Beyond shyness: The face behind social anxiety

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Have you ever found yourself in the far corner of a crowded room? Do you avoid meeting new people? Does public speaking terrify you?

Some people are a little on the shy side. But for others, the thought of socializing or performing in front of others is too much to bear. When these feelings get in the way of everyday life, such as work, school or friendships, it could be social anxiety. It is much more severe than simply being shy. Social anxiety causes a person to feel anxious or fearful in certain or all social situations. The feelings of distress are overwhelming, and go way beyond nervousness. It can cause shortness of breath, headaches and heart palpitations. People with social anxiety tend to:

  • Blush, sweat, tremble, feel a rapid heart rate, or feel their “mind going blank”
  • Feel nauseous or sick to their stomach
  • Show a rigid body posture, make little eye contact, or speak with an overly soft voice
  • Find it scary and difficult to be with other people, especially those they don’t already know, and have a hard time talking to them even though they wish they could
  • Be very self-conscious in front of other people and feel embarrassed and awkward
  • Be very afraid that other people will judge them
  • Stay away from places where there are other people

The disorder is often selective. Some people may be comfortable in social situations but have an intense fear of giving a speech. Other people may become anxious during routine activities, such as starting a conversation with a stranger, participating in a class, or attending a social event. The problem with social anxiety is that it can significantly impair aspects of daily life. It can be difficult to make and keep friends. It can prevent you from going to places or events, or reaching your full potential at work. It can hinder personal relationships.

Treatment for Social Anxiety Disorder:

Several types of treatment are available for social anxiety disorder. Treatment results differ from person to person. Some people only need one type of treatment. However, others may require more than one. Your healthcare provider may refer you to a mental health provider for treatment. Sometimes, primary care providers may suggest medication to treat symptoms.

Treatment options for social anxiety disorder include:
Cognitive behavioral therapy: This therapy helps you learn how to control anxiety through relaxation and breathing, and how to replace negative thoughts with positive ones.
Exposure therapy: This type of therapy helps you gradually face social situations, rather than avoiding them.
Group therapy: This therapy helps you learn social skills and techniques to interact with people in social settings. Participating in group therapy with others who have the same fears may make you feel less alone. It will give you a chance to practice your new skills through role-playing.

At-home treatments include:
Avoiding caffeine: Foods such as coffee, chocolate, and soda are stimulants and may increase anxiety.
Getting plenty of sleep: Getting at least eight hours of sleep per night is recommended. Lack of sleep can increase anxiety and worsen symptoms of social phobia. Your healthcare provider may prescribe medications that treat anxiety and depression if your condition doesn’t improve with therapy and lifestyle changes. These medications do not cure social anxiety disorder. However, they can improve your symptoms and help you function in your daily life. It can take up to three months for medication to improve your symptoms. Common side effects of these medications include:
insomnia (sleeplessness)
weight gain
upset stomach
lack of sexual desire
Talk to your health care provider about the benefits and risks to decide which treatment is right for you.

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