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A Step by Step Guide to Understanding and Overcoming Social Anxiety

By November 4, 2022December 18th, 2023Adult Counseling, Integrated Care Clinic

What is Social Anxiety? 

Most people feel slightly nervous when going into a party where they don’t know anything or having to give a presentation in front of a hundred people. However, for some people, that worry can be disproportionate to the actual situation. 

Social anxiety disorder may be occurring when:

  1. You have marked fear or anxiety about one or more social situations where you might be exposed to scrutiny by others or negatively evaluated by others.
  2. You are always anxious in the same social situations 
  3. Your fear appears disproportionate to the actual threat posed by the situation.
  4. You avoid the social situations as much as you can or endure them with intense fear or anxiety.
  5. The fear causes you significant distress
  6. It has lasted for 6 months or more 

If this sounds like you, you are not alone! Approximately 15 million adults in the US have social anxiety (ADAA, 2020). Social anxiety disorder is an extremely common mental health condition that may be at play due to an interaction between biological and environmental factors. It is believed that anxiety disorders run in families, with genetics providing up to a 30% chance of heritability (Gottschalk, 2017). Additionally, social anxiety may have come from being in an extremely embarrassing situation, low self esteem, or having increased stress.

Symptoms of Social Anxiety

Symptoms of social anxiety can be physical, emotional, and behavioral. 

Physical symptoms may include:

  • Muscle tension
  • Sweating
  • Difficulty breathing
  • Feeling dizzy
  • Shaking
  • Dry mouth
  • Nausea 
  • Headaches 
  • Shortness of breath 
  • Fatigue

Emotional symptoms may include 

  • Fear of interacting with new people
  • Concern that others will judge you
  • Fear that other people will know that you are afraid
  • Anticipating the worst case scenario. 

Finally behavioral symptoms may include 

  • Difficulty forming and maintaining new friends
  • Difficulty performing at work or school
  • Having a hard time maintaining eye contact
  • Avoiding social situations 
  • A decline in work performance 
  • Overanalyzing every time you speak with others. 

Self-Help for Social Anxiety

Understand the connection between your thoughts and feelings. 

Our thoughts play a big role in how we feel. For instance, imagine that you walk into a surprise party that your friends threw for you. A person who doesn’t struggle with social anxiety might think about how great it is that all your friends are here for you at this moment. A person with social anxiety might think about how they aren’t dressed up for this at all and that everyone is looking at them. For the first person, they will most likely feel happy and excited. The second person might feel anxious and embarrassed. In essence, the thoughts that you are having can lead to the emotion that you end up feeling (and the actions you end up taking). 

Identify your thinking traps 

People who are socially anxious often fall into some pretty common “thinking traps”. These are tricks that our brain plays on us that often happen automatically. Being able to identify when you are falling into a thinking trap can help you challenge it. 

Some common thinking traps:

  • Black and White Thinking
    • Seeing only one side or the other (such as thinking that if you don’t get an A on every presentation you give in class, you’ve failed)
  • Mind reading 
    • Assuming we know what someone else is thinking (such as when a friend doesn’t say hi to you in the hall, assuming it’s because they are mad at you and not because they didn’t see you)
  • Fortune Telling
    • Predicting the future (such as assuming you are going to have a horrible time at a party)
  • Emotional Reasoning
    • Assuming that just because you feel a certain way, it must be true (such as feeling embarrassed so assuming that you are stupid, or feeling awkward or assuming that everyone else must think you are awkward)
  •  Overgeneralizing 
    • Seeing a pattern based on a single event (such as thinking that you will always embarrass yourself in front of every person you meet)
  • Ignoring the Positive
    • Ignoring good things that happened for some reason (such as thinking that it doesn’t matter that you have one friend because you don’t have as many friends as your neighbor).
  • Should statements 
    • Focusing on the past or thinking that you should have known to do something, often using the word “should” or “ought” (such as thinking that you shouldn’t have said something so stupid)
  • Catastrophizing 
    • Blowing things out of proportion (such as thinking that you will never recover from that terrible presentation you gave in the last class) 

