A lot of us get nervous in social situations, such as going on a first date, dinner with friends or speaking in front of a group of people.
But at what point do nerves turn into full-blown social anxiety?
鈥淧eople who have social phobia or social anxiety really have this intense and persistent fear of being judged, embarrassed, or rejected in social or performance situations,鈥� said , a licensed therapist based in Austin, Texas, and author of the upcoming book, 鈥淲hy Do I Keep Doing This? Unlearn the Habits Keeping You Stuck and Unhappy.鈥�
鈥淭hey essentially can鈥檛 even focus, cannot have conversations. They鈥檙e so concerned about what other people think,鈥� she said. 鈥淭hey kind of get caught up in their own thoughts and will avoid the situations altogether.鈥�
5 questions with Kati Morton
What causes social anxiety?
鈥淚t can come from a lot of different places. For most of my patients and people I鈥檝e spoken with over the years, it comes from childhood. A lot of times, we can feel judged when we鈥檙e younger. Say we were bullied, let鈥檚 say we were left out. Let鈥檚 say our confidence is really low, you know, maybe our parents weren鈥檛 super supportive. I mean, there鈥檚 really a ton of different places anxiety can come from 鈥� each person鈥檚 is individual 鈥� but I do think it鈥檚 important to recognize that anxiety is the most common mental illness in the U.S., and therefore I wouldn鈥檛 be surprised if a lot of people do have social anxiety.鈥�
What are the physical symptoms?
鈥淎 lot of people will say that the physical manifestations of that fear is a racing heart, sweaty palms, like butterflies in the stomach. It can feel like we鈥檙e gonna pass out. A lot of people say they almost feel like they鈥檙e drowning and dying at the same time. It also can cause digestive issues, which you can imagine, all of these symptoms can make the social anxiety feel even more uncomfortable.鈥�
What can you do if you feel anxious in a social setting?
鈥淭he best thing you can do in the moment is to step away. That鈥檚 a great opportunity to say, 鈥極h, I鈥檓 just going to go to the bathroom really quick. I鈥檒l be out in just a few minutes.鈥� [When] you go in the bathroom, you can do a full body shake, which I know sounds kind of strange, but when we feel queued up like that, when we feel anxious, that gives our nervous system a release, and if we don鈥檛 take an action, that鈥檚 when we can have things like a panic attack or we can start to have more of those symptoms like I feel like I鈥檓 going to faint or I鈥檓 gonna throw up or any of those. And so if you shake, you give your nervous system a release for that energy. So that鈥檚 always my number one.
鈥淢y second is to do some deep breathing, you know, I love, I call it four by four breathing or box breathing, breathe in for four [seconds], hold it for four, breathe out for four, do it four times. Easy. You can do it even if you can鈥檛 step away. People might not even realize that you鈥檙e doing it. If you don鈥檛 have makeup on, you can splash cold water in your face. Those are [for] the moment, save you and pull you out of that anxious spiral.鈥�
How can you stop replaying situations in your head or reframe your thinking?
鈥淪o I want you to think of a memory that feels really good, and I want you to pretend you鈥檙e telling me all about it. Tell me about that one vacation you took to Hawaii, or tell me about that wonderful day you had off where you just had nothing to do and you walked around town. Tell me about it. What do you smell? Use all your senses. What are you tasting? And go through that memory in as much detail for as long as you can, and I find most of my patients will say, 鈥業 didn鈥檛 even get all the way through the memory and I fell asleep.鈥欌��
Should you ever avoid social situations altogether?
鈥淚 don鈥檛 for the most part because the way that social anxiety works in our brain and body is that as we kind of retract, like say no and stay home, the more we prove to our system that we can鈥檛 handle it. And so I always want to challenge people to try anyways, like do some tools, like dunk your face, shake out, have a ritual, get yourself prepped and do it. But I also want to hold space for the fact that some people might feel almost into a panic attack already, just sitting in their car, waiting to drive to go somewhere. And if you find yourself that heightened, it might be better you don鈥檛 [go]. I still want you to do all the things we talked about like the shakeouts and talking yourself down, stopping the rumination, doing all of that, but that day just might not be your day. So if you feel like your resilience is low and you essentially cannot weather the storm of a social event, it鈥檚 OK to not go. I just don鈥檛 want that to become a pattern that we get caught in, because like I said, it only reinforces the social anxiety, and that鈥檚 not what we鈥檙e here to do.鈥�
This interview was edited for clarity.
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produced and edited this interview for broadcast with . Raphelson also adapted it for the web.
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