Have A Social Anxiety - Don't Worry You Are Not Alone.

If you have social anxiety disorder believe me you are not alone.

Never give up hope.
Never be afraid to ask for help.
You have right to a free and fulfilling life
.

Celebrities with social anxiety
Kim Basinger

"My hands were shaking. I was sweating so profusely I could not move."
"..I didn't leave the house for 6 months."
"I used to go home and play piano and scream at night to let out my frustrations."
"And this led to my agoraphobia."
"Fear has been something, I have lived with my entire life, the fear of being in public places - which led to anxiety or panic attacks."
"I stayed in my house and literally cried every day."

Barbra Streisand

"I couldn't come out of it."
"I didn't have any sense of humor about it."
"You know, I can't remember my good reviews. I remember negative one. They stay in my mind."
"Performance is not about perfection. I could never perform live if it were. For me, it's about raising the money to do good in the world. It's about self acceptance. It's about believing that i am enough."

Khalil Greene
"..for me it's always been pretty deep."
"I've always taken the game pretty seriously and wanted to perform well."
"For me, it wasn't healthy in terms of how deep it goes. I don't know how to describe it, other than the face it wasn't pleasant."
"It was difficult to concentrate, difficult to sustain my energy level. All my energy was wasted trying to control myself. Just trying to get myself to function, to be able to stay in the game and not be thinking so much what I'm thinking."
"It's just a battle to be relaxed."

Donny Osmond

"I kept trying to remember the words, but they slipped through my fingers.. the harder i tried the more elusive they became."
"The best i could do was not to black out."
"Being in show business, it was embarrasing to come out with this disorder, which at the time i didn't even know what it called. I just thought i was crazy. I can't even tell you how important it is to know that you are not alone, and others have suffered and gotten through it."

There is hope. Just keep going and take one step at a time.

What is Cognitive Behavioral Therapy - CBT

The two main conventional treatments for social anxiety disorder are: cognitive behavioral therapy CBT and medication. Sometimes both may be used at the same time.

Cognitive Behavioral Therapy ( CBT )


The central concept of the cognitive part, of cognitive behavioral therapy CBT is; what we think effects how we feel and what we do. If focuses on your cognition. Another way to view this, is that cognitive therapy focuses on your self talk for example you say to yourself all day long.
The behavioral part, of cognitive behavioral therapy CBT, focuses on behavior rather than the internal thought processes. It includes approaches on how to condition behavior, using principals like pain and pleasure for example we tend behave in a way to avoid pain and/or to gain pleasure.
Cognitive behavioral therapy CBT is a combination of both cognitive and behavioral approaches. However, the emphasis is generally on the cognitive part.
The use of cognitive behavioral therapy in social anxiety disorder will include things like:

  • An explanation of social anxiety disorder.
  • An explanation of how your thoughts affect how you feel and act.
  • An explanation of the concept that the world is not the actual world itself, but your interpretation of it.
  • How your thoughts/beliefs/opinions affect how you interpret the world around you.
  • Exercises to reveal your own personal negative automatic thoughts NATs and self limiting or negative beliefs.
  • Challenging negative automatic thoughts NATs and negative or self limiting beliefs to see if they have any basis in reality.
  • Introducing positive thoughts and beliefs that will be helpful to you, in overcoming social anxiety.
  • Exposure therapy; where you are increasingly exposed to situations which cause anxiety. The aim is that eventually your anxiety reduces to a level which allows you to function adequately.

Cognitive behavioral therapy is usually done one to one with a psychologist. It is a process which can take months. It does require a degree of effort and determination to make it work.

What Are Negative Automatic Thoughts (NAT) And How They Effects You.

In cognitive behavioral therapy, social anxiety is rooted in thoughts.

The central concept in cognitive behavioral therapy is:

What you think  = what you feel and do
If you think negative thoughts, you get negative feelings.

