Social Anxiety Disorder (A Complete Guide)

This brief guide will discuss Social Anxiety Disorder, Anxiety disorders and their criteria, causes of Anxiety and social anxiety disorders and how anxiety disorders can be treated.

What is Anxiety?

When an individual is uncertain about future consequences he or she might face in an unfamiliar and new situation, there will be fear and apprehensions.

This is the body’s natural response and is named as Anxiety.

For instance, giving a presentation in front of the whole class or the first day of a job may cause feelings of fear and nervousness.

Certain amount of Anxiety is necessary for survival and it might actually keep some people motivated to do work and engage in problem-solving.

Anxiety symptoms become problematic when it starts interfering in daily routine and stops the person from being productive.

If the anxiety feelings cross the threshold level and last for six months, then it is called Anxiety Disorder.

What is Social Anxiety Disorder

The social anxiety disorder is recognized in DSM 5, and this is the condition in which the individual gets upset, uncomfortable and apprehensive in the social situations.

The fear in social situations is specifically regarding the judgement by others as stupid, crazy, misfit, and awkward.

To screen the symptoms of social anxiety disorder you can use this self-assessment test here.

Social anxiety disorder is also known as social phobia.

This feeling of awkwardness is more than shyness and makes the person uncomfortable to maintain eye contact, speak, or visiting the places where there are people.

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Difficulties of Individual with Social Anxiety Disorder

Person with social anxiety disorder finds it hard to talk to strangers, in public, dating, maintaining eye-contact, going to parties, work, school, eating before others and initiating conversations.

Person experiencing the social anxiety disorder experience anxiety symptoms.

Sufferers with this disorder start making friends with their own anxiety because of their fear of being with other people.

Anxiety Symptoms

There is a difference between normal anxiety symptoms and Anxiety Disorder, having a knowledge of that will help the person treat it properly.

Most prominent anxiety symptoms are

Excessive worries: this worry is out of proportion about the normal everyday situations.

Feeling agitated: This agitation affects the body by altering its functioning.

The person experiencing anxiety starts getting shaky, dry mouth, sweaty palms and racing heart.

Restlessness: The person experiencing anxiety symptoms gets overly restless and stays uncomfortable and there is always a need to move.

Fatigue: This is another symptom of anxiety, which is because of overactivity and restlessness that person feels fatigued

Difficulty concentrating: Concentration gets disturbed in case of anxiety, as the agitation, and restlessness causes the lack of focus and person ends up in inability to concentrate on the tasks at hand.

Irritability: This is another symptom of anxiety, person starts feeling excessively irritable.

Tense Muscles: The muscles get tense and causes discomfort.

Trouble falling or staying asleep: Person surrounded by anxiety and is prone to anxiety symptoms, it gets difficult for them to get sound sleep.

Anxiety

Anxiety is defined by The American Psychological Association (APA), is an emotion which is characterized by worrying thoughts, feelings of tensions and physical discomfort like stomach ache or increased blood pressure in the face of potential danger.

Anxiety symptoms cause distress but it does not always require medical attention.

Anxiety is necessary for survival. Since the earliest days of humanity, whenever any danger approached, it causes adrenalin to rush.

The adrenaline is a body hormone and it triggers the anxious reactions, ”fight-or-flight.

This, in turn, causes our ancestors to either confront the danger and fight it or run to take refuge in a safe place.

Now, the anxiety is revolving around money, work, health, family life and other areas of life that require an individual’s attention.

A common example of Anxiety would be looking at both sides of the road before crossing it because of the fear of being hit by a car.

Anxiety disorders

When the anxiety symptoms exceed in intensity, it turns into Anxiety Disorder.

It is a mental health diagnosis given to people with excessive worry, apprehension, nervousness, and fear.

Anxiety disorders change how an individual behaves and handles emotions that consequently cause physical symptoms.

Mild level of anxiety symptoms causes discomfort and unsettling feelings but severe anxiety symptoms disturb a person’s day to day life.

As defined by the American Psychological Association, diagnosis of Anxiety disorder is given when the individual is experiencing persistent intrusive concerns or thoughts.

Normal anxiety symptoms when it exceeds a level that it starts interfering in daily life, it becomes an Anxiety Disorder.

After the diagnosis is made, the severity of one’s anxiety is measured using anxiety tests.

