.
- Thinking skills to restructure problematic cognitions that are linked to avoidance. Social anxiety includes many automatic negative thoughts about being around others, and the treatment has an emphasis on developing more rational and useful responses.
- Social skills training includes coaching and behavioral rehearsals on conversation starters, joining conversation, giving eye contact, etc.
Complementary treatments to CBT for SAD: Additional treatments can be added to support individuals during CBT. Mindfulness and self-compassion skills can teach people to come to the present moment and notice worry thoughts and anxious feelings without worsening them. The skills encourage a kindness and understanding to urges to avoid or control worries while holding oneself accountable to change. Acceptance and commitment therapy includes structuring exposures in line with one’s goals and values to return to living life fully.
For more information:
Anxiety and Depression Association of America
Wise Mind Counseling is highly trained and has years of experience treating GAD in all these research based treatment approaches.