I’m exhausted. I feel like I haven’t slept in a week. I’m married to a constant struggle with insomnia stemming from a tremendous amount of anxiety. I’m only 24 years old, and I haven’t experienced enough real stress to leave me so frazzled with a social anxiety disorder. The smallest thing will set me off. I used to think that my discomfort was just normal for introverts, but there’s something else, just underneath the surface. I can be enjoying a perfectly delightful conversation with friends, only to suddenly feel embarrassed and uncomfortable, as if everything that I say comes out wrong. I worry that they don’t like me or that I’m acting foolishly. I can feel my heart-rate rise, and I even look at my wrist and see that my heart-rate is steadily increasing on my Garmin VivoSmartHR fitness tracker.
This experience happens when I’m out on a date or at work and if I don’t get it under control, I can create toxic relationships, but what I need is compassion, not rejection. I need my friends, and I love being with people, but I struggle with social anxiety disorder, and this is how I cope.
A Little Background on Social Anxiety Disorders
Anxiety disorders and depression are among the most troublesome psychological disorders in the world. While it may not seem dangerous to a lot of people, it is considered to be a grave medical condition that many in the world suffer from. Women are twice more likely to suffer from social anxiety disorder, but this condition is not strict to women. At the very least, one out of five men suffers from social anxiety disorder symptoms and other anxiety disorders.
Women and Social Anxiety Disorder Symptoms
Social phobia, sometimes called social anxiety disorder, is a medical condition diagnosed when a person becomes very anxious and self-conscious in everyday social situations, sometimes for no apparent reason. When a person has social anxiety disorder, they have an unyielding fear of being watched and being judged by others. A person with social anxiety disorder gets embarrassed easily and can experience stressful symptoms or even have a panic attack.
My Symptoms with Social Anxiety Disorder
My experience with social anxiety disorder isn’t unique. My mouth gets dry, and I sweat. I can sweat a gallon in a really stressful situation. Sometimes my chest tightens, and I can even feel nauseous. My heart races and my mind follows with an almost paranoid fear that I’m doing something wrong and the people around me are judging me. The sad part is that if you were a fly on the wall, other than my obvious visible sweating, the conversation might appear completely normal until I leave early or just shut down and get quiet. Sometimes that’s harder because I’m no longer engaged in the conversation and I’m slowly sinking into an isolating space – I’m no longer listening, obsessed with my fears, and that can turn awkward.
Everyday Situations that Trigger Social Anxiety
Performing or public speaking: It’s hard enough to get up on stage and perform in front of a crowd and most of us don’t have to deal with that, but we all have to bring ideas to our peers at work or just present a report during a meeting. All eyes are on us.
Being interviewed for a job: An interview is a no-brainer. The stakes are high and the other person “is” judging us, watching us, evaluating us, and looking for cues that we might “not” be a good fit in the workplace. I hate interviews. I have to work myself up and prepare for them.
Making small talk: You might think that innocent conversations should be easy, but they are hard for me, too. I find that it’s easy for me to sort of float away from the conversation because the subject-matter might be difficult to hold my attention, or the company may be uninteresting to me. We’re all in small-talk situations, about every day. If it’s just one person, I do fine, but when a third is mixed in, I fall apart.
Other triggers and situations that are often stressful to people include being teased or criticized, meeting new people, being watched while you are doing something, being the center of attention. Additionally, talking with authority figures, going on a date, speaking in a meeting, attending social gatherings, even using public bathrooms can be stressful enough to cause panic attacks.
However, just because you feel nervous in a social situation does not necessarily mean that you have social phobia. Many people are just naturally shy or self-conscious, but this does not affect their everyday activities. When the nervous feelings, fear, and worry are interfering with your routine and causes your distress, then it just might be a social anxiety disorder.
Other Symptoms of Social Anxiety Disorders
There are many symptoms of social anxiety. The most common symptom is an overwhelming sense of fear, but there are other physical symptoms.
Shortness of Breath – It feels like you can never get enough air.
Chest Pain – Tightness and real physical chest pain. You might think that you’re having a heart-attack, or you might be having a panic attack.
Fear of Dying – Sounds crazy, right? But an acute anxiety response may be tightly linked to a fight-or-flight sense of dread – like you might really be dying.
Chills or Hot Flushes – Feeling cold or excessively hot.
Women and Anxiety Disorders
Women are twice as likely to have a panic disorder than men and about equal for social anxiety. In the U.S., that’s about 15 million women suffering from social phobias, starting around age 13 and more than 30% of women experience symptoms for more than ten years before ever seeking help. Most find treatments for the physical symptoms, but not the underlying psychological causes that will provide them the most long-term relief. About half of the $40 billion per year spent on anxiety disorders in the U.S. is devoted to treating physical conditions, and researchers have commented that gaps in mental health treatment burden the U.S. health system.
The reasons that women suffer more frequently from anxiety disorders is not entirely clear, but some researchers suggest that there are some unique contributing factors. Estrogen and serotonin could play a role.
Estrogen affects the serotonin, a neurotransmitter that regulates mood, appetite, and sleep. Some studies show that when women have elevated levels of estrogen, like during their period, they have a greater capacity to tolerate anxiety and fewer symptoms. One reason that women on the pill may have more experiences of anxiety or depression is a relationship between birth control and depression or anxiety – studies show that birth control contributes to lower levels of estrogen, thus less tolerance for anxiety. Biological Psychiatry, 2013.
Major Types of Anxiety Disorders
Social phobia is only one particular type of anxiety disorder. There are many other types and the major ones include:
GAD or Generalized Anxiety Disorder – People that suffer from this anxiety disorder are often excessively worried about normal day-to-day activities. They worry about family, health, money and work, but more than others so. Those with GAD would often have their thoughts jumping to the worst-case scenario even when there is no reason to worry. For women dealing with this anxiety disorder, the common worry is getting through the day, and they are also the ones with higher risk.
Panic Disorder – This anxiety disorder is most common in women than in men. They would often experience sudden panic attacks even when there is no obvious danger. The risk of panic disorder lies with a person developing a sense of unreality and unreasonable fears. Another cause of concern for people with the panic disorder is the unexplained physical symptoms as sometimes they believe they are losing their minds, having a heart attack or close to dying.
Specific Phobia – This phobia is the fear of a particular thing or situation even when it poses little to no danger – when a person becomes afraid of height, objects, closed-in spaces, etc. Individuals with this kind of phobia would often suffer from severe anxiety whenever they face or think about their specific fears.
Social Phobia – This is also called social anxiety disorder and happens when a person is often worried and afraid of social situations. The most common fear for this kind of anxiety disorder is agoraphobia or being afraid when you are in public places. Most often, when a person with this anxiety disorder would have intense panic attack symptoms when out in the public.
Antidepressants and counseling are the most common ways for treating anxiety disorders. With social phobia, changing your thinking styles and some breathing exercises can help in dealing with your fears. You can also use herbs like chamomile for anxiety. Of course, the most important thing is that you face the social situations you fear instead of avoiding them.