7 tips for living with social anxiety

7 tips for living with social anxiety

By Joyce Chong

In the 2007 National Mental Health and Wellbeing survey that surveyed 16million Australians to gain a picture of the nation’s Mental Health we found that anxiety is the most common mental health disorder experienced by individuals. (see here for a brief summary) 

Within anxiety, social anxiety is the second most common anxiety disorder experienced (behind posttraumatic stress disorder). Social anxiety is linked with poorer quality of life and workplace productivity [1] and also with the increased use of alcohol and cannabis.[2]

If you're one of the many who experience social anxiety or know of someone who does, read on for our 7 tips for living with social anxiety. We've also included a printable version at the bottom of the article.

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1. Know the difference between shyness and social anxiety

It’s easy to fall into the trap of seeing social anxiety as just an extreme of shyness. Indeed, there is a higher rate of social anxiety amongst shy individuals compared to individuals who aren’t shy, however the majority of shy individuals do not have social anxiety.[3]

However, social anxiety differs from shyness in that there is a marked level of fear involved, there is avoidance of feared situations, there is a strong fear of negative evaluation, and the social anxiety has a negative impact on functioning in several areas of life (e.g. work performance or relationships).

For example, a student may feel shy in a tutorial room, but if that person is distressed at the prospect of having to speak in the tutorial, and the tutorials have a participation component that students must pass (that is, they risk failing the entire unit if they don’t contribute) then we are looking more at a picture of social anxiety.

Did you know that for some, the anxiety is present only in situations where performance is concerned? So, while they may do well in most aspects of socialising, there may be anxiety just when doing public speaking or talking to people in positions of authority (e.g. managers, lecturers).

2. Take action…now!

Social anxiety typically starts between late childhood and mid-adolescence, with sufferers waiting an average of 15-20 years before they seek treatment.[1]

Given the wide-ranging impact of these social fears, it is understandable that social anxiety is linked with poorer quality of life and wellbeing – how restrictive would it be if you were afraid to go for a job interview, ask someone for directions, ask a question of your teacher, or even looking people in the eye in a passing conversation in case they think negatively of you?

How long have you lived with social anxiety? How does it hold you back in your life? Take action now so that you don't have to continue to live this way.

3. Challenge your avoidance

Avoiding a scary situation may bring you immediate relief, but over time you may notice that more situations cause you anxiety, or that your anxiety gets more intense.

The reality is that striving to feel safe all of the time is unrealistic, and trying to achieve this means that the number of situations in which you feel comfortable starts to rapidly shrink.

Make changes by taking one small step at a time. For example, if you're afraid of making conversation with people, start off by making small talk about the weather with the check out operator at a new grocery store, then build up to making small talk with the receptionist at your doctor's surgery. It takes one small step to get the ball rolling.

4. Rethink your drink

Social anxiety is associated with an increased rate of alcohol dependence. [4] Alcohol is often used to cope with nerves before and during a social situation, but it's important to rethink your drink and take a good hard look at whether it's just another form of avoidance. 

Why is using alcohol to cope with anxiety a bad thing when many of our social situations involve alcohol? Well, alcohol may make you feel less anxious in the short term, but in the longer term do you learn that you can cope without a drink? Sound familiar? Refer to Point 3 – yes, using alcohol sounds like a form of avoidance.

5. Check your thoughts

Are your thoughts and thinking styles making your anxiety worse? Tune in to your thoughts when you first notice anxiety building up in a social situation. Are you making an incorrect assumption? Are you jumping to conclusions, or catastrophising by focusing on the worst case scenario?

If you're giving a presentation, do you assume that one small mistake in your presentation means that you have made a fool of yourself? Will the worst case scenario of being laughed at by everyone really come true?

We’ve previously blogged about Checking your Thoughts in relation to social anxiety here in our post on social anxiety and Christmas functions so use that as a starting point. You can also find more information on thinking styles here.

6. Conduct an experiment

Sometimes we believe what we believe because we haven’t had evidence to the contrary. Let's say you keep your head down on the bus because you think that others on the bus will stare at you. By keeping your focus on your feet or phone, you won't see that they’re not staring at you. In other words, your belief is reinforced or, at the very least, not disputed.

Let’s mix things up a little. Let’s conduct an experiment by sitting at the back of the bus, and then watching what people actually do. Chances are, you’ll see that people are either looking at their phones, or looking out the window. The thing is, though, you won’t really know unless you do the experiment to test your belief.

