Some level of social anxiety is to be expected in new situations or in situations where one is called to be the center of attention. For example, when we have to do an exhibition, a speech or a concert.
Social anxiety is even normal and adaptive under such circumstances. Indeed, it prepares us to face new situations while preventing us from being too impulsive.
However, there are people in whom this feeling is more intense when confronted with unexpected or sometimes even frequent events. For example, in situations where they have to interact with people who are not part of their family, then they experience a high level of difficulty.
Social anxiety is also called social phobia. An important point in making a diagnosis of social anxiety is to observe the interference of this anxiety in daily life. We can also study the interweaving of anxiety itself. Let’s dig a little deeper into the subject.
What is social anxiety?
People with social anxiety experience an excessive and irrational fear of social situations which do not represent a real danger to their life or to their personal integrity. They can engage in subtle avoidance behaviors.
For example, during a group activity, they will sit in the back and will not ask questions during the meeting. They will also apologize when there is no reason to.
On the other hand, population studies tell us that social anxiety has been on the rise in recent years. Adolescents have less and less direct interactions with their peers in unregulated or scripted environments, such as in class or during extracurricular activities.
This creates much more fragile supportive social environments. Adolescents are even at risk of experiencing impairments in some basic social skills in adults. And this, especially in the world of work. In children, four aspects are important in making a diagnosis:
- First of all, we observe fear in social situations in the presence of adults, but also in the presence of comrades.
- They are not able to establish relationships with their family members.
- They are usually unaware that their fear is excessive and irrational.
- As in adults, they should show symptoms for at least 6 months.
For Mattick and Clarke, social phobia has two aspects: anxiety related to social interactions and fear of criticism. The first refers to the anxiety felt during meetings and conversations with other people. And this, whether they are friends or strangers.
The differences between social anxiety disorder, avoidant personality disorder, and shyness
Shyness refers to embarrassment and inhibition in the presence of other people. This is a lasting trend or predisposition. It is not a simple reaction to certain temporary and specific characteristics. Shyness is therefore a character trait that manifests itself as anxiety and inhibition in most social contexts.
Social anxiety disorder (SAD), avoidant personality disorder (TPE), and shyness are all associated with feelings of embarrassment and fear of being ridiculed. While there are somatic and cognitive similarities, there are also some important differences between these three terms. Here are some of those differences:
- In the case of SAD, the degree of social and professional handicap tends to be greater than in shy people.
- Shyness tends to show up earlier than social anxiety.
- SAD is a chronic condition, whereas shyness can appear early in a person’s life and then go away.
- Avoidance is generally much more common in SAD than in shyness. In addition, the severity of avoidance is also greater in SAD than in shyness.
- In the TPE, there is a fear of rejection and criticism, just like in the CAS. This avoidance behavior is observed from childhood as a personality trait.
- It is usually associated with a greater number of concurrent problems and it is more difficult to address the problem. Indeed, a greater number of situations are avoided. And this, well beyond social situations.
The clinical features of social anxiety
People with social anxiety disorders fear or avoid situations that involve observation from others. Two behavioral components are predominant in most social situations: deficits in social skills and avoidance behaviors.
The people concerned are silent or not very talkative. Their agitation is noticeable. They show great vigilance and their attention is constant. They also move away from social situations.
They tend to direct their attention to information related to social failure. They display a greater sensitivity to anxiety than the nonclinical control groups. Sometimes this sensitivity causes them to overestimate the perception of anxiety they feel.
People with social anxiety disorder have negative internal dialogues. This distracts their attention from other signs their environment is giving them.
These people may perceive the positive and negative aspects of their behavior. However, they overestimate the extent to which their behavioral deficits affect the general impression they make on others.
They are numerous. These may include palpitations, sweating, tension, nausea, blurred vision, chills, tingling sensations, and paresthesia or numbness. In children, it is common for them to experience the phenomenon of a lump in the throat.
People with social anxiety disorder seem to be particularly affected by other symptoms. For example: hot flashes, chills and sweating.
Epidemiology and evolution
The frequency of this disorder is between 3 and 13%. Social anxiety can therefore be considered a fairly common mental disorder. The prevalence rate is highest in the United States. WHO considers the latter to be the same for men and women, but some do not agree with this finding.
Social anxiety disorder usually appears in the middle of adolescence, that is, between the ages of 12 and 18. Once installed, TAS is permanent and lasts a lifetime.
Its development is usually gradual, but it can also appear as a result of a stressful or humiliating experience. When its onset is gradual, people usually cannot remember precisely when it started.
Management of social anxiety disorder
Cognitive behavioral psychotherapies are considered to be effective in the treatment of social anxiety disorder. Treatment may or may not occur in a clinical setting.
In other words, the person may not meet the diagnostic criteria for social phobia. This does not, however, prevent the clinician from providing her with tools to help reduce her blood pressure in potentially stressful situations for her.
In this context, the technique of progressive exposure is commonly used. Through relaxation and parallel work on the thoughts and emotions felt by the person, the therapist establishes a list of goals to be achieved throughout therapy. The end goal is for the patient to be able to face their greatest fears without anxiety.
Beyond social embarrassment …
Certainly, social anxiety can exist naturally in certain situations. It can also manifest in a subject in certain situations without interfering with his performance. However, as we have explained, social anxiety disorder goes far beyond mild social discomfort when doing group tasks.
Rather, it is a chronic avoidance of activities. Exposure to the group is then felt as a demand that cannot be satisfied. It is characterized by profound discomfort which can result in dizziness, numbness or blockage.
It is therefore important to watch adolescents or young adults when they begin to exhibit this type of behavior. Solving the problem in the social realm does not mean that social anxiety has necessarily disappeared in other situations.
For example, a person may have a relatively low level of social anxiety in a sports setting, but experience seizures at work because they have not worked on their ability to control. Therefore, social anxiety therapy should aim to resolve difficulties in all settings.