Like most mental health conditions the underlying drivers of social anxiety are complex. Here are some factors that can trigger, contribute or work together to make social anxiety a problem.
- Bullying – some people with a social anxiety disorder to being treated poorly, publicly shamed or humiliated
- Learned behaviour – certainly, children learn by observing their parents and caregivers. If parents behave such as the world is a frightening, critical place, a child will internalize that.
- Genetics – It is possible that there is a genetic component to social anxiety. Currently, researchers are of the view that multiple genes possibly contribute to anxiety.
- Temperament or nature – It is possible that being timid, shy or clingy as a child might mean an underlying anxious temperament. During, our underlying nature or ways might put us at risk of developing a social anxiety disorder.
- Not having corrective experiences – whilst shyness is a different entity to social anxiety disorder, often people with social anxiety disorder describe themselves as shy. Likewise, the lack of learning or corrective experiences for these shy children leads to them developing a social anxiety disorder in their teenage years.
- Family conflict or sexual abuse – Certainly, feeling unsafe as a child, having traumatic or bad experiences as a child might lead to feelings that the world is unsafe. However, this might lead to understandably self-protective behaviour and distancing. Opportunities as missed to feel safe again, leading to anxiety with others and in the community.
- Controlled or overprotective households – this is similar to learned behaviour in that it involves copying adult behaviour. However, it also prevents children from developing confidence and feeling a sense of mastery by themselves.
Treatment for social anxiety disorder
Where treatment is conducted, cultural factors, presence of any other mental health conditions, age and individual preferences are all considered in determining treatment. To clarify, it is important to talk about these things with your therapist.
Learning about Social anxiety disorder is a starting place. Further, it is a complex condition. Moreover, you can learn about social anxiety by reading articles online, watching videos and joining forums on social anxiety disorder.
Ask your doctor or mental health clinician for information sheets or brochures. Ask questions, at the start and through the treatment journey.
Oftentimes people with social anxiety disorder view it as a personal flaw, failing and are vulnerable to self stigmatization. Self stigmatization is when people are aware of others negative views, internalize and blame themselves. On the other hand, it’s important over time to challenge some of these beliefs.
Changing clinicians or doctors can be challenging for people with social anxiety. Moreover, sharing personal stories raises anxiety, building trust takes time. Disruptions should be avoided. However, telehealth psychology means therapists and clients are not as geographically limited.
Cognitive behavioural therapy for social anxiety disorder forms the basis of treatment. In this type of treatment, your therapist will focus on negative or unhelpful thought patterns about yourself and others. They will teach you ways to challenge these. Behavioral or confidence-building exercises also form part of this therapy.
Graded exposure is used in treating different anxiety conditions such as OCD. Certainly, it also can form part of social anxiety treatment. Breaking down social anxiety, tackling less provoking situations, for example, doing click and collect shopping first. Once at ease picking up items from a supermarket, the next step would be to shop in the aisles.
The client and therapist need to feedback to each other on how they feel therapy is going. Often with anxiety people have questions about therapy and how they are progressing. It is important that these questions are addressed.
During therapy, a psychologist can teach ways to focus externally as opposed to being too internally focused. They help to “re-script” bad memories of social trauma. A psychologist at the end teach ways to prevent relapse and to notice early warning signs of social anxiety returning to the fore.
The NICE guidelines on Social Anxiety Disorder (2013) note the possible challenges people face attending crowded clinics for assessment and treatment. Self-check-in, private space and the use of telehealth psychology are different ways to reduce this initial anxiety.
Guided Self Help
This involves working through online material or worksheets to help. There are various Australian and International resources available online; some free and others for a fee. A quick search on Google or recommendation from a friend might be the way to go.
Social anxiety by its very nature is isolating. Being part of a group, working through some of these issues together can help. People can learn from other’s experience of social anxiety. Also to realize that social anxiety is a common condition, impacting a lot of people in very different ways.
The guidelines on treating social anxiety disorder suggest medications are second-line options. Doctors will want to explore refusal of treatment, try to address concerns about therapy before turning to medication.
At times selective serotonin reuptake inhibitors (SSRIs) are used to treat social anxiety disorder, but they come with side effects. It is important to be aware of activating properties ( increased anxiety, jitteriness, agitation) during the first 2 weeks on these medications. These expected short term side effects are often blamed for medications making things worse.
Contact us Today
Our Epsychiatry team are experienced in treating people with social anxiety. We believe we are well suited to help with our online, telehealth psychologists and psychiatrists. Feel free to send us any questions you have. You can reach us via webchat, email or by phone. Our details are at the bottom of this page.