Why Am I Nervous Around Strangers? Identifying and Treating Social Anxiety Disorder

While many of us may find ourselves nervous in social situations, social anxiety disorder is a specific anxiety disorder with certain symptoms and diagnostic criteria found in the diagnostic and statistical manual. In this article, we'll define social anxiety in general, explore specific social anxiety disorder symptoms, and share some strategies for overcoming social phobia.

Social Anxiety Disorder vs Shyness

Social anxiety disorder, also known as social phobia, is something more than just shyness or introversion. This type of anxiety disorder usually begins in childhood and may last for a while or even your entire life. It involves a persistent fear of social situations in a way that makes it difficult to do even simple tasks and participate in everyday life events.

The intense fear and self-consciousness involved with social anxiety disorder can make people feel out of control, and get in the way of attending school, work, and other activities. Some people with social anxiety disorder experience it as a fear of performance or public speaking (this can be called performance anxiety) and have difficulty speaking or doing other things in front of other people.

In any case, social anxiety disorder can be debilitating, as it can impact mental health and wellness, relationships, and everyday life activities.

Emotional and Behavioral Symptoms of Social Anxiety

Social anxiety is a fairly common mental health issue. Many of us feel anxious when we feel as though we have to "perform" for others in some way. Even if not diagnosed as one of the anxiety disorders, social anxiety may cause both mental and physical symptoms. Some symptoms of social anxiety include:

• Feel nervous or experience significant anxiety at social gatherings
• Trembling, blushing, or sweating
• Intense fear response around social interactions
• Increased heart rate
• Shortness of breath
• Tension
• Difficulty making eye contact with others
• Feel self-conscious and experience fear that others will judge them

These social anxiety disorder symptoms can lead to an official diagnosis of social anxiety disorder, or they may be diagnosed as generalized anxiety disorder. If you have experienced these symptoms for more than six months, then you may have social anxiety disorder.

What causes social anxiety disorder?

Social anxiety disorder can have a number of causes. Risk factors for developing social anxiety disorder include both genetic factors and environmental factors.

Genetic factors for developing social anxiety disorder include:

• Having family members (especially biological parents) who have anxiety disorders
• Certain personality traits, such as higher neuroticism
• Having an existing anxiety disorder, such as generalized anxiety disorder
• Brain chemistry and/or structure
• Other low self-esteem trouble

Environmental factors that may lead an individual to develop social anxiety disorder include:

• Experiencing trauma, abuse, or family conflict
• Experiencing high levels of stress

How can I overcome social anxiety?

The good news is that social anxiety disorder can be treated. Treating social anxiety disorder often involves talk therapy with a licensed therapist, implementing healthy lifestyle habits, and, in certain cases, medication.

Therapy for Social Anxiety Disorder

According to the Anxiety and Depression Association, psychotherapy is a first-line treatment for social anxiety disorder. Cognitive behavioral therapy (CBT) is a common and effective form of therapy for treating social anxiety, as well as other anxiety disorders. In CBT, the therapist will work with the patient to identify patterns of negative thoughts and behaviors and implement strategies to help shift them in a more positive direction. Learning to replace negative thoughts can be helpful for people with social anxiety and other mental health conditions.

Another therapy used for the treatment of social anxiety disorder is acceptance and commitment therapy (ACT). While a newer form of therapy, it is often helpful and uses goal-setting and mindfulness practices to help empower the client and reduce anxiety. Exposure therapy may also be helpful for socially anxious people.

Healthy Lifestyle Habits for Managing Mental and Physical Symptoms of Social Anxiety Disorder

A psychotherapist will also often work with their client on lifestyle habits that may help them better manage symptoms of social anxiety. This can include things like:

• Learning and implementing mindfulness practices such as deep breathing
• Practicing healthy sleep habits
• Taking care of mental health through self-care practices
• Building strong and healthy relationships with others
• Avoid unhealthy substance use (which some people with social anxiety disorder use to self-medicate social anxiety symptoms)

Medication to Treat Social Anxiety Disorder

Social anxiety disorder treated with medication must be supervised by either a medical doctor or a mental health professional like a psychiatrist who is cleared to prescribe medication. Common forms of medication used to treat social anxiety or social phobia include:

• Anti-anxiety medications such as benzodiazepines
• Beta-blockers
• Antidepressants like SSRIs or SNRIs

Support Groups for Social Anxiety Disorder

For those with social phobia, a mental health therapist may suggest group therapy or working with a support group for people with social anxiety disorder. Besides working on strategies for general mental health and well-being, these groups work with others who are managing similar symptoms of social anxiety, and can offer suggestions for strategies for situations that trigger social anxiety disorder.

Under the guidance of a counselor, clients with social anxiety disorder may practice certain social skills, go through social skills training, and gain confidence in learning with each other.

Talking to a Health Care Provider About Your Mental Health

If you suspect that you may be experiencing social anxiety disorder, talking to a mental health professional can help. Mental health disorders like social anxiety disorder can be debilitating and prevent you from living your best life, but there are effective treatments available.

Anxiety symptoms can be difficult to navigate on your own, and working with a Brooklyn anxiety therapist can help you to better navigate social situations, gain confidence, and learn coping skills that reduce stress and anxiety.