Dr Eddie Murphy
Social Anxiety Disorder
“Social anxiety is the persistent fear of social or performance situations in which one is exposed to unfamiliar people or to possible scrutiny by others, and where exposure to such situations provokes intense anxiety.”
– Social Anxiety Ireland
Social anxiety is a hidden anxiety that many people nonetheless experience every day. About 14% or almost one in eight adults experience it and it is more common among women than in men. It most often surfaces in adolescence or early adulthood, but can occur at any time, including early childhood. The majority of people with social anxiety don’t know that they have it. They feel there is something “wrong” with them, but they don’t know what it is. They have never been properly diagnosed, because social anxiety is almost as unfamiliar to counsellors, therapists, doctors, psychologists and psychiatrists as it is to most other people.
People with social anxiety typically have a stronger than usual desire to make a good impression. Unfortunately, they also fear that they are not as good socially as other people. Often, people with social anxiety believe other people are closely observing them and judging them in a negative way – as unintelligent, unattractive, stupid, ridiculous or unacceptable. Having this frame of mind leads to intense self-consciousness and feelings of shame and embarrassment. The urge is to hide or escape from the social situation evoking this sense of being scrutinised and judged. In this sense, social anxiety can be understood as an intense fear of embarrassment.
Physical & emotional symptoms
People with social anxiety experience a wide range of unpleasant symptoms of anxiety, from muscle tension, increased heart rate and dizziness to nausea, dry mouth and breathlessness. However, what particularly concerns them in social situations are what they regard as the clearly visible signs of anxiety, such as blushing, perspiring, shaking or stammering. For the socially anxious, these visible symptoms open them up to judgement by others as unacceptable or in some way ridiculous.
The world gets smaller
The range of social situations in which people can experience anxiety varies significantly from person to person: e.g. it might be limited to eating in public, public speaking, expressing an opinion to a group or in the most extreme cases, almost all social situations.
People with social anxiety tend to either avoid or endure with severe anxiety or distress these situations.
Because their anxiety is so intense and distressing, it’s much easier for people with social anxiety to stay away from social situations and even avoid other people altogether. Individuals can isolate themselves to such an extent that they give up work and remain at home. This then can lead to feelings of sadness and depression.
Others may turn to alcohol to ease their social discomfort and this of course can lead to problems with misuse and dependency. Avoidance, anxious anticipation and distress interfere greatly with the individual’s normal routine at work, in school, social activities and in relationships.
Settling for less
Many individuals with social anxiety have jobs that require less than their capabilities because of their social concerns: the nightmare of job interviews, the agony of working in a job where there is a lot of public contact or the dread of being promoted to a position of authority over others or that involve team meetings or formal presentations.
It is important to note that people who suffer from social anxiety do recognise that their fear is unreasonable or excessive, but as much as they try, they cannot simply stop themselves having these irrational concerns. Without proper treatment, social anxiety tends to develop into a long-standing and unremitting condition.
Treatment
Social anxiety is most often treated with medication, but there is strong evidence for the efficacy of treatment using cognitive behavioural therapy (CBT). In fact, research has shown that CBT is one of the few forms of therapy that reliably helps people to overcome clinical anxiety.
CBT is not one set method but rather a combination of techniques that depend on what’s being treated. For example, CBT for treating depression will be different from CBT for treating social or other anxiety disorders. I include an introduction to CBT for social anxiety in my book, Becoming Your Real Self – A Practical Toolkit For Everyday Challenges.
Social Anxiety Ireland
This is a not-for-profit organisation which provides trusted information and details of what I consider one of the best nonpharmaceutical treatments for social anxiety – group-based CBT.
See socialanxietyireland.com