Mental Health Awareness: A Beginner's Guide to Social Anxiety

In a world where social interactions are fundamental to day-to-day life, understanding social anxiety is becoming increasingly important. This beginner's guide aims to shed light on what social anxiety actually is. We will address misconceptions and the stigma often associated with it, as well as help you to recognise the signs and symptoms of social anxiety. Understanding the impact it can have, we'll go through everything you need to know about social anxiety. Importantly, we will explore different ways you can find support and assistance to make sure no one faces this challenge alone.

What is the definition of social anxiety?

Social anxiety is different from shyness. According to the NHS, social anxiety is characterised by fear that surrounds everyday activities. It affects self-confidence, can put a strain on relationships, and can impact both personal and professional relationships. While occasional anxiety around social scenarios is common, people with social anxiety experience continuous heightened anxiety as well as worry before, during and after social situations. 

VIDEO: Social Anxiety Disorder Explained

Osmosis from Elsevier provides a helpful explanation of social anxiety in the video below, covering the causes, symptoms, diagnosis, treatment, and pathology.

How prevalent is social anxiety in the UK?

Social anxiety is a very prevalent issue that impacts people in the UK. Around 12% of people will experience bad social anxiety at some point in their lives, according to Alena. Aside from this 12%, almost everyone will experience less severe social anxiety at some point. Certain situations will cause social anxiety to occur in almost everyone. However, as mentioned, 12% of people will experience more severe social anxiety.

Is social anxiety (social phobia) the same as general nervousness?

While general nervousness is common, social anxiety (also known as social phobia) is a more severe, distinct issue according to the Mayo Clinic. Unlike nervousness that passes, social anxiety is a persistent fear that disrupts everyday life. It can lead to behaviours such as avoidance and anxiety which can change the way someone lives your life. 

Which health conditions is social anxiety the main symptom of?

Social anxiety often intertwines with other mental health conditions and can be the main symptom of other overarching conditions. People with social anxiety often suffer from other mental health conditions according to the NHS, including:

• Depression

• Generalised Anxiety Disorder

• Panic Disorder

Misconceptions & Stigma

What are common misconceptions of social anxiety?

Unfortunately, there are a number of misconceptions surrounding social anxiety, and mental health as a whole. According to Oxford CBT, there are six main myths surrounding social anxiety. These are:

• Myth 1: Social Anxiety Is Just Being Nervous - Social anxiety encompasses cognitive, emotional, physical, and behavioural challenges in social situations.

• Myth 2: Social Anxiety Is A Problem That You Have To Live With - Effective treatments like CBT or medication can overcome social anxiety, offering the potential for a fear-free life.

• Myth 3: Social Anxiety Is The Same As Shyness - While similar, social anxiety involves fear of social situations, whereas shyness involves withdrawal; not all socially anxious individuals appear shy.

• Myth 4: Social Anxiety Isn’t That Common - Social anxiety affects 2% to 13% of the population, extending beyond occasional nervousness to a potentially debilitating disorder.

• Myth 5: Social Anxiety Only Refers To Public Speaking Fears - Social anxiety encompasses various social and performance situations, including formal events, informal interactions, and everyday events where judgement or evaluation is feared.

• Myth 6: Social Anxiety Can’t Hurt You - Social anxiety can lead to significant life impairments, affecting career, education, relationships, productivity, and mental health, necessitating professional help for management and treatment.

Signs & Symptoms

VIDEO: What are social anxiety symptoms and how can we manage them? - Dr Kishore Chandiramani

Below is a video where renowned psychiatrist, Dr Kishore Chandiramani (GMC number: 4572914), explains the symptoms of social anxiety and how it can be managed:

What are the physical symptoms of social anxiety?

There are a number of physical symptoms that someone may experience with social anxiety. According to the Mayo Clinic, the most common physical symptoms include:

• Blushing

• Rapid heartbeat

• Trembling

• Sweating

• Upset stomach or nausea

• Difficulty breathing

• Dizziness or lightheadedness

• Feeling mentally blank

• Muscle tension

What are the psychological symptoms of social anxiety?

There are several psychological symptoms of social anxiety that someone may experience. The most common, according to the Mayo Clinic, include:

• Persistent fear of being negatively judged in social situations

• Apprehension about embarrassing oneself

• Intense anxiety surrounding interactions with strangers

• Concern that others will perceive one's anxious appearance

• Fear of experiencing physical symptoms that could lead to embarrassment

• Avoidance of social interactions or activities due to fear of humiliation

• Avoidance of situations where attention may be directed towards oneself

• Anticipatory anxiety before social events

• Intense anxiety experienced during social situations

• Post-event analysis, focusing on perceived flaws in interactions

• Expectation of dire consequences stemming from negative social experiences

What behavioural changes can there be with social anxiety?

