Social anxiety
By Holly Marie (Rie)
We all get jittery at times and occasionally we all get nervous around people we don't know. Can you imagine that feeling intensified and multiplied so many times that it's almost unbearable to throw oneself into a social situation? Sometimes anxiety can disrupt your life, and if it severely impairs or limits your ability to function, you may be diagnosed with an anxiety disorder.
There are many types of anxiety disorders. To begin with, there is generalised anxiety disorder, a long lasting anxiety which is not focused on one object or situation. There are also panic disorders which cause sufferers to experience brief attacks of terror, also known as panic attacks, that are commonly triggered by stress, fear or even exercise. Phobias make up the largest category of anxiety disorders and account for any case in which anxiety is caused by a single trigger. Agoraphobia, another anxiety disorder, is strongly linked with panic disorders. With agoraphobia, a sufferer is preoccupied with when a panic attack may occur and in severe cases one may even be confined to their own homes. Obsessive-compulsive disorder is also an anxiety disorder, however it is characterised by repetition and compulsions. Another common anxiety disorder is post-traumatic stress syndrome, which results from a traumatic event such as rape, child abuse, natural disasters, and other serious accidents or stressful situations. Another anxiety disorder is separation anxiety, an extreme fear of being away from a specific place or person. There are also several other unclassified childhood anxiety disorders. Out of all anxiety disorders, however, social anxiety disorder is the most common.
Worldwide, it is estimated that around 13.3% of the population may suffer with social anxiety disorder (SAD) at some point in their lives, making it one of the most common mental illnesses. SAD is more common in women than men, with the average onset being fourteen years of age. Social anxiety disorder, also known as 'social phobia', is an extreme and intense fear of being in social situations. A person with social anxiety may fear judgement, people watching and criticism, causing self consciousness that leads to anxiety. Generally, a person with social anxiety disorder is constantly afraid of making mistakes and being humiliated or embarrassed in front of others. Other situations such as eating or drinking in front of others, using a public toilet, being the centre of attention, working around others, interacting with people, group activities, meeting people with authority, interpersonal relationships and telephone calls may also raise anxiety levels. Lack of social skills or experience in social situations may intensify the fear, building up to a panic attack. There are links between social anxiety disorder and other mental illnesses; for example like depression, obsessive-compulsive disorder, eating disorders, and panic disorder to name a few.
There are a number of symptoms of social anxiety disorder, ranging from thought patterns to actions. Sometimes sufferers may feel that there is “something wrong”, but feel unable to verbalise what it is. Physical symptoms can include a fast heartbeat, confusion, anxiety, sweating, shaking, blushing, muscle tension and upset stomachs. Other symptoms include avoidance of social situations and intense anxiety during social gatherings. During public situations, the sufferer may criticise their words and actions, causing them great distress. Symptoms in children are often different to those of adults, and children may express their anxiety by acting up, clinging to their parents or crying.
Currently there is no exact known cause for social anxiety disorder, however there are several theories. General disposition is one theory. This means that just like your eye colour and your skin colour, social anxiety disorder could be passed on as a family trait. Social anxiety disorder can emerge during development. As the child goes through various stages of development, their desire to be alone changes. Improper chemical balances in the brain can also be a cause. Seretonin, norepinephrine and gamma-aminobutyric acid directly affect the way we feel about a given thought or situation.
Treatments for social anxiety disorder can include a number of things. Regular exercise, a healthy sleep pattern, and reducing caffeine intake are often the first recommendations. Cognitive behavioural therapy can also be highly effective for anxiety and panic disorders. The cognitive function works through how one can be sure others are judging one so harshly and watching one continuously. The behavioural component encourages sufferers to change how they react to social situations. The aim is for sufferers to be shown real world proof that their thoughts are unrealistic, to learn from acting differently and from observing reactions. Cognitive behavioural therapy may also take place in groups, rather than individually, allowing sufferers to share experiences and coping methods. Medications may also be used; for example benzodiazepines to calm the anxiety, but should only be used for a short period of time. Anti-depressants, particularly SSRI's, are generally recommended before moving onto benzodiazepines if the anti-depressants are not beneficial to the sufferer. Medication is generally only used in more severe cases, and used along side therapy.
Everybody has anxiety within them, it's a fact of life. It's the tense feeling when you're in danger, the butterflies in your stomach before a big exam. Stand up, reach out and don't be afraid to support those with social anxiety disorder.