All about social anxiety (social phobia)

Social phobia and social anxiety are anxiety that is linked to meeting other people and, for example, feeling lost or scrutinized. The disease has previously been called social phobia, but today the term social anxiety is used.

Social anxiety can lower your quality of life and make you feel isolated. When you avoid the situations you are afraid of, you often develop safety behaviors that make the anxiety grow even stronger and take over further. Social anxiety is considered a mental illness and causes symptoms that can have a significant impact on the quality of life.

Symptoms of social anxiety

The feeling of doing away with or otherwise attracting negative attention is central. Situations where one feels scrutinized can be extremely stressful. It is not the same as feeling some slight nervousness and discomfort when meeting, for example, new people or giving a presentation. Symptoms of social anxiety

Some typical symptoms of social anxiety are:

  • Shakes
  • Fast or hard heartbeat
  • Dry mouth
  • Redness
  • Hot or cold sweating
  • Lumps in the stomach
  • Dizziness
  • Weakness of the muscles
  • It may feel like you will faint and you often want to escape from uncomfortable situations.

Symptoms often arise in social situations where there are expectations that one should be active. Work situations, telephone calls, meetings with new people and other everyday situations can be perceived as very unpleasant. Some common examples are situations where you get your attention directed to, for example, when you give lectures or speeches, are evaluated by their immediate boss or everyone’s eyes are on a party.

Causes of social anxiety

The underlying causes of social anxiety are not clear. Social anxiety usually develops early, sometime during school or puberty. The problems are in some cases believed to be hereditary. In other cases, they come in step with externally increasing demands or as a result of traumatic events.

If you suffer from social anxiety, you are at higher risk of having other anxiety problems, such as obsessive-compulsive disorder, panic syndrome or phobias.

Social anxiety can have a major impact on life

When you have social anxiety without doing anything about it, it can have a profound effect on life. You can find it difficult to work in your workplace if you are expected to be socially active, or answer telephone calls, for example. This can avoid social contexts and make it difficult to meet new friends or a partner.

For relatives, it can be frustrating and lead to misunderstandings and conflicts within the family. It can be difficult for relatives to understand that you want to be alone, which can easily be misinterpreted as, for example, not being liked.

Security behaviors and insights

A first step towards working with one’s social anxiety is to look at what situations one is avoiding and why one chooses to do so. Many people with anxiety come up with safety behaviors that make them avoid unpleasant situations. Over time, you can develop more and more behaviors that feel better for the moment, but only strengthen anxiety control over life.

Understanding the problems is a first step in the process of alleviating them. Many people with anxiety problems have similar behaviors, and there is much to read about it in books and on the internet. It can also be good to open up about their social anxiety to someone you trust. Information and insight can be a first step towards seeking help from healthcare.

Treatment of social anxiety

The goal of the treatment is to become better at coping with the situations that create anxiety. Social anxiety is primarily treated with CBT, cognitive behavioral therapy. A central part of CBT is exposure; to slowly challenge unpleasant situations linked to anxiety. The purpose is to break harmful habits and safety behaviors. The therapy can be tough and requires you to actively challenge your anxiety to break patterns. Other types of psychotherapy can also be effective. However, you will have to confront your anxiety and work actively even if you do not choose CBT.

Medication in the form of antidepressant medication can be combined with the psychological treatment. Treatment with drugs is not usually done without psychological help. When treating anxiety and other mental illnesses, patience may be required, as both the therapy and the drugs may take time before they begin to function. Something you can do on your own that counteracts anxiety is regular exercise and getting enough sleep. Breathing, mindfulness and other relaxation exercises can make you feel less tense due to the anxiety.

Living with social anxiety

If social anxiety remains untreated, it can often end the life of the affected person. Anxiety can also lead to other mental disorders and addiction problems. The majority of those who choose to undergo cognitive behavioral therapy tend to feel significantly better after their treatment.

Although antidepressants give good results, CBT is seen as a treatment with better effect over a long time.

When Should You Seek Care for Social Anxiety?

If your social anxiety prevents you from living the way you want, you should contact a health care center or an open psychiatric clinic. The same applies if you need to use alcohol or drugs to cope with the anxiety, or if you suffer from a depression. If you go to school, you can sometimes seek help through student health or a youth clinic. Some employers offer employees occupational health care.

If your social anxiety is so strong that you are thinking about taking your life, seek help directly at a health care center, emergency room or by calling 911.

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