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Enjoy the Season: Leave Your Social Anxiety at Home

Dec 06, 2017 02:00PM

By Lisa J. Gotto

Do you get a sense that your lack of social interaction has people perceiving something about you that just isn’t true? Don’t let a case of social anxiety disorder have you missing out this holiday season.

What you may not know is that other people at the party may be experiencing their own battles with Social Anxiety Disorder (SAD). With approximately 15 million American adults affected by the disorder, according to the Anxiety and Depression Association of America, you certainly are not alone.

Why do we have these feelings and insecurities, sometimes referred to as phobias, about social situations? In most cases, the answer can be familial.

“In our experience, social anxiety disorder often runs in families. Anxiety is often modeled from parent to child, says Chelsea M. Haverly, LCSW-C, Co-Founder and Psychotherapist at Anchored Hope Therapy, LLC of Annapolis.

“Adults with anxiety may also have displayed anxious tendencies as children. There are both heritable and environmental factors at play in assessing and diagnosing social anxiety.”

What does it feel like? It definitely goes beyond being shy, but often starts there. The uncomfortableness associated with shyness is amplified by palpable physical symptoms.

Imagine wanting to go somewhere, but being afraid to go and allowing that fear to keep you from going.

“Other physical symptoms [include] nausea, increased heart rate, and muscle tension,” Thomas adds.

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According to Carol Thomas, LCSW-C, a mental health clinician with Anne Arundel Medical Group, symptoms of SAD are as follows:

  • Fear of social situations in which others are judging
  • A fear you may somehow embarrass or humiliate yourself
  • Worry you may inadvertently offend someone
  • Intense fear of interacting or talking with strangers
  • Avoiding situations where you might be the center of attention
  • Having anxiety in anticipation of a feared activity or event
  • Worry you will exhibit physical symptoms like blushing, sweating, or having a shaky voice that may draw attention and cause you embarrassment
  • Overall, expecting the worst to happen during a social situation

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If you’re a typically active person who doesn’t think twice about attending a function, these symptoms may seem inconceivable to you, but the mind of an anxious person works very differently.

The worry about what others will think looms unrealistically large.

What SAD isn’t

There are other conditions associated with being less social, but they shouldn’t be confused with SAD, says Thomas.

“Introversion is a personality trait that could be mistaken for SAD.” She says the difference with introverts is they are content with spending time alone, while SAD is a fear-based condition.  

“It could also be confused with agoraphobia. Agoraphobia is anxiety about being in or anticipating situations from which escape might be difficult or help may not be available in the event of having a panic attack. People with agoraphobia will often avoid leaving their homes due to fears that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; or traveling in a bus, train, or car,” Thomas says.

She cautions that there are also some physical health conditions, such as an overactive thyroid or low blood sugar, as well as certain medications, that can imitate or even worsen an anxiety disorder.

“It is always helpful to be seen by a physician to rule this out.”

Seek treatment and get out there!

Fortunately, there are treatment paths that allow social anxiety sufferers to move toward a more active, less stress-inducing life, says Christine Coyle of Anchored Hope Therapy.

“Research has shown that an effective treatment for Social Anxiety Disorder is Cognitive Behavioral Therapy (CBT). A major aim of CBT and behavioral therapy is to reduce anxiety by eliminating beliefs or behaviors that help to maintain the anxiety disorder,” Coyle says.

What should you expect in treatment? Initially your therapist will support you in identifying beliefs, connect to the emotions you associate with those beliefs, and then assist in changing the behavior associated with the anxiety.

Once this is accomplished, patients usually experience a sense that they can better control their anxiety.

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Social Anxiety in Children: What to Watch For

As previously mentioned, for every socially-anxious adult, there was probably once a socially-anxious child. Dr. Diego Escobosa of Bayside Pediatrics provides a what-to-watch-for list for concerned parents. Recognizing these signs and intervening early can make a big difference in quality of life for today’s child and tomorrow’s adult:

  • After social interaction child has racing thoughts analyzing what he/she should have said or done instead
  • Rapid heart rate, sweating, jitteriness, blushing, and/or trembling around strangers 
    Avoiding social situations
  • Excessive fear days before future social activities
  • Fear of speaking in class or public situations
  • Extremely self-conscious in front of others
  • Gastrointestinal symptoms including: nausea, vomiting, and diarrhea


Anxiety disorders affect 1 in 8 children.

Having some anxiety is a normal part of childhood, and every child goes through phases. A phase is temporary and usually harmless. But children who suffer from an anxiety disorder experience fear, nervousness, and shyness, and they start to avoid places and activities.
—According to the Anxiety and Depression Association of America (ADAA)
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“Changing patterns of unhelpful thinking to enact behavior change is the goal.” Coyle adds that it takes time and patience to change someone’s internal self-talk.

“We are often so hard on ourselves that we do not realize how pervasively negative our self-talk has become. Creating a space for someone to explore themselves and their behavior without judgement is very important.”

A key tenant of CBT for anxiety is the gradual exposure to the things or situations that are feared accompanied by more effective coping skills learned in therapy. While CBT and behavioral therapy have no adverse side effects other than the temporary discomfort of increased anxiety, the process needs to be carefully monitored by a therapist well-trained in the techniques for the treatment to have the best possible outcome.

These sessions will also be accompanied by “homework” that a therapist will assign to address specific areas that the patient should work on between sessions.

The good news, says Thomas, is that, with time, SAD is a highly treatable disorder.

“We all have thoughts that are considered “cognitive distortions.” These are defined as biased ways of thinking about oneself and the world around us. People with SAD have cognitive distortions in regard to interaction with others,” says Thomas.

“Using CBT strategies can help people overcome those irrational thoughts and create new, more accurate ways of thinking to make positive behavioral changes. It takes practice. but it is achievable and can be life changing.”

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