   
For example, if you think negative thoughts like "they think i am weird" or "they don't like me" or "i don't deserve this" or "i can not look weak in front of others" or "I'm useless or "I'm an idiot", you will experience negative emotions like fear and anxiety.

    So changing these negative thoughts into positive ones is the basis for overcoming social anxiety.
We are thinking all the time. We think about things that happen to us, or around us. We think about what has happened in the past, or what may happen in the future. What we think, is filtered through our beliefs and strongly held opinions. This gives meaning to what happens to us. And the meaning we give to something is the most important part. It is the meaning we give something, that produces the strongest feelings.

    Normally, we don't put into words some of our deeply held thoughts and beliefs. They are just there. But when you want to make a change, you need to focus on the thoughts and beliefs that are holding you back. You need to focus on what you are telling yourself all day long. You need to focus on the meaning this is producing for you. You need to focus on this, because the meaning it has for you, produces the strongest effect over how you feel and how you do things.

    You need to know what your negative thoughts are. The best way to do this is to get a pen and paper out right now. Start writing down some of the thoughts you have about yourself on the paper. There is no right or wrong way to do this. Jus write a few statements you have about yourself, like "I'm..." or "I should...". You need to write this down. You cannot just think it. Your thoughts are too fast and fleeting for this. You need to write this down so you can catch the negative thoughts you have about yourself. Writing it down gives your mind something to focus on. Stop reading this now. Get that pen and paper. And start writing now.

    Generally, these negative thoughts occur automatically. That is why they use the term Negative Automatic Thoughts NATs or Automatic Negative Thoughts ANTs. Both terms mean the same thing.
These negative automatic thoughts NATs represent the rules for your reality. The rules by which you live. They give meaning to what happens to you, and around you, and what has happened in the past, and what may happen in the future.

    Changing these negative automatic thoughts NATs, will changes your life. Change these negative automatic thoughts into positive automatic thoughts, will change the way you feel, and the way you do things. It is not easy to do this, but it can be done. The first step is to write them down.

Here are some examples of negative automatic thoughts:

  • I am useless
  • I am an idiot
  • They think badly of me
  • They don't like me
  • I am weird
  • I look foolish
  • I am stupid
  • I am boring
  • I am no good
  • I am odd
  • I am inferior
  • I am inadequate
  • I am unlikeable
  • I can't change
  • I am trapped
  • There is no hope for me
  • I will lose control and expose myself
  • Everyone is watching me
  • Everyone is judging me
  • People don't like me because I am quiet
  • People don't like me because I am nervous
  • I must appear interesting, otherwise people will not like me
  • If the conversation doesn't go well, it is my fault
  • Why am I a complete disaster?
  • I do not belong here
  • They can see how anxious I look
  • This is terrible
  • I am always doing the wrong thing


    I know i sound like a broken record on this, but this is important. Write the thoughts and beliefs you have about yourself on a piece of paper. You may find you can add to the list later on, or that it changes over time. But, write them down now.

    In summary, we are thinking all the time. The thoughts we think, affect how we feel. Negative thoughts = negative feelings. Positive thoughts = positive feelings. This is the key to overcoming social anxiety in cognitive behavioral therapy. When you feel good and think positive thoughts, you do positive things. It is hard to change the way you think. It is hard to change how you perceive reality. But it can be done. It takes effort and persistence. But the results are worth it.

Symptoms Of Social Anxiety Discorder

The symptoms of social anxiety can be divided into 4 main categories:

Category 1: The effects on your feelings:

  • Fear
  • Anxiety
  • Nervousness
  • Panicky feelings
  • Apprehension
  • Embarrassment
  • Feeling of being watched
  • Frustration
  • Irritability
  • Anger
  • Low confidence
  • Feeling sad
  • Feeling low
  • Feeling depressed
  • Feeling hopeless
  • Feeling self-conscious
  • Feeling of being judged

Category 2: The effects on your body:

  • Sweating
  • Racing heart
  • Pounding heart
  • Palpitations
  • Trembling
  • Blushing
  • Aches and pains due to muscle tension
  • Dizziness
  • Feeling faint
  • Feeling sick
  • Loose bowels
  • Urinating frequently
  • Feeling out of breath
  • Dry mouth
  • Blurred vision
  • Cold clammy hands
  • Hot and cold flushes

Category 3: The effects on your behavior:

  • Doing things to make sure you avoid attention
  • Avoiding eye contact
  • Difficulty in talking
  • Getting words mixed up
  • Speaking quickly
  • Speaking quickly
  • Keeping to safe places
  • Talking about safe topics
  • Apologizing excessively

Category 4: The effects on your thinking:

  • Worry about what other people think about you
  • Thinking what might go wrong
  • Dwelling on things you think you did wrong
  • Mind going blank
  • Thinking you look foolish
  • Difficulty in concentration
  • Difficulty in remembering what people say

The signs of social anxiety

     Technically speaking, in medicine, the signs of any condition are what you find on physical examination. In social anxiety, the signs will mainly be the result of your body's physiological "fight or flight" response. These include:

  • Increased blood pressure
  • Increased pulse rate
  • Increased breathing
  • Pupil dilation
  • Pale or flushed appearance
  • Shaking

The overall picture
In practice the symptoms blend and link with each other.

    If you suffer with social anxiety, you will usually, but not always, have some of the symptoms from each category. Sometimes it can be difficult to recognize the symptoms in yourself. This is because it has gone on for so many years, it has become normal for you.
Knowing the definition of social anxiety and the above list of symptoms, is a good start in understanding social anxiety.

With Social Anxiety Disorder, How A Person Thinks?

 
  Dr Aaron Beck, the founder of cognitive behavioral therapy, has compared the experience of social anxiety disorder to walking a tightrope. You feel vulnerable that something serous and awful will happen if you make a wrong step. You may freeze up and become inhibited. You feel that your safety is on the line. You feel you are being judged by others.

    Even before you go into a social situation, there is a lot of anxiety before it happens. You think about what might happen, and what might go wrong. Your mind comes up with a lot of "what ifs.."
You fear you will be exposed. You fear that just one little mistake, just one wrong step off the tightrope, will expose you. You fear this will reveal your weakness and inadequacies. You fear that if others know what you are really like, they will reject you. So you go to great lengths to hide your true self to avoid criticism and rejection from others.

    When you go into a social situation, you fear you are going to be exposed. So you watch out for signs of judgement by others. You are very sensitive to this. Your mind tunes into this - the danger of judgement. And when anyone feels they are in danger, whatever that danger is, they look for signs of that danger. This is an automatic survival mechanism. So if the danger is judgement, you are constantly alert for signs of this. Which means you may interpret a nod or a yawn or a frown as a judgement and hence, a criticism of you.

    Then the next thing that happens, from these perceived criticisms, or potential criticism, is a tendency to shut down. For example, you may not remember what you wanted to say, or talk quietly, or get your words mixed up, or you lose your natural expressiveness like smiles and gestures.
So avoidance becomes a way of coping. It prevents the pain and fear of social situations. Avoidance is one of the main features of social anxiety disorder.

And here are some examples:
  1. Avoiding going out with friends
  2. Avoiding leisure activities
  3. Avoiding going to meetings
  4. Avoiding social functions like wedding
  5. Avoiding meeting neighbors
  6. Turning away when you see someone coming
  7. Avoiding eating in public places
  8. Avoiding using your hands in the presence of others.