Symptoms of Anxiety Disorder

There are many types of Anxiety Disorder and with their distinguished symptoms, however, more general type of Anxiety Disorder is called Generalized Anxiety Disorder (GAD) which is most prevalent and consist of basic Anxiety symptoms such as:

1. Feeling of being” on-edge”
2. Restlessness
3. Excessive worry
4. Excessive irritability
5. Difficulty in concentrating and focusing
6. Sleep disturbances

In daily life, these symptoms are normal to experience but those with GAD experience them on a higher intensity and persistently.

Types of Anxiety Disorder

Anxiety Disorders include the following types of diagnosis classified by The Diagnostic and Statistical Manual of Mental Health Disorders: Fifth Edition (DSM-V):

Separation anxiety disorder: Excessive fear of separating from those to whom the individual is attached lasting for 4 weeks in children and 6 months in adults.

●       High level of anxiety symptoms when anticipating or being away from home or attachment figure

●       Persistent worry of losing a loved one

●       Persistent worry of harm to oneself

●       Refusal to go out, away from a caregiver

●       Fear of being alone or sleeping away from home

●       Nightmares with the theme of separation

Selective Mutism:

●       Failure to speak outside of home in social situations even in school

●       They can speak at home when the parents are present

●       Inability to speak even in the presence of close friends or immediate family members

Specific phobia:

●       Excessive fear related to a particular object or situation, for instance, height, animals, flying or toilet anxiety.

●       Avoidance of the phobic stimulus

●       Children might show signs of this disorder by clinging, throwing tantrums, crying or freezing

Social anxiety disorder, or Social phobia:

●       Fear of being in situations where others might judge based on performance, for example gym anxiety.

●       Fear or having conversation or meeting unfamiliar people

●       The individual fears that his anxiety symptoms will show and he will be negatively evaluated

●       Avoidance of social situations or endured with extreme fear.

Anxiety when playing sports, attending meetings or reading in class are also seen as a part of social anxiety disorder.

Panic disorder:

●       Unexpected persistent panic attacks

●       Sudden intense discomfort that reaches a peak within a minute

●       Symptoms include sweating, palpitations, pain in chest, heat sensations or chills, fear of dying or losing control

●       Excessive worry about having an unexpected panic attack

Agoraphobia:

●       Extreme fear and avoidance of situations, events or places where escape is not possible in the face of danger

●       It can be fear of open spaces, public transportations, enclosed places, being in a crowd or going outside of home

●       They can avoid public situations to the extent that their everyday life becomes extremely difficult.

Generalized anxiety disorder:

The symptoms of generalized anxiety disorder have been explained earlier, this is the most common disorder among the population of having an anxiety disorder.

It includes excessive worry about almost everything that causes discomfort and disrupts the day-to-day life of a person and those around him.

The DSM-V recognizes all of the different types of anxiety disorders mentioned above.

Except for another type not listed here, High functioning anxiety. Here are the top books for people with high functioning anxiety.

Anxiety Attack

Anxiety attack is like a panic attack but its intensity is a little less and it can stay for a longer period of time and may worsen with the stressful event approaching.

Every individual with anxiety attacks experiences symptoms differently and in different severity.

Because not all the symptoms of Anxiety attack happen to everyone and they change every time.

The symptoms are as follows:

●       Sweating

●       Dry mouth

●       Worry and apprehensions

●       Failing dizzy

●       Restlessness

●       Tingling or numbness

●       Shortness of breath

●       Fear

A panic attack stays for a minute or two but an anxiety attack can stay for longer periods of time.

Causes of Social Anxiety Disorder

Like many other mental conditions, the causes of anxiety disorders are not fully understood.

Those who are already prone to anxiety symptoms may develop anxiety disorder after any traumatic or extremely stressful life event.

There can be some Medical causes of anxiety symptoms. Any underlying medical condition might be causing the symptoms of anxiety.

Examples of such conditions include:

●       diabetes

●       heart diseases

●       drug misuse or withdrawal

●       thyroid problems

●       rare tumours

●       as a side effect of any medications

There are some risk factors that might be leading to the development of Anxiety-related disorders.

These risk factors include

·        Personality Type

·        Stress build-up

·        Having blood relatives who have anxiety or anxiety disorder

·        Going through certain trauma

·        Other mental disorders like depression or OCD

·        Substance use

·        Low self-esteem

·        Negative thoughts

·        Depression

·        Sensitivity to criticism

·        Poor social skills that don’t improve

Current life situations can also cause anxiety symptoms.

Like, feeling under stress while studying or preparing for exams, losing a closed one, less sleep hours, too much work pressure, money problems or being out of work.

