Social Anxiety Disorder

Amal is a young man in his 20s. When he was a child, everyone thought he was very shy. Now that he’s in university, he’s having a hard time fitting in. He rarely joins class discussions, and he avoids talking to his classmates. He lives in constant fear of doing or saying the wrong thing. He thinks that other people will judge him or laugh at him. When he does talk to others, he feels shaky and nauseous. Amal has always been a good student, but his grades are starting to slip. His teachers notice that he doesn’t asks questions or participate—in fact, he’s been missing more and more classes as the school year goes on.

On this page:

• What is it?
• Who does it affect?
• What can I do about it?
• Where do I go from here?

We can all feel nervous in social situations like job interviews or when we’re giving presentations. But if you’re so scared of interacting with others that it affects your relationships with other people or it affects your work or school performance, you may have something called social anxiety disorder.

What is It?

Social anxiety disorder, also known as social phobia, is a mental illness. It belongs to a group of mental illnesses called anxiety disorders. People with social anxiety disorder feel very nervous and uncomfortable in social situations like meeting new people. Or they might feel very anxious when they have to do something in front of other people, like talking in a meeting. Some people feel very anxious in both situations.

People with social anxiety disorder often feel like they will say or do the wrong thing. Or they might think that other people will look down on them and think poorly of them because they’re “strange” or “stupid.” It’s important to know that adults with social anxiety disorder recognize that they feel too anxious, but they may not be able to control it.

Some people may have a panic attack or feel some physical signs of anxiety when they’re facing a social situation. Common physical signs of anxiety include stomach aches, shallow breathing, sweating or feeling hot flashes, feeling like your heart is racing, feeling tightness in your chest, feeling tense and feeling shaky.

Social anxiety disorder can have a very negative effect on your well-being and quality of life. The illness can cause a lot of problems in your relationships with partners, family and friends. It can also seriously affect your school or work life. You may avoid certain careers or fields of study, avoid contributing your ideas, turn down promotions, drop out of school or take many days off because you feel so anxious. Some people with social anxiety disorder fear one or just a few specific social situations. Others fear a wide range of social situations.

Could I have social anxiety disorder?

It’s normal to feel a bit nervous or anxious when you have to give a speech or when you’re meeting people for the first time. But with social anxiety disorder, your anxiety is so intense that it affects many parts of your life. It might affect your school or work life, relationships, things you do for fun or your day-to-day life.

These are some other signs you might have social anxiety disorder:

• I’m scared other people will think I’m stupid or strange if I say something wrong
• I’m scared to do things like join in during meetings at work or discussions at school or give presentations in front of a group of people
• When I’m in an uncomfortable social situation, I think other people can see how anxious I feel
• I go out of my way to avoid social situations that make me anxious, and I dread situations I can’t avoid
• I drink a lot or use other substances to lower my anxiety before I to go to a social event
• If you agree with some or all of the above statements, the best thing to do is talk to your doctor.

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Who Does It Affect?

Social anxiety disorder is one of the most common types of anxiety disorders, and one of the most common mental illnesses. About 8% of people will experience symptoms of social anxiety disorder at some point in their life. Without treatment, social anxiety disorder can last for a long time. Unfortunately, many people never seek help for social anxiety disorder.

There are some groups of people at higher risk of experiencing social anxiety disorder:

• Age—Social anxiety disorder often starts sometime between childhood and teenage years. The majority of people with social anxiety disorder say that their symptoms started before they were 18
• Women—Women are more likely to experience social anxiety disorder than men
• Other mental illnesses or substance use disorder—Many people with social anxiety disorder have other mental illness like depression, panic disorder, bulimia nervosa (an eating disorder)  and substance use disorders. However, social anxiety seems to appear before other mental illnesses.

Social anxiety disorder in children

Young children usually don’t know that they are experiencing anxiety. They just know that they have stomach aches, headaches or other physical symptoms of anxiety. Children also know that they just don’t want to do certain activities. So children might express their anxiety by complaining about physical discomfort, avoiding social activities, refusing to go to school or acting out.

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What can I do about it?

There are a few different things you can do:

• Counselling—Many people with social anxiety disorder benefit from a form of counselling called cognitive-behavioural therapy or CBT. A mental health professional trained in CBT can help you work through the thoughts or beliefs and behaviours that lead to or maintain your social anxiety. CBT helps you cope with social anxiety by teaching you skills to build confidence in social situations. You can also learn how to interact with people and maintain relationships. CBT is usually a short-term treatment. You can get the most out of treatment by regularly practicing CBT skills.
• Exposure—Exposure (sometimes called desensitization) helps you “unlearn” anxiety associated with a situation or thing. With the guidance and support of a qualified professional, you gradually take small, planned steps towards a situation you fear until you no longer feel overwhelmed by that situation. It can be a very effective treatment for many different phobias, including social phobia.  Exposure is an important part of CBT treatment for social anxiety.
• Medication—Anti-anxiety medications or antidepressants can be used in combination with counselling or exposure to reduce your body’s response to anxiety.
• Support groups—You are not alone. Anxiety disorder support groups in person or online are a great way to share your experiences and learn from the experiences of others.
• Self-help—There are some things you can do on your own to help keep you feeling better. Regular exercise, eating well, managing stress, spending time with friends and family, spirituality, and monitoring your use of alcohol and other drugs can help keep anxiety from getting worse. Talking to your doctor, asking questions, and feeling in charge of your own health are also very important. Always talk to your doctor about what you’re doing on your own.

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Where do I go from here?

In addition to talking to your family doctor, check out the resources below for more information about social anxiety disorder:

AnxietyBC
Visit www.anxietybc.com or call 604-525-7566 for self-help information and community resources.

BC Partners for Mental Health and Addictions Information
Visit www.heretohelp.bc.ca for info sheets and personal stories about social anxiety disorder. You’ll also find more information, tips and self-tests to help you understand many different mental health problems.

Resources available in many languages:
* If English is not your first language, say the name of your preferred language in English to be connected to an interpreter. More than 100 languages are available.

HealthLink BC
Call 811 or visit www.healthlinkbc.ca to access free, non-emergency health information for anyone in your family, including mental health information. Through 811, you can also speak to a registered nurse about symptoms you’re worried about, or a pharmacist about medication questions.

Crisis lines aren’t only for people in crisis. You can call for information on local services or if you just need someone to talk to. If you are in distress, call 310-6789 (do not add 604, 778 or 250 before the number) 24 hours a day to connect to a BC crisis line, without a wait or busy signal. The crisis lines linked in through 310-6789 have received advanced training in mental health issues and services by members of the BC Partners for Mental Health and Addictions Information.

© 2013

This info sheet was prepared by CMHA BC Division on behalf of the BC Partners for Mental Health and Addictions Information and HeretoHelp. Funding was provided by BC Mental Health and Substance Use Services, an agency of the Provincial Health Services Authority. For more resources visit HeretoHelp.bc.ca.