social anxiety

so many to choose from, this'll do
so many to choose from, this’ll do

According to the DSM-IV, Social Anxiety Disorder is characterized by the following criteria (source: behavenet.com):

  • A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating and embarrassing.
  • Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack.
  • The person recognizes that the fear is excessive or unreasonable.
  • The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
  • The avoidance, anxious anticipation, or distress in the feared social or performance situations interferes significantly with the person’s normal routine, occupational functioning, or social activities or relationships, or there is marked distress about having the phobia.
  • In individuals under 18 years, the duration is at least six months.
  • The fear or avoidance is not due to the direct physiological effects of a substance or general medical condition and is not better accounted for by another mental disorder.

There is also the specific Generalized Social Anxiety Disorder, in which fears include most social situations. In this case an additional diagnosis of Avoidant Personality Disorder.

This is a topic I could pretty much devote an entire site to, and I’ve considered it. I’m kind of an expert. Let me give you my credentials.

I’ve spent about twenty years at Personal Experience University. No, it’s not accredited, and people tend to give it less credence than a “real degree”, but given the right amount of correct introspection, I would give it twice the value of a scholarly education.

I think I’ve traced the roots back to when I was five. Nature versus nurture is the classic debate, and in my case I think it’s a bit of both. On the nature side I was a bright kid. I have no research to back this up, but I feel it had a major hand in my life in this regard. On the nurture side, I had many experiences that reinforced this negative pattern throughout my life, beginning with the original at age five.

Now I know the psychologist/iatrists out there will harumph about my self-diagnosis using the internet. But it’s pretty plain to see, in my case. Straight-forward, clean cut. I’ll walk you through the diagnostic criteria with regards to myself, and ask that you play along and have a conversation as I’m having with yourself.

Fear of social situations

A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating and embarrassing.

It’s hard to sum up these paragraphs into a section title, but “fear of social situations” fits the bill. It’s written almost as law is written, with every word counting.

The fear must be marked and persistent. A good synonym for “marked” would be “pronounced”, or “significant”. Do you get a few butterflies that fade away after you’re settled into the situation? Probably not marked or persistent. Unfamiliar people and possible scrutiny by others is also key. And the final piece of the puzzle in this criteria is that you feel like you will embarrass yourself in this situation.

My big triggers are unknown situations: first day of school, a meeting with someone I’ve never met before, situations I’ve never been in that involve people. The fear is marked and persistent, although I’ve only had panic attacks once or twice in my entire life. The thing is, I’m just really good at avoiding situations that are going to cause anxiety for me. So good that I have hampered my ability to live life.

Maybe you’re the same way.

Anxiety/Panic Attacks

Anxiety is, to put it simply, fear. Some physical symptoms that may accompany fear are: blushing, sweating, trembling, heart palpitations, and nausea. You may stammer or speak too quickly. All of these physical symptoms cruelly increase your anxiety. It’s a never-ending cycle.

I know quite a bit about anxiety as well. My wife has been professionally diagnosed with Generalized Anxiety Disorder, and used to suffer from crippling panic attacks. I’ve seen the extreme side through her.

As I said earlier, my anxiety remains mild, because I’ve become excellent at avoiding those situations that will cause anxiety for me. As a result, however, my success in life has suffered. I got poor grades in high school, dropped out of university within a couple weeks of starting, had no friends, no love life, nothing. I became a shut-in.

Let me be clear to you: This is not an option. Some of you reading this may be in the same boat I was in ten years ago. Avoiding your fear, letting it destroy your chance to live. You’re only on this planet once (as far as I know). Make the best of it.

Recognizing that the fear is unreasonable and/or excessive

This is another cruel aspect of the condition. Your mind is telling you that you are in mortal danger, and some animal part of your subconscious pushing you to retreat and run away. At the same time, you know that your fear is completely unreasonable, and that there is nothing to fear from the situation.