Treatment of Social Anxiety Disorder

Sometimes because of anxiety symptoms, other conditions take place such as depression, substance dependence and sometimes they are the underlying cause of anxiety symptoms.

Such conditions have strong effects on the mental health of a person and need to be taken care of immediately before treating any anxiety disorder.

Medications, psychotherapy and behavioural therapies are the forms of treatments for Anxiety Disorder.

They will be discussed one by one.

Self-treatment

In order to manage anxiety symptoms or anxiety disorder without having to go under clinical supervision, many people choose self-treatment at home.

These techniques might not be effective for a person with severe anxiety symptoms or in the long run.

Following are the techniques for people with mild anxiety symptoms and who need short term benefits:

●       Relaxation techniques: Relaxation techniques have great benefits even if the person does not have anxiety symptoms. These include deep breathing, yoga, resting in the dark, meditation and long baths. One needs to learn how to stay calm in situations like reading in a class full of people.

●       Stress management: one of the main reasons for elevated anxiety symptoms is stress-related work. Learning stress management techniques helps in limiting the trigger. These include organizing beforehand for the upcoming deadline, making to-do lists and committing to take time out from work or study

●       Support network: anxiety symptoms turn into depression when the person stops seeking support and going out with friends. anxiety symptoms can be managed by talking things out with people who care and are supportive. And for those who are not comfortable with seeking help from familiar people, there are online platforms available where they can talk it out or start journaling for anxiety.

●       Exercise: exercising is a great way to release bodily tensions. If hardcore exercise is too much, a person can get incredible benefits just from sticking to a daily brisk walk. It improves physical health as well as increases positive feelings

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Professional Help

Psychological counselling is a standard treatment for anxiety symptoms. The techniques used in counselling can be cognitive behaviour therapy, psychotherapy or eclectic therapy which is a combination of other therapies.

●       Cognitive Behavior Therapy: CBT aims at changing the harmful negative thoughts upon recognizing them that maybe playing a role in sustaining the anxiety symptoms. It focuses on psychoeducation the client about cognitive distortions and with the help of relaxing techniques and systematic desensitization in some cases, manages the anxiety symptoms. CBT has been proven to recover the person from anxiety symptoms altogether by exposing the person to fearful stimulus and making them confront the situations they tend to avoid because of anxiety symptoms.

Management by Medications

In milder to moderate cases, a person can get better by professional counselling alone.

However, sometimes the symptoms become so distressing that he needs medication.

There are different kinds of medications for anxiety symptoms management that control mental and physical symptoms.

These include Benzodiazepines, beta-blockers, antidepressants, and tricyclics.

●       Benzodiazepines: They manage the anxiety symptoms quite quickly but they are highly addictive and have few side-effects. Valium or Diazepam are commonly prescribed Benzodiazepines

●       Antidepressants: they target depression but are prescribed for anxiety symptoms as well. These are serotonin reuptake inhibitors and they have side effects of nausea, sexual dysfunction, and jitters when the treatment begins. Prozac or Fluoxetine and Celexa or Citalopram are commonly used antidepressants.

Apart from the drugs mentioned above, other medicines such as Seroquel are also effective.

Sometimes the side effects can get severe, in such cases, seek medical advice immediately.

Conclusion

anxiety symptoms is a natural response of a body in times of facing danger or a possible threat to survival.

It is not a medical condition as long as it is not severe enough to affect daily life.

When anxiety symptoms exceed its normal amount and distresses daily life for six months, it becomes an Anxiety Disorder.

There are different types of Anxiety disorders, among them, GAD is the most prevalent and common.

Other types are specific phobia, social anxiety disorder, selective mutism, agoraphobia, and panic disorder.

Causes are complicated but any traumatic event in life can trigger anxiety.

The treatment includes self-treatment at home, having psychological help and medications as well.

It has been suggested that having a good sleep routine, keeping check-lists and a balanced diet improves the anxiety symptoms and manages it for the short term.

It is very important for one to embrace his social anxiety, trying to accept his condition and seeking self confidence for example, through finding a suitable job.

Frequently Asked Questions Social Anxiety Disorders

Please feel free to ask any questions in the comment section below.

References

NIMH

Medical News Today

Healthline

Recommended Readings

Anxiety Worry Workbook Cognitive Behavior Therapy

Wisdom Anxiety Intrusive Thoughts

What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety (What-to-Do Guides for Kids)

A Little SPOT of Anxiety: A Story About Calming Your Worries

Dare: The New Way to End Anxiety and Stop Panic Attacks

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