Examples of Social Anxiety Disorder

Social anxiety disorder (social phobia) is the third largest
psychological problem in the United States today.....
very few people really understand this...

A man finds it difficult to walk down the street because he’s self-conscious and feels that people are watching him from their windows. Worse, he may run into a person on the sidewalk and be forced to say hello to them. He’s not sure he can do that. His voice will catch, his "hello" will sound weak, and the other person will know he’s frightened. More than anything else, he doesn’t want anyone to know that he’s afraid. He keeps his eyes safely away from anyone else’s gaze and prays he can make it home without having to talk to anyone.

A woman hates to stand in line in the grocery store because she’s afraid that everyone is watching her. She knows that it’s not really true, but she can’t shake the feeling. While she is shopping, she is conscious of the fact that people might be staring at her from the big mirrors on the inside front of the ceiling. Now, she has to talk to the person who’s checking out the groceries. She tries to smile, but her voice comes out weakly. She’s sure she’s making a fool of herself. Her self-consciousness and her anxiety rise to the roof.

Another person sits in front of the telephone and agonizes because she’s afraid to pick up the receiver and make a call. She’s even afraid to call an unknown person in a business office about the electric bill because she’s afraid she’ll be "putting someone out" and they will be upset with her. It’s very hard for her to take rejection, even over the phone, even from someone she doesn’t know. She’s especially afraid to call people she knows because she feels that she’ll be calling at the wrong time -- the other person will be busy — and they won’t want to talk with her. She feels rejected even before she makes the call. Once the call is made and over, she sits, analyzes, and ruminates about what was said, what tone it was said in, and how she was perceived by the other person....her anxiety and racing thoughts concerning the call prove to her that she "goofed" this conversation up, too, just like she always does. Sometimes she gets embarrassed just thinking about the call.

"I would freeze up every time I had to meet someone in authority...."

A man hates to go to work because a meeting is scheduled the next day. He knows that these meetings always involve co-workers talking with each other about their current projects. Just the thought of speaking in front of co-workers raises his anxiety. Sometimes he can’t sleep the night before because of the anticipatory anxiety that builds up. Finally, the meeting is over. A big wave of relief spills over him as he begins to relax. But the memory of the meeting is still uppermost in his mind. He is convinced he made a fool of himself and that everyone in the room saw how afraid he was when he spoke and how stupid he acted in their presence. At next week’s meeting, the boss is going to be there. Even though this meeting is seven days away, his stomach turns raw with anxiety and the the fear floods over him again. He knows that in front of the boss he’ll stammer, hesitate, his face will turn red, he won’t remember what to say, and everyone will witness his embarrassment and humiliation.

He has seven miserable days of anxiety ahead of him, to think about it, ruminate over it, worry about it, overexaggerate it in his mind...over and over again...

A student won’t attend her university classes on the first day because she knows that in some classes the professor will instruct them to go around the room and introduce themselves. Just thinking about sitting there, waiting to introduce herself to a roomful of strangers who will be staring at her makes her feel nauseous. She knows she won’t be able to think clearly because her anxiety will be so high, and she is sure she will leave out important details. Her voice might even quaver and she would sound scared and tentative. The anxiety is just too much to bear -- so she skips the first day of class to avoid the possibility of having to introduce herself in public.

"I’m the only one in the world who has these horrible symptoms...."

Another young man wants to go to parties and other social events -- indeed, he is very, very lonely -- but he never goes anywhere because he’s very nervous about meeting new people. Too many people will be there and crowds only make things worse for him. The thought of meeting new people scares him -- will he know what to say? Will they stare at him and make him feel even more insignificant? Will they reject him outright? Even if they seem nice, they’re sure to notice his frozen look and his inability to fully smile. They’ll sense his discomfort and tenseness and they won’t like him – there’s just no way to win – "I’m always going to be an outcast," he says. And he spends the night alone, at home, watching television again. He feels comfortable at home. In fact, home is the only place he does feel comfortable. He hasn’t gone anywhere in twelve years.

"It’s just easier to avoid social situations."

In public places, such as work, meetings, or shopping, people with social phobia feel that everyone is watching and staring at them (even though rationally they know this isn’t true). The socially anxious person can’t relax, "take it easy", and enjoy themselves in public. In fact, they can never relax when other people are around. It always feels like others are evaluating them, being critical of them, or "judging" them in some way. The person with social phobia knows that people don’t do this openly, of course, but they still feel the self-consciousness and the judgment while they are in the other person’s presence. It’s sometimes impossible to let go, relax, and focus on anything else except the anxiety. Because the anxiety is so very painful, it’s much easier just to stay away from social situations and avoid other people.

"More than anything, he doesn’t want anyone to know he’s afraid...."

Many times people with social anxiety simply must be alone -- closeted -- with the door closed behind them. Even when they’re around familiar people, a person with social phobia may feel overwhelmed and have the feeling that others are noticing their every movement and critiquing their every thought. They feel like they are being observed critically and that other people are making negative judgments about them.