Challenge your thoughts 

Now that you understand the connection between your thoughts and feelings, and have an idea of some thinking traps that you may use throughout your day, you can try to challenge those thoughts. Here are some ways you can do that:

  • Look for evidence that your thought may not be 100% true. 
  • Ask yourself if there are other ways of looking at the situation. 
  • Look for other possible explanations. 
  • Ask if you’ve had any experiences that demonstrate that this thought is not always true all of the time. 
  • Are there any small, minor things that might go against the thought that you might be overlooking?
  • If you’ve been in this situation before, is there anything different from the last time and anything that you can learn from a previous experience?
  • Is my thought actually based on fact or am I using a thinking trap? 
  • What is the worst that can happen? 
  • What is the best that can happen? 
  • Is it helpful to think this way? 
  • If this were happening to someone else, what would I suggest they do?

Break the cycle of avoidance

Avoidance is incredibly common in social anxiety and happens when we try to escape unpleasant feelings. This might happen when a person with social anxiety might try to avoid the feared situation completely, which will result in instant relief. Unfortunately, in the long term, avoidance actually makes our anxiety worse! This is because we never get to test out the negative thoughts that we have so we can’t see if they are real or not, and we never have a chance to engage in more positive experiences that could be more motivating. 

It can be really helpful to approach the situations that make you anxious and conduct behavioral experiments. When you do this, consider rating your anxiety before the situation and identifying the negative thoughts you might have beforehand. Then, look at what actually happened and figure out what conclusions you can actually draw. Oftentimes, your predictions are not always accurate! 

Watch out for your safety behaviors

A safety behavior is a behavior that someone might do when they cannot completely avoid a feared situation. An example might be using headphones in a grocery store so that no one else can talk to you, or limiting eye contact with other people in public. The problem with safety behaviors is that they prevent you from fully testing out your feared situation. If you wear headphones because you’re nervous to go to the grocery store and nothing embarrassing happens, you might assume that the only reason something embarrassing didn’t happen is because you were wearing headphones! Try to become aware of different safety behaviors you might be using and attempt to stop using them! 

Utilize video feedback

Consider recording yourself when you feel anxious so that you can actually see what you look like and compare your negative thoughts to reality.  For instance, you could record yourself giving a speech in front of a mirror or have a friend or family member record you when you are out in public.

Use mindfulness techniques when you are in an anxiety provoking situation

Use Deep Breathing:

  • Take a deep breath in through your nose for a count of four.
  • Hold for a second.
  • Breath out through your nose for a count of four.
  • Repeat for several minutes until you feel more calm.

Grounding involves focusing your attention on the present moment and away from any anxious thoughts or sensations you may be feeling. Here are the steps: 

Identify: 

What are 5 things that you see?

  • Look for things in your immediate environment that you haven’t noticed before, such as the way light is reflecting in the room, or cracks in the walls.

What are 4 things that you feel?

  • These are physical sensations, so notice the feeling of the chair against your leg or arm, the feeling of your hair against the back of your neck, or pick up an object and notice how it feels in your hand.

What are 3 things that you hear?

  • Listen to the sounds you weren’t paying attention to, such as the clock or the AC blowing.

What are 2 things that you smell?

  • Try to notice smells in your environment. You could also pick up a candle or candy near you.

What is 1 thing you can taste?

  • Try to have gum or candy near you, and pretend you are eating it for the first time in your life, focusing on all of the flavors you are experiencing.

Consider seeking a CBT Therapist 

Cognitive Behavioral Therapy (CBT) is an evidenced-based therapy that involves learning all of the steps detailed adobe and more, and is used for social anxiety. In this therapy, you will learn new ways of thinking, feeling, and reacting to the overwhelming sensations that you may experience during social situations.

If you would like more support on how to implement these practices and manage social anxiety or other types of anxiety, please reach out to me, Dr. Hannah Gilfix. 

Citations:

Gottschalk, M. G., & Domschke, K. (2022). Genetics of generalized anxiety disorder and related traits. Dialogues in clinical neuroscience.

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