Taking Steps to Overcome Social Anxiety

Patient Expert

People often mistake social anxiety disorder for shyness. But the 15 million adults suffering from the disorder know how debilitating it can be, how it interferes with their daily lives and that it needs to be treated. The intense fear of being judged by others in social or performance situations may include symptoms so extreme that people have few or no social or romantic relationships, and they feel powerless, alone, or ashamed.

My colleagues Murray Stein, MD, MPH, and John Walker, PhD, are leading experts in the field and the authors of Triumph Over Shyness, Conquering Social Anxiety Disorder (Second Edition, 2009). I'd like to share some of what they say.

Their book has a lot of valuable information about shyness and social anxiety, and what you can do to overcome social anxiety disorder, which is also called social phobia. Here are some excerpts.

Drs. Stein and Walker describe how shyness differs from social anxiety.

Shyness refers to a tendency to withdraw from people, particularly unfamiliar people. It is a normal personality trait. This means that everyone has some degree of shyness some people have a lot, some have a little, and most people fall somewhere in between.

Social anxiety is closely affiliated with, though not identical to, shyness. We should start by defining anxiety. Anxiety is an uncomfortable internal state (that is, something people feel inside) usually associated with uncertainty or the unknown. Anxiety is an emotion. Anxiety is a lot like fear, but fear is what we feel when we know what we're afraid of. When someone points a gun at your head you don't feel anxiety. You feel fear You know exactly what it is that is causing your heart to race, your knees to shake, and your life to flash before your eyes.

When you exit the door of your house to take out the garbage at night you may feel anxious wondering if someone is lurking in the shadows waiting to attack you. This is anxiety, not fear, because you don't know whether something bad is going to happen; you think it is a possibility, but you can't be sure.

Social anxiety refers to the special kind of anxiety or discomfort you may experience when you are around other people. Usually, social anxiety is associated with concerns about being scrutinized. When you are around other people and you worry about what they think of you and you feel uncomfortable, you are experiencing social anxiety. When persons with social anxiety disorder are faced with a situation where others might observe them, they experience extreme anxiety.

The authors make recommendations to triumph over social anxiety.

You need to do four things to overcome your social anxiety:
1. Understand your anxiety pattern.
2. Change how you handle your thoughts in anxiety-provoking situations.
3. Change your anxious behaviors.
4. Accept anxious thoughts and feelings as you move toward your goals in life.
If you make a commitment to follow these four steps, you will dramatically reduce your social anxiety. For any kind of program to be successful whether it's self-help, individual therapy, or group therapy you must make it a priority.

I agree with the authors that self-help can be effective.

We were skeptical at first about the ability of self-help books to deal with anxiety. This changed as people told us their experiences using such books. We frequently met people who suffered with a serious anxiety problem for years and did not understand it until they read a book or a magazine article that encouraged them to find help. We have been recommending high-quality educational and self-help materials for many years.

Pre-order your copy of Triumph Over Shyness, Conquering Social Anxiety Disorder (Second Edition, 2009) from the Anxiety Disorders Association of America (ADAA). It will be available this spring.
PLEASE NOTE: The Anxiety Disorders Association of America (ADAA) does not endorse or promote any specific medications or treatments.