Heart Racing?    Sweating?    Fear?   Dry Mouth?    Panic?

Feeling Faint?   Frozen?   Nausea?   Upset Stomach?

Is this your Self Talk?

Everyone is staring at me..

I have nothing to say..

I’m going to say something stupid..

They won’t like me..

What is Social Anxiety Disorder?

Social anxiety disorder is one of the most common anxiety disorders, affecting between 7 and 13% of the population. People with social anxiety disorder tend to feel quite nervous or uncomfortable in social situations. They are very concerned that they will do something embarrassing or humiliating, or that others will think badly of them. These individuals are very self-conscious and constantly feel “on stage.”

Recognizing Social Anxiety Disorder – Do I have it?

What is a Social Situation?

A social situation includes any situation in which you and at least one other person are present. Social situations tend to fall into two main categories: performance situations and interpersonal interactions.

Performance Situations:
These are situations where people feel they are being observed by others. Examples include:
•    Public speaking (e.g., presenting at a meeting
•    Participating in meetings or classes(e.g. asking or answering questions)
•    Eating in front of others
•    Using public washrooms
•    Writing in front of others (e.g. signing a cheque of filling out a form)
•    Performing in public (e.g. singing or acting on stage, or playing a sport)
•    Entering a room where everyone is already seated

Interpersonal Interactions:

These are situations where people are interacting with others and developing closer relationships. Examples include:
•    Meeting new people
•    Talking to co-workers or friends
•    Inviting others to do things
•    Going to social events (e.g. parties or dinners)
•    Dating
•    Being assertive
•    Expressing opinions
•    Talking on the phone
•    Working in a group (e.g. working on a project with other co-workers)
•    Ordering food at a restaurant
•    Returning something at a store
•    Having a job interview

Note: It is not uncommon for people to fear some social situations and feel quite comfortable in others. For example, some people feel very comfortable speaking or performing in front of large groups of people, but feel anxious making small talk or meeting new people. Other people are comfortable spending time with friends and family, and interacting socially with co-workers, but are very fearful of performance situations, such as participating in business meetings or giving formal speeches. Also, some people fear only a single situation (such as public speaking), while others fear and avoid a wide range of social situations.

What Does Social Anxiety Look Like?

When faced with a feared social situation, people with social anxiety experience the following:
Physical Symptoms(what you feel)
•    Examples: racing heart, upset stomach, shaking, choking sensations, sweating, blushing, trembling, dry mouth, shortness of breath, nausea, dizziness, light-headedness, blurred vision, urge to urinate, etc.
•    People with social anxiety are often very concerned about visible signs of anxiety, such as blushing or trembling.
Negative Thoughts (what you think)
•    Examples: “I’m going to say something stupid,” “I’ll get anxious and others will notice,” “They won’t like me,” “Others will think I’m stupid,” “I’ll offend someone,” or “No one will talk to me.”
•    People with social anxiety tend to have negative thoughts about themselves (e.g., “I’ll have nothing to say”), as well as how others will react to them (e.g., “Others will think I’m weird”).
•    People with social anxiety also tend to focus their attention on themselves during social situations. They focus on their performance and how anxious they feel and look.

Avoidance and Safety Behaviors(what you do)
•    Examples: Avoiding (e.g., not going to the party), escaping a scary social situation (e.g., leaving the party early) or engaging in protective behaviours to try and stay safe (e.g., drinking alcohol, staying quiet, and avoiding eye contact).
•    People with social anxiety will often try to avoid or escape social situations. If they do go into social situations, they tend to do things to feel less anxious or to protect themselves from embarrassment or negative evaluation (e.g., if I’m worried about saying something stupid, then I’ll try to avoid talking).

When Does Social Anxiety Become a Problem?

It’s normal to feel anxious in social situations from time to time. For example, many people feel anxious in job interviews or when having to give a formal speech. Social anxiety can be a problem when it becomes too intense or happens too often. When it does, social anxiety can cause significant distress and affect many aspects of a person’s life including:

Work and school
•    Examples: difficulty with job interviews; problems interacting with bosses or co-workers; trouble asking and answering questions in meetings or classes; refusing job promotions; avoiding certain types of jobs or career paths; poor performance at work or school; decreased enjoyment of work or school.

•    Examples: difficulty developing and keeping friendships and romantic relationships; trouble opening up to others; difficulty sharing opinions

Recreational activities/Hobbies.
•    Examples: avoid trying new things; avoid taking classes or lessons; avoid activities that involve interacting with others, such as going skiing or to the gym

Day-to-day activities.
•    Examples: difficulty running errands and completing daily activities, such as going grocery shopping, going out to eat, taking the bus, asking for directions, etc.