    If avoidance is not an option, and you want, or need to endure a social situation, safety strategies come into play. You may develop a wide range of strategies to do this. For example:

  • Looking at the floor to avoid eye contact
  • Constantly practicing in your mind what you are about to say - to check you have got it right.
  • Talking fast
  • Or talking slowly
  • Talking quietly
  • Using a lot of make-up to hide blushing
  • Leaving the room immediately after a meeting
  • Trying to amuse people by telling jokes
  • Or, never risk telling a joke
  • Not expressing your opinion
  • Not talking about yourself
  • Not saying anything that might be challenging
  • Keeping an eye on the escape route
  • Or any behavior which avoids unwanted attention

    And even after the event is over, your mind can still be anxious, while it constantly turns over the thoughts and images and memories of what happened. You think, over and over again, about certain aspects of your interaction with others. And you focus on what you think you did wrong. But what you think you did wrong may not be the reality of the event. However it is real for you. Then you make assumptions about what other people think about you. And these assumptions are generally negative and critical of yourself. Which leads to thoughts like "I'm stupid" or "I'm useless" or "I'm no good" or "I'm hopeless". And these thoughts constantly go around in your mind.

    This makes you feel different from other people, in a negative way. Your confidence and self esteem are rock bottom. You feel inferior. You come to expect people will ignore or reject you. And you interpret things that way. You live in fear, muddling through from one social event to another. Perhaps you feel relieved that you made a lucky escape the last time. But there is an undercurrent of fear, that you may be exposed the next time.

    This constant struggle can get you down. It can make you feel frustrated and angry and guilty and low and depressed. Which means anxiety may not be the only emotion in social anxiety.

    In summary, social anxiety disorder is like walking a tightrope. You live in constant fear of taking the wrong step. This fear is the fear of being judged or exposed or criticized. You hide your true self. You develop ways to cope with your fear, like avoidance and safety strategies. However, this constant struggle can lead to more than anxiety alone. It can lead to frustration, anger, guilt and depression.

Difference Between Shyness And Social Anxiety.

Shyness is a very common experience.


   There are no agreed criteria for shyness. Yet we instinctively know what shyness is. This is because most of us have been through stages of shyness, in childhood, teenage years or early adulthood. And those experiences may have been painful.

    Shyness is the norm in early life, and as we grow up, it usually becomes less. About 80% of people report they have experienced shyness in childhood and adolescence. About half of these people grow out of it. However, this still leaves  about 40% and may be up to 50% of adults who feel they are still shy in some social situations.

    It appears shyness is on the increase. This is possibly due to the impact of technology. Using computers and mobile devices is a more acceptable way of communicating today, both in personal and work life. Many generations have grown up very familiar with using computers, learning online or using computer CDs, playing video games, texting, using online forms of communication etc. In fact, many jobs today involve a considerable amount of time in front of a computer. And a lot of services today are automated. For example no human contact is needed to shop online, use an ATM or online banking, or use automated telephone answering services, or to buy something from a vending machine. For someone who is shy, these forms of communication, and automated services, may be a relief. But is does avoid human contact. Which means technology and automated services, may be a way of avoiding overcoming shyness.

    Shyness tends to be more of a problem when interacting with someone in a position of authority, or in one to one situations, especially when talking to an attractive person.
Shyness is different from introversion. A person who is introverted prefers activities on their own rather than in a social group. They do not seek out social interaction. Extroverted people tend to be the opposite, and seek out the excitement of social interactions. Shyness can occur in either introverted or extroverted people.

    Many shy people feel ashamed of themselves for being shy. They feel it is their fault. They feel they are to blame for not overcoming their problem.

    However, there are some social advantages to shyness. It is an attractive quality to many people. There is perhaps some mystery about a person who is shy. It may lead the other person to want to know more about the shy person. And there is a sense of doing something good in gaining the confidence of a shy person. Also, some people admire shyness, as it can seem like a form of modesty. So there are possibly some social advantages to being shy, which may perpetuate the shyness.

Difference between shyness and social anxiety
    There is a lot of overlap between social anxiety disorder and shyness. Social anxiety disorder does have an element of shyness to it. However the main difference between the two, is severity.

Severity in the level of anxiety:

    Mild anxiety levels is social situations is in keeping with shyness. High anxiety levels in social situations is more in keeping with social anxiety disorder.

