Social anxiety is effectively an extreme type of shyness that can result in people feeling very self-conscious, inferior, and subject to judgement from others in social situations. It’s the third most common form of psychological disorder, after depression and alcoholism, and doesn’t always occur in isolation.
There are two types of social anxiety:
Specific social phobia: This is when someone may feel able to mix with people socially in most situations but may struggle in particular circumstances, such as when they need to speak publicly, eat in front of others, etc. In these instances they may feel they are being scrutinised and judged and may worry about what could go wrong.
General social phobia: People with this phobia become anxious whenever they are around people. They may feel they are being looked at and judged. It can be very disabling and people often cope with this by avoiding social situations that they feel will make them anxious. This may prevent them from forming long-term relationships.
The symptoms of social anxiety
Once recognised, social anxieties can usually be successfully treated. Therefore if you think you may have a social anxiety it is important to look out for common signs and symptoms so you can seek help.
Physical signs: Sweating, palpitations (feeling of increased or irregular heartbeat), dry mouth, blushing and trembling are all common signs that you may be anxious. You might also have difficulty breathing which may escalate into a panic attack. Sometimes people fear the symptoms as they worry this may result in them being judged harshly by others.
Psychological signs: If you have a social anxiety, you may worry excessively about a social situation or ruminate about situations in the past. You may be aware that you have a problem, but look for ways around it. You may choose to avoid certain situations or use alcohol and drugs to relax and reduce your anxiety so you can function normally. If you regularly use alcohol in this way, it can become an additional problem, so it is important to seek help.
Causes of social anxiety
It is not fully understood why some people develop a social anxiety while others may not. Sometimes it runs in families, so there may be a biological factor, but often it can stem from past experiences. Bad treatment at school (bullying and teasing) or how we were treated by our families and friends can affect us in later life too.
Dealing with a social anxiety
If you think you may have a social phobia, it’s important to discuss this with your GP, who will be able to refer you on to someone in your area that can help. You may find this hard to do, but treatment for this type of anxiety can be very successful.
Cognitive Behavioural Therapy (CBT): CBT has been shown to be highly successful in treating social anxieties.
Social skills: Sometimes re-learning social skills such as starting a conversation can help you feel more equipped to deal with social situations.
Medication: There are medications that can be prescribed to ease the symptoms of anxiety.
Self-help groups: Joining a self-help group can be really helpful.
Self-help publications: There are many good self-help books that guide you through the causes of social anxiety and the things you can do to help yourself. A book our therapists and clients have found helpful is:
- Overcoming social anxiety and shyness by Gillian Butler
This is an accessible self-help book based on Cognitive Behavioural Therapy. It provides a good explanation of social anxiety and ways to challenge it. There are many exercises and techniques for those who like to work in a structured way.
Feel free to contact us to ask about psychological therapies available at First Psychology Edinburgh that may help with social anxiety.
Lucy Clark, Senior Clinical Psychologist (Online only)