social anxiety

Living (And Thriving) With Social Anxiety Disorder

Understanding the difference between social anxiety disorder (SAD) and general anxiety is key in getting a proper diagnosis and treatment. Anxiety (defined as feelings of tension, fear and stress that can cause physical changes such as an increased heart rate) is a normal response to stress, perceived stress, or future stressful events. If you ever played sports, you probably felt anxiety before or during a game or match. Performing in front of an audience or going for a job interview can cause feelings of anxiety. And who among us has not felt a rush of adrenaline prior to speaking in front of a crowd? The shortened state of fear and tension associated with anxiety can—and does—have positive effects in our lives. A little anxiety can motivate us to practice harder, study for exams and research the company before a job interview. Anxiety, in limited amounts, is something we all experience, have grown up with and continue to live with throughout adulthood. However, in SAD, the feelings of anxiety are profound, unreasonable, long-lasting and usually coupled with debilitating symptoms.  

What Is SAD?

Simply put: SAD is fear of social settings that involve interacting with other people. It hinges on thoughts of fear and anxiety over being judged and evaluated negatively by other people. The fear and anxiety associated with SAD does not cease immediately and is usually accompanied by physical symptoms (such as increased heart rate). As a result, people with SAD have constant feelings of fear and anxiety in a wide variety of social activities common in everyday normal social interactions. Social anxiety disorder is the third most prevalent psychological disorder in the U.S. and is not limited to any particular group of people. Millions of adults in America are diagnosed with SAD… but millions more stay quiet and suffer alone, falsely believing that there is no hope. Moreover, SAD is oftentimes misdiagnosed:

People with social anxiety are misdiagnosed almost 90% of the time… Social anxiety disorder [has] been mislabeled “schizophrenic,” “manic-depressive,” “clinically depressed,” “panic disordered,” and “personality disordered,” among other misdiagnoses.

Understanding SAD

One of the best ways to understand SAD is based upon people’s responses to the following list of activities. However, it must be noted that the list below is not complete, and SAD can manifest itself in a wide variety of social interactions:   

  • Going out in public or using public restrooms
  • Going to school or work
  • Talking with strangers
  • Dating
  • Eating in front of others
  • Speaking in public
  • Meeting new people
  • Group discussions
  • Speaking up in class

Physical And Other Symptoms Associated with SAD

Physical symptoms associated with SAD vary from person to person and vary in intensity. Generally speaking, symptoms occur prior to the events listed above and may last throughout the event and even for weeks afterward:

  • Increased or rapid heartbeat
  • Muscle tension
  • Dizziness and/or lightheadedness
  • Stomach pains and/or diarrhea
  • Feeling out of breath
  • Sweating
  • Nausea
  • Headaches
  • “Out-of-body” sensation

People with SAD oftentimes avoid making eye contact. There can also be feelings of dread or hopelessness, especially leading up to a scheduled social event… and even afterward. A person with SAD might replay a social event over and over, wondering if they did something wrong or worrying about how others viewed them. People with SAD may also be overly sensitive to criticism, freeze up when meeting people in authority and try to avoid social settings all together. Further, people with SAD may understand that their thoughts are unreasonable, or irrational, but they are still unable to act rationally under the circumstances.  

SAD Is A Treatable Anxiety Disorder

People with SAD often do not seek help or treatment because of feelings of embarrassment, shame, guilt and helplessness. They may also believe that there is no cure for their “unusual” behavior. But they are wrong. SAD is one of the most treatable anxiety disorders. Doctors can use either psychotherapy or medication to help alleviate the symptoms associated with SAD. In many cases, the first step is talking to a professional about what’s happening and seeking a course of treatment. It is possible to live life comfortably, while managing—and eventually overcoming—the fear of social interactions.  


How We Can Help You?

Best Day Psychiatry and Counseling is here to help you have a better day and find a better way. We treat a wide range of psychiatric conditions for both children and adults. Contact us today, we’re ready to help:

Fayatteville: (910) 323-1543 Fuquay-Varina: (919) 567-0684 Raleigh: (919) 670-3939