Social Anxiety Disorder: The Facts
•    Although social anxiety disorder can start at any age, most people with social anxiety disorder first experienced problems in childhood or adolescence.
•    Social anxiety disorder can develop suddenly after a stressful or humiliating experience or slowly over time.
•    Social anxiety tends to run in families.
•    Men and women are equally likely to develop social anxiety disorder.
•    Social anxiety disorder is associated with a number of other problems including low self-esteem, poor body image, depression, and substance abuse problems.

Home Management Strategies for Social Anxiety Disorder

What Is Anxiety?

Most people do not recognize their anxiety for what it is, and instead think there is something “wrong” with them. Some people are preoccupied with the symptoms of anxiety (e.g. stomach aches, increased heart rate, shortness of breath, etc.). Others think they are weird, weak, or even going crazy! Unfortunately, these thoughts only make people feel even more anxious and self-conscious.
Therefore, the first step to successfully managing anxiety is to learn to understand and recognize it. Being well informed is essential!

The Facts!
Myth: Reading, thinking, and learning about anxiety will make you even MORE anxious.
Fact: If you do not know what you are dealing with, how do you manage it? Having accurate information about anxiety can reduce confusion, fear, and shame. Anxiety is a common and normal experience, and it CAN be managed successfully!

Learning the Facts about Anxiety

1. Anxiety is normal. Everyone experiences anxiety at times.  For example, it is normal to feel anxious when on a roller-coaster, or before a job interview.
2. Anxiety is adaptive. It is a system in our body that helps us to deal with real danger (for example, anxiety allows us to jump out of the way of a speeding car) or to perform at our best (for example, it motivates us to prepare for a big presentation). When you experience anxiety, your body’s “fight-flight-freeze” response (also called the “adrenaline response”) is triggered. This prepares your body to defend itself.

More on Flight-Flight-Freeze
Our body’s natural alarm system (the fight-flight-freeze response) can be activated when there is a real danger, such as coming across a bear when hiking in the woods. In this case, you may flee (e.g., run away from the bear), freeze (e.g., stay still until the bear passes), or fight (e.g., yell and wave your arms to appear big and scary).
But this response can also happen when something simply feels dangerous, but really isn’t, such as being interviewed for a job. For example, you may feel jittery, on edge, or uncomfortable. You may snap at people (fight) or have a hard time thinking clearly (freeze). These feelings can become overwhelming enough that make you want to avoid doing the interview (flight). Many people stop doing things or going places that make them feel anxious.

Can you think some ways you may fight, flight, or freeze because of your anxiety?

3. Anxiety is not dangerous. Although anxiety may feel uncomfortable, it is not dangerous or harmful to you. Remember, all the sensations you feel when you are anxious are there to protect you from danger, not hurt you!

4. Anxiety does not last forever. When you are anxious, you may feel like the anxiety is going to last forever.

But, anxiety is temporary and it will eventually decrease!

5. Anxiety is mostly anonymous. Most people (except those close to you) cannot tell when you are anxious because it does not show on your face.

6. Anxiety can become a problem. Anxiety is a problem when our body reacts as if there is danger when there is no real danger. It’s like having an overly sensitive smoke alarm system in your body!

7. Anxiety problems are common. One-in-ten adults suffer from anxiety problems.

Anxiety is like a smoke alarm system:

A smoke alarm can help to protect us when there is an actual fire, but when a smoke alarm is too sensitive and goes off when there isn’t really a fire (e.g., burning toast in toaster), it is rather annoying.

Like a smoke alarm, anxiety is helpful and adaptive when it works right. But, if it goes off when there is no real danger, it is not only scary, it is also very exhausting.

However, we DO NOT want to get rid of the alarm (or eliminate anxiety) because it protects us from danger. We want to fix it (i.e., bring the anxiety down to a more manageable level) so it works properly for us!

What Happens to your Body when you are Anxious?