According to the NHS, behavioural changes associated with social anxiety disorder may manifest as:

• Avoiding social activities that include group conversations, attending parties, or going for dinner with other people

• Persistent worry about actions being seen as embarrassing such as blushing, sweating or appearing incompetent. 

Which environmental influences can cause social anxiety?

According to the Mayo Clinic, several outside influences can contribute towards someone experiencing social anxiety. The most common are:

• Family History: Increased risk if immediate family members have the disorder.

• Negative Experiences: Exposure to teasing, bullying, rejection, or other forms of social humiliation.

• Trauma or Abuse: Negative life events like family conflict, trauma, or abuse may be associated with the disorder.

• Temperament: Shyness, timidity, or withdrawal in new social situations can heighten vulnerability.

• New Social or Work Demands: Symptoms may emerge during teenage years or in response to new social or professional challenges.

• Appearance or Condition: Conditions or features that draw attention, such as facial disfigurement or speech impediments, can exacerbate feelings of self-consciousness and trigger social anxiety.

The Impact of Social Anxiety

How can social anxiety impact on personal life?

Social anxiety can have a significant impact on someone's personal life. The Mayo Clinic has outlined a number of ways that personal life is affected by social anxiety. It can cause someone to experience low self-esteem, have issues with assertiveness, become overly negative about themself, and can also lead to hypersensitivity to criticism. As well as these issues, it can also cause someone to have poor social skills and a low number of friends.

How can social anxiety impact on physical health?

Social anxiety can have significant effects on physical health due to the body's response to stress and fear. The NHS states that social anxiety can trigger your heightened stress response which increases levels of cortisol and adrenaline. Physically, you can experience symptoms such as nausea, sweating, trembling, and a rapid heartbeat. You may feel tense, and you may also experience more illnesses as your immune system weakens due to chronic stress.

Seeking Help

When should you seek help for social anxiety?

According to the NHS, you should seek help for social anxiety if you notice that it is significantly impacting your daily life and well-being. If you experience physical symptoms such as nausea, sweating, trembling, or rapid heartbeat in social situations, or if these symptoms occur frequently and interfere with your ability to function then you may also wish to seek help. You should seek help if you feel like your overall quality of life is being affected.

Which professional services are available for social anxiety?

For individuals dealing with social anxiety, there are various professional services and resources available to provide support and assistance. Here are some options to consider:

• Anxiety UK: Anxiety UK offers resources and support specifically for individuals with social anxiety.

• British Association for Counselling and Psychotherapy (BACP): The BACP provides information about therapy options for social anxiety, including cognitive-behavioural therapy (CBT), which is often recommended as an effective treatment.

• Social Anxiety Alliance UK: This organisation offers support, information, and resources for individuals dealing with social anxiety. 

Can therapy and medication help?

Yes, therapy and medication can be effective in treating social anxiety disorder. Cognitive-behavioural therapy (CBT) is a common and highly effective form of therapy for social anxiety disorder. CBT helps individuals identify and challenge negative thought patterns and behaviours that contribute to their anxiety. Medications help regulate serotonin levels in the brain, which can improve mood and reduce anxiety symptoms. Other medications, such as SNRIs or benzodiazepines, may also be prescribed in some cases, according to the Mayo Clinic.

Self-Help Strategies for Social Anxiety

Can self-help techniques help to treat social anxiety?

Yes, self-help techniques can be beneficial in managing and reducing symptoms of social anxiety. While they may not replace professional treatment, they can complement therapy and medication or be useful for individuals with mild to moderate symptoms. NHS Inform have put together a self help guide for social anxiety that people who are struggling can use.

Can mindfulness and relaxation help with social anxiety disorder?

Yes, mindfulness and relaxation techniques can be helpful in managing symptoms of social anxiety disorder. Mindfulness and relaxation practices can help calm the body's stress response, reducing overall anxiety levels and making it easier to cope with social situations. While there is still ongoing research on the specific effects of mindfulness training on social anxiety disorder, preliminary evidence suggests that it may impact self-processing and reduce social anxiety symptoms (Goldin et al, 2009).

Can strong support from friends and family help with social anxiety?

Yes, strong support from friends and family can be incredibly helpful for individuals dealing with social anxiety. Sharing your struggles with trusted friends and family members can provide validation and understanding, helping you feel less alone in your experiences. Friends and family can also offer emotional support and encouragement, reassuring you during difficult times and boosting your confidence, according to Social Anxiety Alliance UK.

Sources

• Anxiety UK - Social Anxiety

• NHS - Social Anxiety

• Royal College of Psychiatrists - Shyness and Social Phobia

• Social Anxiety UK

• Patient.info - Social Anxiety Disorder

• NICE - Social Anxiety Disorder

• BACP - Social Anxiety

• Mental Health UK - Social Anxiety Disorder Diagnosis