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Social Anxiety: How to Break the Cycle of Avoidance and Isolation



Social anxiety disorder (formerly termed "social phobia") is a much more common problem than past estimates have led us to believe. Millions of people all over the world suffer from this devastating and traumatic condition every day, either from a specific social anxiety or from a more generalized social anxiety.




Social Anxiety



In the United States, epidemiological studies have recently pegged social anxiety disorder as the third largest psychological disorder in the country, after depression and alcoholism. It is estimated that about 7% of the population suffers from some form of social anxiety at the present time. The lifetime prevalence rate for developing social anxiety disorder is 13-14%.


A specific social anxiety would be the fear of speaking in front of groups (only), whereas people with generalized social anxiety are anxious, nervous, and uncomfortable in almost all social situations.


It is much more common for people with social anxiety to have a generalized type of this disorder. When anticipatory anxiety, worry, indecision, depression, embarrassment, feelings of inferiority, and self-blame are involved across most life situations, a generalized form of social anxiety is at work.


The physiological manifestations that accompany social anxiety may include intense fear, racing heart, turning red or blushing, excessive sweating, dry throat and mouth, trembling (fear of picking up a glass of water or using utensils to eat), swallowing with difficulty, and muscle twitches, particularly around the face and neck.


People with social anxiety disorder know that their anxiety is irrational and does not make rational (i.e., cognitive) sense. Nevertheless, "knowing" something is not the same thing as "believing" and "feeling" something.


Thus, for people with social anxiety, thoughts and feelings of anxiety persist and show no signs of going away -- despite the fact that socially-anxious people "face their fears" every day of their lives.


The good news is that cognitive-behavioral therapy for social anxiety has been markedly successful. Research and clinical evidence alike indicate that cognitive-behavioral therapy, which should be comprehensive in nature, produces permanent changes in the lives of people.


Social anxiety disorder can be overcome, although it takes both consistency and persistence. But, barring cognitive problems (e.g., dementia, Alzheimer's Disease) everyone can make progress against social anxiety using the appropriate type of cognitive-behavioral therapy.


At The Social Anxiety Institute, we call cognitive-behavioral therapy for social anxiety disorder "comprehensive" cognitive-behavioral therapy, to differentiate it from the general idea that cognitive concepts are simplistic and can be addressed by using only a few strategies.


A successful therapy program for social anxiety disorder must address the dozens of cognitive methods, strategies, and concepts that will allow people's brains (i.e., their brain associations or neural pathways) to literally change. The brain is continually learning, and irrational thoughts and beliefs can change as a result of this cognitive process.


Social anxiety, as well as the other anxiety disorders, can be successfully treated. In seeking support for this problem, search for a specialist -- someone who (a) understands this problem well and (b) knows from experience how to treat it.


It is true that we who have lived through social anxiety do realize our mind is many times irrational and we over-exaggerate, but it still FEELS like others are watching and judging us. Our self-consciousness is a feeling and it is very real.


Those of us who have (or have had) social anxiety need support, encouragement, and a relatively stress-free environment while we are in therapy, so that our brain can absorb all the changes that are occurring without being damaged by external factors (i.e., negative environments, negative people). If our environment is relatively peaceful when undergoing treatment for social anxiety, then it is easier to learn new habits that will permanently change our thoughts, beliefs, feelings, and our lives.


That is, the person who feels anxious while reading in public uses specific strategies to meet his goal, whereas the person who wants to learn how to make introductions and engage in small talk during social activities slowly works toward her goals. We use role-plays, acting, the tape recorder and video camera, question and answer periods, mock job interviews, and doing foolish things deliberately as part of our behavioral therapy group for people with social anxiety.


Therapy groups for social anxiety should always be encouraging, positive, and supportive. If the right atmosphere is set, people can make (and continue to make) progress up their "hierarchy" of social anxieties.


Dr. Thomas A. Richards currently runs all our treatment programs and is a leading clinical authority on the treatment of social anxiety disorder. Dr. Richards began seeing patients with social anxiety in the early 1990s and has seen thousands of patients since that time. The first CBT therapy group for social anxiety started in 1994. International therapy groups began in 1998.


