Navigating social interactions can be challenging for many, but for some, it's more than just butterflies in the stomach — it's a profound and overwhelming fear known as social anxiety disorder. In this blog, we unpack the stigmas and realities of social anxiety, exploring the various forms of social anxiety and the significant impact it can have on individuals' lives. From the fear of public speaking to the dread of social gatherings, we unravel the complexities of social anxiety disorder, shedding light on its prevalence, causes, and effects on the brain.
Understanding Social Anxiety and it’s Forms
Many people become uncomfortable in social interactions, especially ones involving performance of any kind. Even the most beloved singers and entertainers, from Harry Styles to Jennifer Lawrence, have described their own experiences with anxiety before performing or acting in front of a camera. Another common performance anxiety is test anxiety. Most high school or college students have probably experienced test anxiety at some point in their lives, ranging from mild to severe symptoms that can impact their overall grades or GPA, thus impacting their view and worth as students.
What is Social Anxiety Disorder?
On the other hand, social anxiety disorder, also known as social phobia, is a type of anxiety disorder characterized by excessive fear, discomfort, and avoidance of social or performance situations that may lead to criticism, scrutiny, and possible embarrassment. This can look like a fear of talking in public or eating in front of other people. It may also look like a broad and general fear around poor functioning with an audience.
Therapists who treat social anxiety disorder distinguish two main components:
Social Fears
Poor Social Skills
In both of these forms of social anxiety, those with the disorder report socially performing far less competent than they actually do (Comer 131).
This disorder can interfere greatly with life, causing someone to miss out on life’s responsibilities and experiences. Someone who cannot talk in public may turn down an outing to go bowling with friends at work, leading to them being perceived as stuck-up, disinterested and perhaps even a bad friend, especially since many people with this disorder tend to keep their fears and diagnosis a secret from others.
Research has shown that 7% of people in the United States and other countries (around 60% female) experience social anxiety disorder in any given year, while around 12% experience it at some point in their lives. Who is most affected? Late childhood to adolescent African, Hispanic, or Asian American women from less privileged financial backgrounds.
Causes of Social Anxiety Disorder: The Impact of Social Media
There are cognitive and biological explanations for social anxiety disorder. Cognitive behavioral theorists suggest that people with social anxiety overestimate the likelihood for social interactions to go poorly. One main suspect is social media. In recent years, researchers have learned that use of phones and computers may unintentionally give our generation anxiety, especially social and generalized anxiety. Surveys suggest fears around others using their photos without permission, pressures to disclose too much information on social network platforms, as well as the pressure to post specific kinds of content to garner more “likes” and popularity. Risk factors can also include new work demands, family history of the disorder, temperament, as well as other medical conditions.
The Role of the Brain in Social Anxiety
The human brain is a complex organ that regulates all our behaviors, thoughts, and emotions. Researchers who take on a more biological perspective towards explaining several anxiety disorders link it to the structures and connections in the brain. It's divided into many different parts, each with its own specific function.
Two structures in the brain play a huge role in social anxiety:
The Amygdala
The Medial Prefrontal Cortex.
These structures have been found to show altered activity in brain scans, such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) scans used to study the brains of people with social anxiety (Comer 133).
The amygdala is part of the limbic system, a generally small almond-shaped structure deep in the brain, processing emotions and memory. The amygdala is responsible for detecting emergency situations. In people with social anxiety disorder, the amygdala may be overactive and physically larger, triggering an intense, irrational fear response when they're in social situations. Due to this structure regulating memory, those with social anxiety may suffer from impaired working memory, which is a type of memory used to perform tasks after verbal instruction, for example.
The prefrontal cortex is the part of the brain that regulates complex cognitive, emotional, and behavioral functioning. It's often coined the “control panel” of our personality and ability to interact with others. When you're in an anxiety-inducing social event or party, for example, the prefrontal cortex is supposed to keep the amygdala, or your fear, in check. But in people with social anxiety disorder, the prefrontal cortex is more underactive and smaller than in those without the disorder. This is a classic cause-and-effect situation. The prefrontal cortex is underactive and smaller, so it won’t send signals to the amygdala to stop lighting up and processing people’s faces as fearful.
Managing and Treating Social Anxiety
Social anxiety is a complex anxiety disorder that greatly impacts the brain and its functions. It's associated with overactivity in the amygdala and potential underactivity in the prefrontal cortex, leading to intense fear responses in social situations. Therapists and clinicians who treat this disorder may try to reduce social fears by pharmaceutical therapy and/or cognitive-behavioral therapy (including exposure techniques). These forms of therapy aim to improve social skills by social skills training (Comer 131-134). Psychiatric nurses or psychiatrists treating those with social anxiety may prescribe SSRIs (selective serotonin reuptake inhibitors) or benzodiazepines in combination with CBT (cognitive-behavioral therapy). This disorder can ultimately affect many aspects of life, such as memory, cognitive functioning, and even physical brain structure. However, with proper treatment, including cognitive-behavioral therapy and medication, people with social anxiety can manage their symptoms and lead fulfilling lives.
Beginning therapy can be a scary journey for anyone, especially those of us who suffer from social anxiety disorder. In recent months, I have begun my personal journey with mental health and CBT (Cognitive Behavioral Therapy) surrounding my social anxiety. Through developing better coping mechanisms and changing my thinking patterns, I feel I can better set and achieve my goals at work, school, and even my romantic relationship. This type of therapy allows the client to focus on the root issue, which in my case was a fear of social gathering and situations.
Sources: Abnormal Psych 11th Edition by Ronald J. Comer
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