Anxiety can cause many sensations in your body as it prepares for danger. These sensations are called the “alarm reaction”, which takes place when the body’s natural Alarm System (that is, the “fight-flight-freeze” response) has been activated.
•    Rapid heart beat and rapid breathing – When your body is preparing itself for action, it makes sure enough blood and oxygen is being circulated to your major muscle groups and essential organs, allowing you to run away or fight off danger.
•    Sweating – Sweating cools the body. It also makes the skin more slippery and difficult for an attacking animal or person to grab hold of you.
•    Nausea and stomach upset – When faced with danger, the body shuts down systems/processes that are not needed for survival; that way, it can direct energy to functions that are critical for survival. Digestion is one of the processes that is not needed at times of danger. Because of this, anxiety might lead to feelings of stomach upset, nausea, or diarrhoea.
•    Feeling dizzy or lightheaded – Because our blood and oxygen goes to major muscle groups when we are in danger, this means that we will breathe much faster in order to move oxygen toward those muscles. However, this can cause hyperventilation (too much oxygen from breathing very rapidly to prepare the body for action), which can makes you feel dizzy or lightheaded. Also, since most of your blood and oxygen is going to your arms and legs (for “fight or flight”), there is a slight decrease of blood to the brain, which can also make you dizzy. Don’t worry though: the slight decrease in blood flow to the brain is not dangerous at all!
•    Tight or painful chest – Your muscles tense up as your body prepares for danger. So your chest may feel tight or painful when you take in large breaths while those chest muscles are tense.
•    Numbness and tingling sensations – Hyperventilation (taking in too much oxygen) can also cause numbness and tingling sensations. The tingling sensations is also be related to the fact that the hairs on our bodies often stand up when faced with danger to increase our sensitivity to touch or movement. Finally, fingers and toes may also feel numb/tingly as blood flows away from places where it is not needed (like our fingers) and towards major muscle groups that are needed (like our arms).
•    Unreality or bright vision – When responding to danger, our pupils dilate to let in more light and to make sure that we can see clearly enough. This reaction makes our environment look brighter or fuzzier, and sometimes less real.
•    Heavy legs – As the legs prepare for action (fight or flight), increased muscle tension, as well as increased blood flow to those muscles, can cause the sensation of heavy legs.

More About How Anxiety Works

Anxiety does not only affect your body, but it also affects your thoughts and behaviours.
There are three parts to anxiety:
•    Physical symptoms (how our body responds)
•    Thoughts (what we say to ourselves)
•    Behaviours (what we do – our actions).

Learning to recognize these signs of anxiety can help you to be less afraid of it.
•    Physical Symptoms e.g., stomach ache, cold sweat, heart racing
•    Thoughts e.g., What if I forget what I want to say during the presentation?
•    Behaviours e.g. find an excuse to get out of it

Recognizing physical symptoms of anxiety
You can learn to identify the physical signs of anxiety by asking yourself: “What happens when I’m anxious? Where do I feel the anxiety in my body?” For example, when you feel anxious, you may get butterflies in your stomach, sweat a lot, breathe heavily, and feel dizzy or lightheaded.
REMEMBER: If you often experience many uncomfortable physical symptoms, but doctors cannot find anything wrong with you physically, you may have problems with anxiety. You are definitely not “going crazy”! Although these symptoms may be uncomfortable, they are not harmful!

Recognizing anxious thoughts
Anxiety also affects how we think. Anxious thoughts typically involve a fear of something bad happening.
See Realistic Thinking for helpful tips on how to identify and challenge your anxious thoughts.

Recognizing anxious behaviours
Anxiety can make us feel very uncomfortable, and it can make us believe that we are in danger, so it is no wonder that you may feel a strong urge to escape or avoid situations/activities/people that make you anxious. For example, if you are scared of dogs, you would probably avoid going to places where you may encounter a dog (e.g., dog park).
To help you identify situations that you avoid, try to come up with as many answers as possible to the following:
•    If you wake up tomorrow morning and all your anxiety had magically disappeared, what would you do?
•    How would you act?
•    How would someone close to you know you weren’t anxious?
Finish the following sentences:
•    My anxiety stops me from…. .
•    When I am not anxious, I will be able to…..
Once you are able to understand and recognize anxiety, you will be better prepared to move on to the next stage – learning how to manage anxiety!

Disclosure & Disclaimer:

Jackie Maclean, Clinical Hypnotherapist (the practitioner), is not a licensed physician or mental health provider. The information provided on this website is not intended to diagnose, treat, cure or prevent any disease. Further, Hypnosis and Hypnotherapy cannot, and should not, stand alone as the sole medical or psychological intervention for any disorder. Hypnosis should not be used instead of appropriate medical, dental, or psychological treatment, and any individual with a medical or psychological problem should first consult a qualified health care provider for diagnosis and professional advice. Hypnosis should only be practiced by those who have been appropriately trained, who practice appropriately, and within the scope of their training. Although many experience good results through my hypnotherapy programs, there are those who do not. For example, even though a large percentage of people quit smoking through my programs, there are some who do not.