7. Seek professional help

A lot can be done to help with social anxiety, so please take action before 15-20 years pass you by (see Point 2). Psychological treatments such as Cognitive Behaviour Therapy (CBT) and Acceptance and Commitment Therapy (ACT) have been shown to be effective in the treatment of social anxiety.[5]  You can also speak with your GP to discuss medication options.

Thanks for reading. We hope that the tips on managing social anxiety are helpful. 

Want more? Learn about Social Set, our 8-session Social Anxiety Course. Work one-on-one with a psychologist to develop a tailored approach to bounce back from social anxiety.

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REFERENCES

[1] American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th edition, DSM-5). Washington: American Psychological Association.

[2] Buckner, J.D., Schmidt, N.B., Lang, A.R., Small, J.W., Schlauch, R.C., & Lewinsohn, P.M. (2008). Specificity of Social Anxiety Disorder as a risk factor for alcohol and cannabis dependence. Journal of Psychiatric Research, 42, 230-239.

[3] Heiser, N.A., Turner, S.M., & Beidel, D.C. (2003). Shyness: relationship to social phobia and other psychiatric disorders. Behaviour Research and Therapy, 41, 209-221.

[4] Schneier, F.R, Foose, T.E., Hasin, D.S., Heimberg, R.G., Liu, S.M., Grant, B.F., & Blanco, C. (2010). Social anxiety disorder and alcohol use disorder comorbidity in the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological Medicine, 40, 977-988.

[5] Craske, M.G., et al. (2014). Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators. Journal of Consulting and Clinical Psychology, 82, 1034-1048.

Christmas parties - A guide for the socially anxious

CHRISTMAS PARTIES - A GUIDE FOR THE SOCIALLY ANXIOUS

by Joyce Chong

At this time of the year we’re right in the midst of numerous social gatherings – end-of-year drinks with friends, work Christmas parties, holiday catch-up with the soccer team, family gatherings, the list goes on.

While it’s a social time, for some the prospect of enduring gathering after gathering full of people is something that triggers anxiety and even panic. For those experiencing social anxiety, we’ve put together a guide to help get through the holiday season.

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What is Social Anxiety?

Social anxiety occurs when we feel anxious in social performance situations because of the perceived potential for scrutiny by others or for our anxiety symptoms to ‘leak out’ and be visible to others.

The degree of anxiety experienced can vary according to different factors including who we're around (e.g. people in positions of authority vs. peers) or the type of occasion (e.g. public speaking vs. one-to-one).

In such situations, we can experience a range of physical changes (e.g. increased heart rate, increased breathing rate, butterflies in the stomach, and feeling flushed) as well as cognitive changes (e.g. worrying, jumping to conclusions, mind-reading). There is typically a preference to avoid the situation or, if this is not possible, to endure the situation with intense anxiety.

 

HOW DO YOU KNOW IF YOU HAVE SOCIAL ANXIETY?

Social situations can cause us all to feel nervous from time to time, for example when meeting our partner’s family and friends for the first time, or when delivering a presentation to a hundred people.

Signs of nerves getting a bit out of hand include some of the following [1]:

• The anxiety is excessive relative to what others would experience in a similar situation.

• There's deliberate avoidance of situations, for example, sending emails to the manager so as to avoid face-to-face meetings, or catching up individually with team members (at a significant time cost) rather than address everyone at once.

• There is a need to do certain things to decrease anxiety in order to get through a situation. This may include drinking alcohol to calm the nerves, carrying medication to calm anxious feelings before they get too intense, or ensuring that our best friend or partner is there before agreeing to attending an event.

• The anxiety, and the avoidance of such social situations, is having a negative impact on daily functioning. This includes missing out on promotions because the new work role involves public speaking, or turning down the opportunity to coach a sporting team because that would lead to being the focus of attention during a game.

How common is social anxiety disorder?

The 2007 Australian National Mental Health Survey found that, of the 16 million individuals surveyed, 4.7% of these individuals had a diagnosis of Social Anxiety Disorder in the previous 12 months [2]. That’s about 1 in 20 who experience sufficiently severe levels of social anxiety to warrant a diagnosis.

Of course, this only captures those with a diagnosis of Social Anxiety Disorder, and does not include those who may be living with similar difficulties but not yet identified what it is.

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So how can you survive Christmas when you feel so anxious?

