Meet James. James is in his mid-20s. He likes to cook and works as a computer programmer. James seems like he “has it all” but he is very lonely. He wants company and companionship but James has social anxiety. He is fearful and anxious to the point that he avoids any social contact with others as much as possible. He lives with his parents but beyond them, he has no significant relationships with others. His social anxiety feels like a prison. He wants to change. The good news? James can get help for social anxiety.
If you are like James, you are in the company of many. Social anxiety is extremely common. People visit doctors because of anxiety more often than they do for colds!
Social anxiety is treatable. Treatment can be long or short; it all depends on the person. There are several different types including medication, cognitive behavioural therapy (CBT), exposure-based therapy, social skills training, relaxation techniques, and self-help approaches.
Medication treatment may involve anti-depressants or beta blockers. The self-help approach involves books and programs that you can do yourself, and as a result, there is often a great sense of personal satisfaction as well as low cost. There is more information about treatment below.
Signs of Social Anxiety
Some signs that a person has social anxiety are obvious. For example, someone might avoid or refuse to take part in social activities or sitauations. Other signs aremore subtle and hard to spot. These include “safety behaviours” like wearing extra makeup to hide blushing, over-preparation for meetings or presentations, always needing to go with a trusted person to a social gathering, keeping conversation on topics that are thought to be “safe”, avoiding eye contact, and trying to always have a role at social event (e.g., cooking or cleaning dishes). When someone has social anxiety they may experience an elevated hear rate, dizziness, shaking, shortness of breath, blushing, and/or sweating.
How does treatment work?
Medications for social anxiety must be prescribed and monitored by a doctor. They can take some time for them to start working and it sometimes takes times to get the dosage and type right. Cognitive therapy involves recognizing the thoughts that cause anxiety e.g., I will look stupid at the party. With the help of a counsellor or therapist, you work to replace negative thoughts with more realistic ones. While undergoing the therapy, you might be encouraged to write out what their thoughts are, consider the evidence that the thoughts are true, and then write out new beliefs and evidence in favour of those beliefs. You might also be encouraged to test out new beliefs.
Exposure therapy, as the name suggests, involves exposing one’s self to the scary or fearful social situations and scenarios. You would start with easy situations and work up to your most feared ones. This therapy may involve role-playing or simulated exposures to help you get used to being social. Social skills training involves education, rehearsal, and feedback in order to improve general social skills. A person taking this training might work on making eye contact, presentation skills, assertiveness, body language, listening, and managing conflict. Role play may be used with this approach as well.
Which treatment is best for me?
In order to get the best possible treatment for you, talk to your doctor or counsellor. Even if you are more interested in the self-help approach, your doctor can recommend a self-help book or program that will be right for you.
Do you have social anxiety? How do you deal with it?