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Are You Allergic To People?

By: IRENE J. SLEIGHT, MS

Imagine staring down the barrel of a gun with your life at the mercy of a madman. Your nervous system would rev out of control as it prepares your body to run like hell or retaliate. This innate reaction, known as the fight or flight response, would be appropriate and necessary in a life threatening situation.

Now, imagine having this same overwhelming physiological response, only this time you are buying groceries at a local supermarket, eating in a restaurant, perhaps being introduced to someone, or giving a small talk. This is what it feels like to the millions who silently suffer from social anxiety disorder. It’s a disproportionate fear of being evaluated, judged, and embarrassed in social situations.

People with social anxiety fear the high amount of anxiety experienced before, during, and after social situations and events, not the panic attack itself. While it may be easy to intellectually articulate why it’s so illogical to be fearful, it’s as though one’s nervous system has an agenda of its own.

The socially anxious tend to read and interpret facial expressions that may or may not be accurate, but nonetheless elicit an overwhelming anxiety response. It is more of a continuum, rather than a neatly packaged checklist of symptoms. Public speaking, job interviewing, and asking someone for a date are the most common, and milder forms of social anxiety. However, when daily life becomes severely disrupted, it can lead to a highly debilitating form of avoidance behavior known as social phobia. In the extreme, some build a hermetic life, and feel forced to quit school or work. They don’t necessarily prefer isolation, but rather their desire for social interaction is outwitted by their fear. It is often the seemingly, innocuous situations like asking a stranger for directions that can trigger intense anxiety, and lead to a horrible, life-restricting disorder.

As the third largest mental health care problem in the U.S., social anxiety affects 7-8% of the population, but is often lumped together with other anxiety disorders, thus diluting its already misunderstood status. It is frequently equated with being shy, but the socially anxious are often extroverts. Ironically, many of those who suffer from social anxiety can act their way through social savvy professions, but they do so with great distress. Their outward demeanor becomes a constant agonizing performance, while inside they are frightened and anxious that their timidity will be discovered. It is this group in particular that goes undiagnosed and untreated. They often don’t understand it themselves, nor would others believe that someone who outwardly appears so confident could be so terrified. It’s because it’s so irrational that people fear talking about it.

It is no surprise, but unfortunate that many people with social anxiety turn to alcohol and drugs in a desperate attempt to hide their discomfort. Alcohol has long been used to help people socialize by decreasing inhibitions. While alcohol temporarily soothes the anxiety, one runs the risk of becoming an alcoholic. Rates of alcoholism and other substance abuse problems are higher among people with social anxiety, and many alcoholics have identified it as the root cause of their drinking problem. Once you get hooked, it becomes extremely difficult to overcome, because of the social component in re-learning how to interact without the crutch.

No one knows for certain what causes social anxiety, although researchers speculate a variety of biological, psychological, and environmental factors. Whether it’s due to a biological predisposition, faulty learning, or environmental programming, it doesn’t have to be a permanent trait, and it can be unlearned. By changing your interpretation of events, you can alter “what if” thinking to a less dramatic “so what if!” That is the basic premise of the most widely accepted form of treatment known cognitive-behavioral therapy (CBT).

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CBT is an effective treatment for overcoming social anxiety. It helps you identify and change negative thought patterns which fuel the stress response. The idea is to replace maladaptive thoughts, beliefs, and expectations with healthier ways of thinking and responding to social situations. This will ultimately reduce one’s automatic stress response. A trained therapist would help a client construct an exposure hierarchy of specific anxiety producing situations. The goal is to systematically desensitize the amount of anxiety experienced from the least to the most feared situation. Clients would mentally rehearse each situation with imaginal exposure until the anxiety is diminished, which helps prepare them for real-life exposure.

Relaxation techniques such as paced diaphragmatic (belly) breathing and muscle relaxation are taught, and used as coping techniques for managing the physical symptoms of anxiety during each exposure. This process requires unwavering commitment, dedication, and practice, practice, practice.

Finding proper treatment is well worth the time and investment when you consider the steep consequences. There is no reason to let anxiety keep you from getting the most from life, or resign yourself to such a life-restricting disorder when treatment options are available today. Not every person with social anxiety needs a therapist, and many self-help books are available. In more severe cases, medication can be used in conjunction with traditional therapy.

If you or anyone you know may be suffering from social anxiety, I urge you to act immediately. It doesn’t go away on its own, and can lead to an unnecessary life-long struggle. Don’t let social anxiety keep you from getting the most from life. It is treatable!