Social anxiety is the third most common mental health difficulty in the world (after depression and alcohol dependence). Lots of people feel occasionally shy or might be introverted in their personality, social anxiety is quite different.
Young people with social anxiety experience a significant amount of anxiety, stress, and embarrassment on a daily basis. It’s not occasional, it’s every day.
The amount of anxiety that they experience is so emotional painful that they to avoid situations entirely, or endure them with a high level of distress.
A young person is faced with what feels like the impossible position of REALLY wanting to make a good impression with others (especially other young people) while at the same time are feeling REALLY insecure about their ability to do so.
Typical Social Situations that provoke Social Anxiety
Taking the bus can be incredibly anxiety provoking for someone who has social anxiety. It can provoke so many different what if thoughts:
- What if I get on and see someone I know
- What if I get on and I see someone I know and they blank me
- What if I see someone I know and they try to talk to me and I go blank or say something stupid
- What if the bus is packed and there’s no seats and I feel trapped
- What if I miss my stop
Joining in a conversation with a group:
- What if I don’t know what they’re talking about
- What if I can’t think of anything to say
- What if I say something really stupid and they laugh at me
- What do I do if / when my mind goes blank
- What if they see my hand / leg shaking
- What will I do if / when I start to blush from my neck all the way into my face, they’ll think I’m weird or there’s something wrong with me
Nights out can be hugely anxiety provoking:
- What if I don’t know anyone there / what if I know everyone there
- What if I don’t drink, they’ll think I’m weird
- What if I drink too much and make a fool of myself and it’ll be all over insta and snap stories and people will be laughing and talking about me for weeks
- What if someone tries to kiss me
- What if no-one kisses me
- If I dance badly will they laugh at me, will they think I’m weird if I don’t dance at all
It might surprise you but for lots of the young people I meet, ordering a take away can be something very anxiety provoking:
- What if I forget what we’re ordering and I go blank / silent on the phone, they’ll think I’m a weirdo
- What if I forget our address
- What if they ask me a question I don’t know the answer to
Interestingly, one of the most difficult times for social anxiety is when there’s actually no-one around to make us feel anxious and we’re not being social at all – bed time!
It is very rare that someone who experiences social anxiety will just pop off to sleep nice and relaxed, mind empty of negative thoughts. It is much more likely to be like the picture on the right, waking up in the middle of the night thinking back on something they said the day before and worrying about what the other person(s) thought about it. It can be sometimes really hard to get off to sleep when your mind is going 1000 miles per hour thinking over and over and analysing from almost every conceivable angle something you said or something someone said to you. You’re then jumping to what you have ahead of you tomorrow and how you’ll cope with being around people. Is it any wonder with that much going on in your mind that it can be hard to wind down and get to sleep!
The Three Stages of Social Anxiety
The before stage is usually when someone with social anxiety is flooded and overwhelmed by the what if thoughts, and it’s not usually just one or two waves and waves of them. The one thing these thoughts usually have in common is that they are usually catastrophic. Before an event is coming up when someone gets overwhelmed by social anxiety all they can ever think about is that the worst possible things will definitely happen to them, it’s guaranteed, if it wasn’t guaranteed then why do I feel so anxious, it’s a sign, it’s the world telling me not to go, it will be a disaster, I know it! When the person with social anxiety has an event coming up it automatically activates their negative self-concept and that’s the only lens that they believe people will see them through too.
So in the build up to a party or other potentially enjoyable event the person experiences an almost constant state of anticipatory anxiety, but again only anticipating the worst possible outcomes. The main danger that they anticipate is that whoever is there will definitely make negative judgement of them.
This is when the planning for safety begins. In many situations the only thing the person believes will truly protect them is to avoid the event all together. By doing so they make their social anxiety even more powerful because they get a relief from their increasing anxiety and they also believe they’ve prevented something catastrophic from happening by not going.
If the person absolutely can’t find a way to avoid the event then they have to find a way to endure the event even though they feel distressed or overwhelmed. This is particularly difficult for young people who feel very socially anxious in school. School is not somewhere we usually have much choice about going or not and it’s filled with hundreds of other teenagers, who as we know can be a judgmental bunch at the best of times.
