By Bart Magee, Ph.D.
It’s an emotionally confusing time in the current age of the COVID-19 Pandemic. While not quite post pandemic, we’re no longer under lockdown or full restriction. Many workplaces remain remote, while more restaurants, bars, and other social gathering places are open and crowded. While many people are feeling relieved and happy to resume social engagements, others remain cautious, continuing to restrict their activities. Whether and where to don a mask remains a moving target. In this socially uncertain climate, it’s no surprise that social anxiety has been on the rise, particularly among young people. Social anxiety disorder, which affects over 15 million adults in the US, was already increasing before the pandemic and is now growing exponentially. It’s one of the more serious mental health challenges or our time. What is social anxiety and how can we address it?
Social anxiety is much more that everyday nervousness about being in a group or social setting. It's a pervasive fear of being judged by others or humiliated. It’s a fear of being seen as socially deficient, fearing that social interactions will bring shame and embarrassment. It’s an extreme self-consciousness and social performance anxiety. These fears stimulate a hyper focus on any negative or awkward social interactions (in fantasy or memory) leading to thoughts about worst case scenarios, such as various forms of social banishment. Feeling anxious on its own perpetuates the cycle, as the fear that others might observe the signs of anxiety only causes greater self-consciousness and worry about a humiliating experience.
The natural reaction to fears like these is to avoid or escape from the situations that bring them on. While providing temporary relief, escape only makes the problem worse by giving support to the worry, “I felt better after leaving that party, so it must have been really dangerous.” The COVID pandemic normalized these avoidant responses, and took away opportunities to flex social muscles. On top of that, the news, social media, and public health directives have emphasized the need to fear others as the source of deadly contagion and mandated avoidance as the only response. Little has been done to counter COVID misinformation, (for example, most people vastly overestimate the chances of vaccinated people infecting one another and the chances of becoming severely ill) which perpetuates a general climate of physical and social anxiety. Anxiety is an emotional force that easily flows across boundaries: a fear of being infected or infecting others enhances the fear of being emotionally harmed or harming others. As we emerge more and more from the pandemic, we need to ask how much of lingering COVID anxiety may be a cover for unaddressed social anxiety.
Social avoidance, anxiety, and the increased isolation that follows can cause other mental health problems, often depression, as well as general health disorders. Feeling socially inadequate leads to feeling deficient as a person. That feeling, in addition to the accumulating loss of life opportunities, increases hopeless and suicidal thinking. For young adults these risks can be most acute. Young people with social anxiety are keenly aware of what their social lives “should” look like, i.e. having lots of friends, dating and having sexual and romantic involvements, and being accepted and liked at school or work. Recently, studies have shown how Instagram and other social media platforms exacerbate these risks. Depression and social isolation lead to a downward spiral.
What helps turn things around? Finding the support of a trusted other, a friend or family member who one can confide in and lean on, is vital. Anything to break down and counter the impulse to isolate can help. Basic self-care is essential, starting with attending to sleep, exercise, diet and maintaining healthy routines, including reducing or eliminating interaction with social media. Next, it’s important to lower one’s overall level of anxiety. Mindfulness and other meditation practices can be a big help. Finding lower risk, higher reward social activities is a next step. At first, social activities with more structure will feel safer. Also, ones that offer more in the area of play and fun can provide the positive feedback needed. For example, there are many kinds of groups that sponsor games and sporting activities of all kinds. Classes, everything from dance to improv comedy can provide a safe setting for socializing. Going out alone can feel intimidating so finding a friend to serve as co-pilot helps.
And speaking of friends, how can friends or family help? Keep in mind that people with social anxiety figure out ways to hide or rationalize it. Fear of being seen as anxious is one if the main drivers. One might have the impulse to pour on the reassurance and support, or to try to talk one out their fears. While this is understandable, it can increase feelings of inadequacy, as in, “What’s wrong with me that this stuff is so difficult?” Another approach would be to normalize the feelings— everyone has them to some degree— and emphasize that with practice (building the social muscle), it gets better.
Psychotherapy is the recommended mental health treatment. A large number of the hundred people in treatment at Access Institute are young adults struggling with social anxiety. Therapy helps by providing a safe place where one’s deepest fears can be expressed and addressed. Feelings of shame and fears of humiliation emerge in the relationship with the therapist and can be sensitively worked through. Therapy also helps to dig into the emotional roots of the difficulties. Feelings of social awkwardness begin with early experiences in groups, in families, at school and in peer groups. Unresolved feelings from the past linger along with us and attach themselves to present experiences. A therapist becomes an essential support as one embarks on the winding and often bumpy road to recovery and social/emotional growth. While medication cannot cure social anxiety, for some it can help facilitate psychotherapy and the healing process.
Access Institute’s mental health resources, all available on an income-based sliding scale, are just a phone call away at (415) 861-5449 ex 380 for intake.