Severity in the degree of avoidance:

    Little or no avoidance of social situations, is in keeping with shyness. However, avoidance which interferes with life is characteristic of social anxiety disorder. For example, they may avoid going out, or meeting people, or drop out of school, or avoid careers they are capable of. It interferes with their life now, and in what they want to do in the future.

Severity in the persistence of symptoms:

    Generally someone who is shy will feel uncomfortable when meeting someone for the first time. This usually gets better with time, as they become more familiar and comfortable in the social setting. However, someone with social anxiety disorder may continue to be anxious even when they get to know the other person better.

    In summary, shyness is common. Shyness people tend to feel it is their fault, and blame themselves for being shy. However, there can be some social advantages to being shy. Shyness affects both introverted and extroverted people. The main difference between shyness and social anxiety disorder is in the severity to which it affects their life.

When Social Phobia Or Social Anxiety Starts And Why?

Social anxiety normally develops in childhood or early adolescence.

There are broadly two groups.

Group One:

 
  Social anxiety develops in adolescence between the ages of 11 to 19 years. The person may, or may not, even been previously shy. Social anxiety develops in this period because it is a time of self aware and self conscious. It is a period where a person starts to think more about what other people think about them.

Group Two:

    This is usually the more severs form. Parents will describe the person as always being that way since they were a child. The child would avoid any sort of social interaction. For example, if someone would come to the house, they would run upstairs, or if they saw someone they know walking in the street, they would look the other way. Another example is selective mutism. Here the child is capable of speech, but refuses to speak other people- they will often only speak to the parents.

How common is social anxiety?

social anxiety disorder is common.

    It is difficult to give an accurate estimate. This is because most people with social anxiety never seek help - they see it as part of who they are. In addition, there can be some difficulty in the diagnosis, because it depends on subjective judgments.

    There are estimates for social anxiety from 2% to 7% to 13% of the population.
A reasonable estimate would be 5% of the population. This has been used by many experts in the field.

    This means, 1 in every 20 people suffer with social anxiety disorder. Imagine, for every 20 people you knew at school, 1 of them had social anxiety disorder. That person was probably very shy, would never speak up in class, and may have had 1 or 2 close friends.
So, if you suffer with social anxiety disorder, you are not alone. There are many people like you.

Why do I have social anxiety?

There is no direct answer for this. However, here are some factors:
  1. There is no proven relationship between adverse events in childhood and adolescent, and the onset of social anxiety.
  2. There does not seem to be a cultural effect. For example, in cultures which are more reserved like Japan, they have similar rates of social anxiety disorder to the US and UK.
  3. Adolescence is a factor. It is a time of becoming self conscious and thinking about what other people think about you.
  4. There is a strong familial tendency in example social anxiety disorder tends to run in families.
  5. There appears to be a genetic element. This has been confirmed by studies on twins.
  6. The brain in someone with social anxiety disorder appears to be overactive in a particular area. This area is called the limbic system. This includes a part know as the amygdala. This is where brain processes and regulates emotions and memories and determines possible threats. It is part of our survival mechanism which becomes activated when we are in danger. However, in someone with social anxiety disorder, it is overactive. It is like it is turned on all the time.
    On conclusion, social anxiety disorder is common. It effects 1 in 20 people. It usually starts in childhood or adolescence. This is a family and genetic component to it. In the brain, the part which is responsible for emotions, like fear, is overactive.

Social Phobia Definition And Different Critera Of Social Anxiety.

    Social anxiety disorder is defined as social phobia in the Diagnostic and Statistical Manual of the American Psychiatric Association DSM-IV.

For the current definition of social phobia, there are 4 main criteria:

Criteria 1:

   A marked and persistent fear, of one or more, social or performance situations, in which the person is exposed to unfamiliar people, or to possible scrutiny by others. The individual fears that he or she will act in a way or show anxiety symptoms that will be humiliating or embarrassing. In this you fear social situations.

Criteria 2:

   Exposure to the feared social situations almost invariably provokes anxiety. In it your fear causes anxiety.