In the social situation the person with social anxiety can struggle even more because of the exceptionally high standards / perfectionism they expect of themselves in every social situation. They expect that they have to be the most interesting, the funniest, the most empathetic, most intelligent all the times, to all people or else it won’t be good enough and they’ve failed socially.
The other difficult aspect in the During phase is the dilemma’s that are experienced. “
“If I talk too much people will think I’m rude and full of myself and if I don’t say anything at all they’ll think I’m rude and boring“
With those kinds of thoughts going on it really does feel like you can’t win.
You’re doing your best to concentrate on the conversation with the other person(s) while at the same time you are being bombarded by your own very strong and very loud internal critic.
In the situation the person with social anxiety shifts their attention from an external (the social world) to internal focus (our internal world) .
In the During phase the person become very very self-conscious and preoccupied with the physical sensations they’re feeling inside. With racing what if thoughts and their insides on high alert the during phase can feel emotionally and physically exhausting.
In the During phase the person with social anxiety also assumes or believes that they can Mind Read. They are certain that they know what the other person is thinking, they’re definitely thinking about them and they’re thinking terrible things, I know it!
I often ask people who experience social anxiety why is it that the Mind Reading skill that they have comes with a very unfortunate terms and conditions attached. The Mind Reading can only mind read negative thoughts of others, why is that? What’s happening here is that the person is projecting their own negative feelings about themselves onto someone else and convinces themselves that if they think this badly about themselves then the other person MUST think that way too.
In order to try and cope and survive the situation the person with social anxiety uses Safety Behaviours:
- Asking the other person lots of questions when speaking with someone new (to keep the focus off of oneself).
- Selecting a position in the situation to avoid possible scrutiny (e.g., sitting in the back of the room)
- Drinking alcohol or taking drugs
- Taking on roles in social situations so that one does not have to interact (taking pictures or setting up equipment)
- Wearing high next tops or wearing hair in certain ways to cover blushing or to avoid eye contact
- Averting eye contact to avoid being noticed by others
- Apologising (because have assumed have said something wrong or rude)
The above safety behaviours are designed and intended to take the focus off the person so that there’s less risk of being judged. However it often has the opposite effect than intended:
- Drink to feel less anxious but drink too much and draw attention to self by being really drunk
- Apologising for assumed rudness or saying something “wrong” – the other person wonders why are they apologising, doesn’t make sense, draws more attention on the person.
- Averting eye contact – other person wonders do they not like them anymore, why aren’t they looking at me, that’s unusual, more attention on the person.
The After phase
Physically the After phase is usually experienced as a reduction in the physical signs of anxiety and physical and mental exhaustion from the energy needed to endure and survive the event.
This is also when the mental “post-mortem” occurs when the person ruminates over and over again about the event, analysing every last comment they said, what someone else said, looks they got, how many people talked to them, what they should have said, what they regretted saying, how embarassing they felt or how much people must have thought what they said or did was embarassing.
If a situation unexpectedly ran smoothly then when you have social anxiety you believe that they only reason it went well was because of Luck! The other thing that occurs is that the person believes that their safety behaviours saved them.
So what next, what does someone do if they’re strugging in the ways described above? Luckily there are some great sources of information and support to help people take the next steps:
Understanding Social Anxiety and Shyness – Gillian Butler is the complete guide to understanding and learning how to cope with social anxiety
Social Anxiety Ireland Social Anxiety Ireland (SAI) originated as a group-based, cognitive behavioral therapy (CBT) treatment program for Social Anxiety within the Department of Adult Psychology of the Mater Hospital in 1998. It was established in the context of few services providing diagnosis specific treatments for what is widely recognized as the third most common mental health problem, nationally and globally.
SAI is the only entity Ireland, outside of the public health system, providing professional and evidence-based psychological treatments to individuals with social anxiety. Both the NICE guidelines and more recent studies point to psychological treatments being among, if not the, most effective for this condition, even when compared with medication.
This blog also has other sections relevant to someone who experiences social anxiety,