Cognitive behavioral therapy for social anxiety disorder must be comprehensive and cover all aspects of social anxiety. Our groups are active, structured groups that work on anti-anxiety strategies on a daily, consistent basis. Cognitive therapy includes strategies to learn how to think and believe differently about ourselves. Behavioral therapy puts the cognitive strategies into place in your daily life.


I have had social anxiety for as long as I can remember. I have seen countless therapists, and finally, at 28 years old, I have a therapist who is really helping me. I would like to spread the word that social anxiety disorder is treatable if you find a knowledgeable therapist who specializes in CBT READ MORE


Social anxiety disorder in kids can cause them to avoid things that worry them. While this might work to calm anxiety in the short term, hiding from anxiety really only makes it get worse. It can also become a habit. Asking for help can be hard, but it really is important.


The idea that people might be paying particular attention to what you do makes a lot of kids anxious. Some kids feel so anxious that they develop something called social anxiety disorder, which is diagnosed when you worry so much about how you appear to others that you stop doing things you need to (and want to) do for fear of embarrassing yourself.


We are funded by donors like you! You can make a difference by joining our mission and helping people affected by anxiety and anxiety disorders. There are many ways to get involved such as monthly giving or starting a fundraiser. Choose what works best for you!


A social situation includes any situation in which you and at least 1 other person are present. Social situations tend to fall into 2 main categories: performance situations and interpersonal interactions.


Note: It is not uncommon for people to fear some social situations and feel quite comfortable in others. For example, some people are comfortable spending time with friends and family, and interacting socially with co-workers but are very fearful of performance situations, such as participating in business meetings or giving formal speeches. Also, some people fear only a single situation (such as public speaking), while others fear and avoid a wide range of social situations.


Social Anxiety is the third largest mental health care problem in the world today. Alcoholism is first, depression is second, and social anxiety is third. Social anxiety causes chronic anxiety and fear over social situations. It prevents people from leading the life they want; it stops them from taking the job they are good at doing; it prevents them from having friends and relationships, even though they want them. Social anxiety destroys lives. Yet it can be fully overcome with appropriate, active, structured, cognitive-behavioral therapy.


The Social Anxiety Institute is the largest website on the internet about social anxiety disorder (social phobia). Therapy programs have run at the Institute full-time since 1994. Major new help for overcoming is always under development and revisions to therapy programs occurred in 2019. Another therapy program revision will be complete in 2020.


For treatment: Overcoming social anxiety: Step by Step A structured guide to overcoming social anxiety (a "How to" guide to get over social anxiety). This therapy program is the most commonly used program to help people overcome social anxiety. It was written and explained by a person who had a severe case of social anxiety himself: Dr. Thomas A. Richards, the founder and director of the Social Anxiety Institute, Inc.


Whether you were already socially anxious before the pandemic, or you are developing social anxiety as a result of being in isolation, the prospect of returning to society can feel daunting to even the strongest person.


Thompson C, Mancebo MC, Moitra E. Changes in social anxiety symptoms and loneliness after increased isolation during the COVID-19 pandemic. Psychiatry Res. 2021;298:113834. doi:10.1016/j.psychres.2021.113834


When not interacting with close friends or family, people with severe social anxiety have a deep-seated fear of being judged, rejected, embarrassed or humiliated during social interactions. As irrational as those fears may be, they are difficult to escape.


Recent research into specific genetic markers for social anxiety have focused on changes in a gene called SLCGA4, which is involved in the transport of the neurotransmitter serotonin, a chemical that can help soothe nerves and stabilize moods. Both shortages and excesses of serotonin have been linked to social anxiety symptoms, and people with social anxiety disorder struggle to produce serotonin consistently and without fluctuation.


Action in the amygdala triggers an avalanche of symptoms identified with intense anxiety, including rapid heartbeat, sweaty palms, respiratory excitement, muscle tightening, a surge in blood sugar levels, and a freezing of the brain that leaves anxiety sufferers unable to think or reason normally. 2ff7e9595c


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