Social Anxiety Disorder (SAD) is mental health condition that causes one to experience extreme discomfort when interacting with others. This discomfort is usually driven by an underlying fear of being judged or rejected in some way. While it is normal for almost all people to experience anxiety and discomfort during social interactions, when you have social anxiety, you experience such high distress that you find it difficult to relax, concentrate, and function when triggered. You may also find yourself avoiding situations that require you to interact with others, even situations that are necessary to your development and functioning.
Common triggering situations for social anxiety include:
- Having to interact with a clerk to make a purchase
- Responding to a question
- Sharing an opinion
- Asking to use the bathroom at school
- Having to answer the phone
- Having to be out in public, where you might be approached by a stranger
- Getting a job that involves interacting with others
- Going to school
- Attending a party or social gathering
- Giving a presentation
- Joining an activity or club
- Visiting family during the holidays
Avoidance and Safety Behaviors
When you have Social Anxiety Disorder, you tend to rely on avoidance and other safety behaviors to deal with your distress. Here are some common avoidance strategies:
- Covering your face with hair, hats, glasses, etc.
- Not speaking/responding to questions
- Not greeting others
- Not raising your hand in class
- Not making eye contact
- Not accepting invitations
- Refusing school
- Not applying to colleges/jobs
- Not leaving the house
- Avoiding a responsibility that requires interacting with others, such as dealing with an administrative issue at college.
- Constantly reading a book, looking at your phone, or playing a handheld video game when in public
Social Anxiety Disorder is a very treatable condition. The recommended therapy is Cognitive Behavioral Therapy (CBT). The “cognitive” part of the treatment involves exploring some of the underlying thoughts, fears, and beliefs that are fueling one’s anxiety during social interactions. The “behavioral” component involves gradually reducing one’s avoidance and reliance on safety behaviors at a pace decided on by the patient and the therapist. If therapy alone is too difficult or distressing, the addition of medication for anxiety (usually an SSRI) is sometimes recommended.