We've put together some simple tips to help you over the next few weeks. Of course, be sure to seek help in the new year before this hits again next Christmas. Chances are there are also other social situations in which you may feel anxious (e.g. other parties, work meetings, meeting new people), so why not learn how to better manage these situations? In the meantime, check out these tips:

1. Face the fear… one baby step at a time

When we have to face any unfamiliar situation it helps to practice beforehand. Unfortunately it can be difficult to recreate our very own ‘practice work Christmas party’. Instead, try making small talk in ‘low stakes’ situations such as making small talk at the checkout when buying groceries, or asking a stranger for the time. If the consequences of the interaction are small - in that the likelihood of encountering this person again is low - it becomes easier to face the fear.

2. Prepare in advance

Often part of the fear is knowing what to say, particularly when there is a lull in conversation. If it helps, prepare some general conversation topics that could apply in most situations.

For instance, when talking to people who work, some general questions could include asking around how their year at work has been, what projects are on the horizon, and what they have planned for the holidays or how much time they're taking off work.

When talking to parents, you could ask them if they have anything special planned for Christmas, or ask them about their kids.

If you know they're into food and dining you can ask them if they have favourite cuisines, or what the best meal that they've ever had is.

3. Live in the moment, not in your head

We’ve probably all been in conversations where we’ve noticed that the other person isn’t quite listening. Rather, it feels like they're waiting for us to pause before jumping in to say what's been on their mind, irrespective of whether it fits with the flow of the conversation. 

These disjointed conversations often arise because we place pressure on ourselves to find something to talk about, or to find 'common ground' with the other person. And, when we live in our heads, we miss out what is in the moment during the conversation.

So, learn to listen actively instead. It is, quite simply, one of the best ways to work out a talking point. Not convinced? Let's say we're talking to an acquaintance about her upcoming holiday in South America where she is particularly looking forward to visiting Machu Picchu in Peru. 

Rather than focusing on our thoughts which may include, "What do I know about South America that I can talk about?" or "I have to come up with my own exciting holiday so I don't seem boring.", by focusing on listening to why she is especially looking forward to about Machu Picchu we can 'springboard' off her topic. Questions that easily flow on from looking forward to?", or "Are there other places in Peru that you're planning to visit?" 

4. Check your thoughts

We do say to ‘check your thoughts’ a lot at The Skill Collective, and that’s because we really believe that our thoughts can ‘ramp up’ our anxiety. By assuming that we'll definitely embarrass ourselves, that we can’t cope with this awful situation, and that everyone will be staring at us, we let these thoughts increase our anxiety and question our ability to cope.

How true are our thoughts?

• Do we, ourselves, pay full attention to the situation that we’re in, or are we sometimes caught up in our own thoughts about how tasty the Christmas turkey looks or how we're going to finish our report before we go on leave? If we do sometimes live in our heads, is it possible that others do too, rather than focusing their entire attention on us or judging us negatively?

• What is the worst thing that someone could think about us? How likely is it that they will be having this exact thought about us?

• If we make one small mistake – for example knocking over dropping a bit of salad on the table – how significant will that one small mistake be? Will it be the talking point at Christmases to come? Will anyone else remember dropping the salad?

5. Keep stress levels down in the lead up to the event

Heading straight from one event to another in a short space of time is a recipe for stress and anxiety. So, space out social gatherings where possible, take time prior to the gathering to compose nerves, and do some relaxation to calm stress levels. Just a simple case of breathing slowly in and out can help.

6. Be wary of a bit of 'Dutch courage'

Ah yes, it becomes all too easy doesn’t it, when the majority of social gatherings that we attend serve alcohol. A bit of social lubricant may seem like a good idea at the time, but taken to the extreme we can then forget what we have said, thus potentially creating a further layer of thoughts where we worry about having potentially embarrassed ourselves.

Also, if we rely on alcohol to cope, how can we ever learn that it is possible for us to manage anxiety on our own? That is, we become reliant on alcohol, and we don’t really face the issue.

Importantly:

The steps that we have outlined above are to help make things more bearable over the coming weeks and, as such, focus on small but manageable steps.

While they may be of help over the Christmas period, if you do identify with many of the symptoms of social anxiety described above, please do seek advice from your mental health professional about how to best tailor the above tips to your own situation to produce longer-term improvements.

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Contact us to make an individual appointment to get started on making changes if social anxiety gets in the way of your life.

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REFERENCES:

[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.

[2] Australian Bureau of Statistics (2008). National survey of mental health and wellbeing: Summary of results, 2007, cat 4326.0, retrieved 11th December 2015, https://www.health.gov.au/internet/main/publishing.nsf/content/A24556C814804A99CA257BF0001CAC45/$File/mha25.pdf