One of the worst circumstances, though, is meeting people who are "authority figures". Especially people such as bosses and supervisors at work, but including almost anyone who is seen as being "better" in some way. People with social anxiety may get a lump in their throat and their facial muscles may freeze up when they meet this person. The anxiety level is very high and they’re so focused on "not failing" and "giving themselves away" that they don’t even remember what was said. But later on, they’re sure they must have said the wrong thing...because they always do.

How is it ever possible to feel "comfortable" or "natural" under these circumstances?

To the person with social anxiety, going to a job interview is pure torture: you know your excessive anxiety will give you away. You’ll look funny, you’ll be hesitant, maybe you’ll even blush, and you won’t be able to find the right words to answer all the questions. Maybe this is the worst part of all: You know that you are going to say the wrong thing. You just know it. It is especially frustrating because you know you could do the job well if you could just get past this terrifying and intimidating interview.

Welcome to the world of the socially anxious.

Social anxiety is the third largest psychological problem in the United States today. This type of anxiety affects 15 million Americans in any given year. Unlike some other psychological problems, social anxiety is not well understood by the general public or by medical and mental health care professionals, such as doctors, psychiatrists, psychologists, therapists, social workers, and counselors. In fact, people with social anxiety are misdiagnosed almost 90% of the time. People coming to our anxiety clinic with diagnosable DSM-IV social phobia have been mislabeled "schizophrenic", "manic-depressive", "clinically depressed", "panic disordered", and "personality disordered", among other misdiagnoses.

Because few socially-anxious people have heard of their own problem, and have never seen it discussed on any of the television talk shows, they think they are the only ones in the whole world who have these terrible symptoms. Therefore, they must keep quiet about them. It would be awful if everyone realized how much anxiety they experienced in daily life. Unfortunately, without some kind of education, knowledge and treatment, social anxiety continues to wreak havoc throughout their lives. Adding to the dilemma, when a person with social phobia finally gets up the nerve to seek help, the chances that they can find it are very, very slim.

Making the situation more difficult is that social anxiety does not come and go like some other physical and psychological problems. If you have social anxiety one day......you have it every day for the rest of your life, unless you receive the appropriate therapy.

The feelings I described to you at the beginning of the article are those of people with "generalized" social anxiety. That is, these symptoms apply to most social events and functions in almost every area of life. I suffered from social phobia myself for twenty years before I ever saw the term or read about its symptoms in a book.

As with all problems, everyone with social anxiety has slightly different symptoms. Some people, for example, cannot write in public because they fear people are watching and their hand will shake. Others are very introverted and they find it too difficult to hold down a job. Still others have severe anxiety about eating or drinking in the presence of other people. Blushing, sweating, and "freezing" are other physiological symptoms.  Some people with social anxiety feel that a certain part of their body (such as the face or neck) are particularly "strange looking" and vulnerable to being stared at.

One thing that all socially anxious people share is the knowledge that their thoughts and fears are basically irrational. That is, people with social anxiety know that others are really not critically judging or evaluating them all the time. They understand that people are not trying to embarrass or humiliate them. They realize that their thoughts and feelings are somewhat irrational. Yet, despite this rational knowledge, they still continue to feel that way.

The good news is that social anxiety is not only treatable, but the treatment is also successful. Social anxiety no longer needs to be a life-long, devastating condition.

It is these automatic "feelings" and thoughts that occur in social situations that must be met and conquered in therapy. Usually these feelings are tied to thoughts that are entwined in a vicious cycle in the persons’ mind.

How can social anxiety be treated? Many therapeutic methods have been studied, but cognitive-behavioral techniques have been shown to work the best. In fact, treatment of social anxiety through these cognitive-behavioral methods produces long-lasting, permanent relief from the anxiety-laden world of social anxiety.

A better life exists for all people who suffer from social anxiety.....

Social phobia responds to relatively short-term therapy, depending on the severity of the condition. To overcome social anxiety, completion of a CBT therapy group is also essential.   What socially-anxious people do not need is years and years of therapy. In fact, socially anxious people who are taught to "analyze" and "ruminate" over their problems usually make their social anxiety worse.

There is a better life for all people with social anxiety. Without treatment, social anxiety is a torturous emotional problem; with treatment, its bark is worse than its bite. Add to this that the current research is clear that cognitive-behavioral therapy is highly successful in the treatment of social anxiety. In fact, people who are unsuccessful are the ones who are not persistent in their therapy and who won’t practice simple anti-anxiety strategies at home — they are the ones who give up. If a person is motivated to end the years of crippling anxiety, then cognitive-behavioral treatment provides methods, techniques, and strategies that all combine to lessen anxiety and make the world a much more enjoyable place. Many of us have been through the crippling fears and constant anxiety that social anxiety produces -- and have come out healthier and happier on the other side.

-- Thomas A. Richards, Ph.D.
Psychologist,
Director, Social Anxiety Institute

"Overcoming Social Anxiety" Therapy Series

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