Criteria 3:

   The person recognizes that the fear is excessive and unreasonable. In it you know the situation you fear is not dangerous. You know others are not bothered by it. But knowing this, and knowing that your suffering is unnecessary, only makes it worse.

Criteria 4:

   The feared social or performance situations are avoided, or else are endured with intense anxiety or distress. You avoid, or go through with distress, the situations that make you fearful.

There are 3 additional general points from DSM IV, for the diagnosis of social phobia:

  1. The problem must interfere with the person's life.
  2. The problem must cause a significant degree of distress.
  3. The problem must have persisted for at least 6 months.

DSM IV also defines two types of social phobia: specific and generalized social phobia

Specific Social Phobia:

For some people, the feared social situation is limited and confined to a few situations. For example:

  1. Public speaking - the most common specific social phobia.
  2. Talking on the telephone.
  3. Prolonging a conversation.
  4. Eating when others can see what you are doing.
  5. Writing when others can see what you are doing.
  6. Being in an intimate relationship.

Generalized social phobia:

For other people, the fear exists to most situations involving interaction with others.

In summary, social anxiety disorder is defined as social phobia by DSM IV. The diagnostic criteria include:

  1. A social situation is feared.
  2. The fear causes anxiety.
  3. The fear and anxiety is excessive.
  4. There is avoidance of the social situation, or the social situation is endured with distress.
  5. The fear interferes with a person's life, causing a significant degree of distress, and has persisted for at least 6 months.

    If you suffer with social phobia, you are in a difficult situation. Your fear response tells you to avoid or escape the frightening situation. This is your body's physical fight or flight response. But logically, you don't want to run away, or avoid the situation. You don't want to be lonely and isolated. And you can't control, or find it difficult to control, the source of your fear. So most people try to endure, or limit, the social situations, due to the distress they cause.

Social Anxiety Disorder - Social Phobia, How It Effects Your Life.

  
Social anxiety disorder, also known as social phobia, describes the fear, nervousness and apprehension in relationships you have with other people. We all feel a degree of this, and that's normal. But in social anxiety disorder, the intensity of the symptoms are far higher, leading to a significant impact on your life.

   If you have social anxiety disorder, you get anxious when you think you might to something that will be humiliating or embarrassing. You think other people are judging you. And that they judge you in a negative way. You fear you might do something humiliating or embarrassing. This fear is inhibiting. It makes you self-aware. And because your mind focuses on these possible outcomes, you might even do something which is embarrassing, but more often than not, you don't. However, this fear leads to a downward cycle of avoidance and more anxiety when you interact with other people.
If you suffer with social anxiety, you tend to assume, that when you interact with other people, this will be painfully revealing. You fear others might notice your weakness, or awkwardness, or that you will be rejected, or dismissed, or ignored, or criticized. You fear you are not behaving in an acceptable way.

   This perception of social situations makes it hard for you to be normal, to act naturally, to talk normally, or even to make friends. This can lead to isolation and loneliness.

If you have social anxiety, some of the unfortunate consequences can be:
  1. Dropping out of school,
  2. Not pursuing careers you are capable of,
  3. Difficulties at work, or in your personal life,
  4. Lack of intimate relationships, or finding someone share your life with.

   Sometimes, you might not even be aware you have the condition. Or, you become aware of it later in life, perhaps in your 40s or 50s. This means you have suffered with the effects of social anxiety for all these years. And, there is a good chance it could have been prevented, with the appropriate help.
Someone with social anxiety can have many positive things about them like being friendly, or having a sense of fun, or being serous, or lively, or amusing, or kind or the ability to behave in a spontaneous way. But, feeling as ease with other people is hard if you have social anxiety. So it hides these good things about you, from view. And because these good things about you are hidden from view, over time, you can lose your belief and confidence in these worthy aspects of yourself.

   One of the great benefits of learning to overcome social anxiety is that it allows you to express yourself, enjoy being yourself, and to rediscover yourself.