Anxiety is the most commonly diagnosed mental health issue, and social anxiety is one of the most common anxiety disorders. Anxiety is a very normal human reaction—it's adaptive and helps us prepare for danger—but it can become an issue when it affects our daily functions in a way that causes us to avoid certain people, places, situations, or things.
Social anxiety is fear and avoidance of social situations, says Ashlyn Swartz, LCSW, a psychotherapist with Main Line Health's Women's Emotional Wellness Center. Usually, it's the anticipation of the event, not the event itself, that causes anxiety. Social anxiety comes in different shapes and forms, but it often involves intense fear about social situations, concern that you'll feel shame or embarrassment about saying or doing the wrong thing, or worry that you will be judged or criticized. Social anxiety can also trigger a range of physical symptoms, including blushing, sweating, shaking, increased heart rate, and dizziness.
"At some point, we've all felt uncomfortable in social situations, whether it's public speaking, meeting new people, going to a party where you don't know anyone, or going to a job interview, but it becomes an issue when we're actively avoiding those things," Swartz says.
What causes social anxiety disorders?
According to Swartz, anxiety can be both a neurological challenge as well as a learned behavior. Some people may have learned the anxiety from an anxious parent, or perhaps they once said something that others teased them about, causing them to fear similar situations. "That could then lead you to be uncomfortable in social situations," Swartz says.
A lot of people think they lack social skills when they actually lack the confidence to use the social skills that they have.
Anxiety, and social anxiety, is common. Approximately 19 percent of the population in the United States has anxiety. Social anxiety disorder affects about 15 million Americans, or seven percent of the population. These numbers are likely underreported, since many people do not seek help.
Mental health issues, including social anxiety disorder, have become even more prevalent since the start of the COVID-19 pandemic. Because we were advised to stay home and avoid others, it can be extremely difficult for many to go back into pre-pandemic daily routines and get reacclimated to their surroundings.
Social anxiety treatment and coping methods
Even though anxiety disorders are so common, only 36 percent of those suffering receive treatment. Anxiety is very treatable, and Swartz notes that with the right tools and resources, social anxiety disorders can improve quickly. Cognitive behavioral therapy is often utilized to help patients with social anxiety challenges and reframe their thoughts to feel more positive and confident about social situations. The goal is to learn to manage the anxiety, not necessarily to eliminate it, since avoidance can lead to more anxiety.
Below are a few of the coping tools Swartz recommends:
1. Observe your social anxiety. Swartz recommends paying attention to your social anxiety so you can learn about the types of situations that you find fearful, along with the thoughts and concerns that you feel when you think about that type of situation. Keep a log of these situations by writing down the date the situation occurred, what the situation was, and how it made you feel. This will help you identify common factors that make you anxious and help you better prepare in the future.
2. Learn to relax. It's also helpful to learn how to relax in moments of anxiety. Calm breathing, muscle relaxation, mindfulness, and grounding techniques all can help you relax. "[These practices] bring you back to the moment and relax you so your physical symptoms aren't spiraling to the point where you're not able to focus on the present situation," Swartz says.
3. Think more realistically. Social anxiety causes people to think negatively about what might happen in a social situation. Some may fear that no one will talk to them or others will find them weird or off-putting. "Often, these are thoughts or guesses, not necessarily facts," Swartz says. Make a point to acknowledge that your feared situation might happen in a social setting. Then, evaluate your thoughts based on fact, and gauge how realistic it is for it to actually occur. You can also practice imaginal exposure, and map out what people may say or do so you can prepare for any situation. Swartz says that this will help you feel less fearful in those particular situations.
4. Face your fears. While it may help in the short term, avoiding feared social situations will only make those situations scarier. "You're going to have to speak to a group of people at some point, so in the long run it really prevents you from learning that the feared expectations are unlikely," Swartz says. Facing the feared situations can help decrease your stress and anxiety about the situation. Practice helps build confidence and shows you that these situations are not as bad as you once feared. Doing so also gives you the opportunity to contribute and see what you have to offer. "Maybe you have a lot to really contribute, but you don't know that because you haven't really given yourself the opportunity to do it," Swartz adds.
5. Medications. In moments where the anxiety is intense, medication may be necessary to provide short-term relief. Anxiety medications can help alleviate the physical symptoms of anxiety so you can use tools and coping mechanisms to work through the anxiety. Though anxiety medication can help with symptoms, it is not a long-term cure, and it is best used for immediate relief.
Swartz encourages people to remind themselves that they don't have to be perfect. It's important to be comfortable with the discomfort of social situations so that eventually, they won't be quite as uncomfortable.
If social anxiety is limiting your ability to function in your daily life, there are resources and help available. Social anxiety can be treated quickly with practical tools, and the first step is to reach out for help.
Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia, including the Women's Emotional Wellness Center which offers a host of outpatient psychotherapy groups that address coping with anxiety. To schedule an appointment with a specialist at Women's Emotional Wellness Center, 1.888.CARE.898 (227.3898) or use our secure online appointment request form.