Social Anxiety/Stress | Kay Trotter

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Social Anxiety/Stress

Social Anxiety/Stress

Shyness is the tendency to feel awkward, worried or tense during social encounters, especially with unfamiliar people. There are many degrees of shyness. Stronger forms are usually referred to as social anxiety or social phobia. Shyness may merely be a personality trait or can occur at certain stages of development in children.
The primary defining characteristic of shyness is a fear of what other people will think of a person’s behavior, which results in the person becoming scared of doing or saying what he or she wants to, out of fear of negative reactions, criticism, or rejection, and simply opting to avoid social situations instead.

Severely shy people may have physical symptoms like blushing, sweating, a pounding heart or upset stomach; negative feelings about themselves; worries about how others view them; and a tendency to withdraw from social interactions.
Most people feel shy at least occasionally. Some people’s shyness is so intense, however, that it can keep them from interacting with others even when they want or need to— leading to problems in relationships and at work.


A chronic and disabling form of shyness is called social phobia or social anxiety disorder, and is a chronic problem that can result in a reduced quality of life.

The difference between social anxiety and normal shyness is that social anxiety involves an intense feeling of fear in social situations and especially situations that are unfamiliar or in which one will be watched or evaluated by others. The feeling of fear is so great that in these types of situations one may be so worried that he or she feels anxious just thinking about them and will go to great lengths to avoid them.

Like many other mental health conditions, social anxiety disorder likely arises from a complex interaction of environment and genes, including inherited traits, brain chemistry, brain structure and negative experiences (e.g., bullying, rejection, sexual abuse).

Left untreated, social anxiety disorder can be debilitating.

Social anxiety disorder can cause:

  • Low self-esteem
  • Trouble being assertive
  • Negative self-talk
  • Hypersensitivity to criticism
  • Poor social skills

Social anxiety disorder can also result in:

  • A poor work record
  • Low academic achievement
  • Isolation and difficult social relationships
  • Substance abuse
  • Excessive drinking, particularly in men
  • Suicide


Emotional and behavioral social anxiety disorder signs and symptoms include:

  • Intense fear of interacting with strangers
  • Fear of situations in which you may be judged
  • Worrying about embarrassing or humiliating yourself
  • Fear that others will notice that you look anxious
  • Anxiety that disrupts your daily routine, work, school or other activities
  • Avoiding doing things or speaking to people out of fear of embarrassment
  • Avoiding situations where you might be the center of attention
  • Difficulty making eye contact
  • Difficulty talking

Physical social anxiety disorder signs and symptoms include:

  • Blushing
  • Sweating
  • Trembling or shaking
  • Fast heartbeat
  • Upset stomach
  • Nausea
  • Shaky voice
  • Muscle tension
  • Confusion
  • Diarrhea
  • Cold, clammy hands


Overcoming social anxiety depends on the person and the situation. In some cases it can be relatively easy—just a matter of time for many individuals—yet for some people social anxiety can become a very difficult, painful and even disabling problem. The reasons are unknown. Recovery from chronic social anxiety is possible in many cases, but usually only with some kind of therapy or sustained self-help or support group work.

Types of Treatment

  • Cognitive Behavorial Therapy (CBT) can be one of the most effective treatments available. The goal of CBT is to guide the patient’s thoughts in a more rational direction when faced with anxiety; it helps the person to stop avoiding situations that once caused anxiety and teaches people to react differently to the situations that trigger their anxiety. Cognitive behavior therapy may include systematic desensitization or controlled exposure to the feared situation. With systematic desensitization, the person imagines the anxious social situation and works through their fears in a safe and controlled environment. CBT may also include role-playing to practice social skills and gain the comfort and confidence in order to relate to others.
  • Relaxation techniques include breathing methods and muscle relaxation strategies. Calm breathing or ‘diaphragmatic breathing’ is a breathing technique used to slow down and control one’s breathing when they start to feel anxious or even stressed.
  • Medication such as antidepressants like Paxil or benzodiazepines such as Xanax, Librium, Valium, and Ativan. Beta-blockers, which are often used to treat heart conditions, may be used to mitigate some of the physical symptoms of social anxiety, such as reducing heart rate or blood pressure.