If you don’t have social anxiety, think of it as being similar to your experience on a roller-coaster. The animal part of your brain is telling you that you are moving much too fast, that you shouldn’t be upside down or falling at the speed you’re falling. Your inner animal tells you that you can’t possibly survive this.

But your conscious mind, the part of you that makes you human, realizes that you’re perfectly safe. You’re all strapped in, the ride runs hundreds of times a day all year without incident. Sure, there may be a minute chance that this is the time it jumps the rails, but it’s ridiculous to be afraid.

Avoidance

Some people choose to avoid the situation, some people endure it and ride the fear. Either outcome is unpleasant.

I happen to enjoy roller-coasters, a lot. Some people are scared to death by them. They have a phobia. The animal part of their brain takes control, and they panic. They are overcome by anxiety and just want to get off of the ride. Or maybe they avoid it entirely, telling their friends to go ahead and they’ll go get cotton candy or ride the bumper cars or something. The result is that they miss out on the joyous experience of a really crazy roller-coaster.

Avoidance is an aspect of the disorder which I have become very good at, as I’ve mentioned before. On one hand, it lets me avoid most of the unpleasant effects of anxiety. On the other, it is a destroyer of life. I’ve missed out on countless opportunities in life because of my fear.

Have you?

It brings me to the next point…

Significant Interference

This one is a no-brainer. If your social anxiety isn’t disrupting your life in some way, why are you seeking help for it?

The key here is that a lot of people without Social Anxiety Disorder still experience social anxiety. Everyone feels butterflies before a blind date. Most people get anxious before public speaking. Countless performers claim to suffer from stage fright before every show, even after thirty years in the business. It is a normal part of life.

Social anxiety is normal. It becomes a disorder when it interferes with normal operation in your life.

Conclusion

I’m going to skip the last two criteria, as they simply say that periods of intense social anxiety lasting less than six months are relatively normal for children and teenagers, and that some drugs and illnesses can cause social anxieties and this doesn’t really give a person Social Anxiety Disorder.

Below, in the resources section, I’ve placed two self-tests you can take, to give yourself a rough idea of whether or not you have Social Anxiety Disorder, and to what degree. As with any self-test, it’s not going to be 100% accurate, and will change over time as your answers change. Use it as a guide.

I am a big believer in professional help for mental disorders. Finding a good psychologist is a boon to anyone with Social Anxiety Disorder. I personally have never gone this route, as I have never been able to afford it. Opportunities in America are limited for the lower class. I don’t even have basic health insurance, let alone one that covers mental health.

If you have the resources, seek professional help. If you don’t, you can do this. I’ve been working ten years on myself, and have made significant progress. It doesn’t effect my daily life anymore, not to the extent it did.

I used to not be able to go into a store I’d never been into before. Now, I do it all the time without thought. I still have my favorite gas stations and such, but that’s because I’m a creature of habit, not because of any anxiety.

I used to not be able to make phone calls at all, not even to friends. I hated talking on the phone. I still avoid some calls, but I’ve made significant progress in that direction.

I dropped out of college less than a month in to my first venture ten years ago. As of today, I’ve been back and taking a full course load for a semester and a half. I’ve had to give presentations, I’ve been late for class and had to find a seat, I’ve had to talk to strangers. I also have a big challenge coming tomorrow (for someone with SAD), and I intend to conquer. The fact that I’m still in school is a testament to my progress.

I still have trouble with eye contact, but I’m working on it, and improving. I can make small talk with anyone now.

I intend on putting what I’ve learned online. This post may be the start of a splinter site. I don’t feel it really belongs on my personal blog. But it’s a topic I’m passionate about, and empathetic about. I want to save people from the shit I’ve had to go through.

I’ll end with a message to you, the sufferer: Every sunrise is a new chance to conquer your demons.

Resources

Liebowitz Social Anxiety Scale (LSAS): Self-test

Social Phobia Inventory (SPIN): Self-test

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