Social anxiety

 

Social anxiety, or fear of social situations, such as talking in front of groups of people etc – is one of the most common mental health conditions, affecting around 13% of people at some point during their lives. Symptoms can be a combination of emotional (anxiety, fear etc), physical (blushing, racing heart etc) and cognitive (thinking we are being scrutinised or negatively judged by people etc) responses and can cause significant distress, leading people to avoidance and over time having significant impact.

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One problem is that the avoidance associated with social anxiety means the fears and negative thoughts don’t get challenged, so social situations feel progressively more and more daunting, and we get trapped in vicious circles of rising anxiety and further avoidance. Social anxiety can be either generalised, applying to many different social situations, or specific, such as speaking in front of groups of people, which many people may experience.

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Behind all of these there is nearly always significant distorted thinking or ways of experiencing others. We may believe that other people are having critical thoughts about us, or that symptoms such as hesitant speech, or not making eye contact, are very noticeable and are being negatively judged. The fight or flight stress response then gets activated and symptoms can snowball, sometimes with trembling, sweating or even nausea. There can be accompanying mental health issues such as alcohol misuse to calm the nerves, or more generalized anxiety, or depression.

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The good news is that social anxiety responds well to interventions. Psychotherapy can get to the bottom of what is happening and begin to unwind distorted thinking patterns. For example, looking at the fear that others are judging us harshly, or waiting for us to slip up, whereas in fact people be paying us a lot less attention than is imagined, or feel much more positive towards us. Cognitive Behavioural Therapy (CBT) is an evidenced-based therapy that teaches healthier ways of thinking, behaving and relating to situations, changing how we experience other people. Psychodynamic therapy might look at the reasons why we feel others are so judgmental, possibly as a result of critical or demanding figures in our lives, or at other causes of self-esteem issues. All the approaches point us towards more realistic ways of experiencing social situations, and with that greater confidence in how to handle them. 

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Here are some TedX Talks with some interesting perspectives on social anxiety:

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Why We’re Socially Awkward and Why That’s Awesome

Social Anxiety in the Modern World

Social Anxiety: The Silent Pandemic That Needs A Louder Voice

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The sites below also have some useful information on social anxiety:

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Mayo Clinic

NHS

Mind

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