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mental health mondays :: social disease

the woman on the left is an introvert.
the woman in the centre is judging you.
EDIT :: unsure if you meet the threshold for social anxiety? this quiz, while not a diagnostic tool, offers some guidance. the site also has information on what social anxiety is, common symptoms, and paths to treatment. [yes, i took the quiz. yes, my answers indicate some level of social anxiety.]

like a lot of introverts, i enjoy public speaking. think that sounds contradictory? i can understand your confusion, because there's a tendency to assume that all introverts are shy types, lacking in confidence. but for many introverts, discomfort doesn't come from having to be around people, but from having to interact with people, and the more personal and less structured the interaction, the more uncomfortable we get. but put us in a situation where we have to do something like deliver a speech in a highly controlled environment, where the other people are at a distance and where there's no need for incidental small talk, and we're surprisingly comfortable.

that wasn't always the case, for me, though. for most of my early life, i was so petrified of public speaking that i would go to almost any length to avoid it. if i had to speak in front of a class at school, i would feel physically ill for hours beforehand. i tried the whole "confront your fears" thing by participating in school debate clubs and model parliaments, which succeeded only in making me feel like the worst public speaker in recorded history. [not that any of it was recorded. i'm thankful every day for the fact that recording and sharing technology was unknown at the time.] at that point in my life, i wasn't just an introvert, but someone with a social phobia, and a very common one.

i share those rather mundane details as a way of illustrating a point: social phobia, or social anxiety, is not the same as being introverted. social anxiety stems from a deep-seated fear of the reactions of others. in our ancient, pre-linguistic cave-dwelling past, that reaction was what warned us not to just wander up to groups of hominids we didn't know. it's still the reaction that makes us say "no, strange person in the dirty panel van, i would not like to come and see the video arcade that you've installed in your basement." but, as we've reformed our world faster than our mind can adjust, those very reasonable reactions start poking out like springs in an old mattress, and, like those springs, they can cause some pretty ungodly pain.

people with social anxiety have difficulty meeting other people, interacting with authority figures, and being the subject of attention [especially if the attention seems belittling, like someone teasing them or criticizing them]. introverts, despite the fact that western culture esteems extroverts, can generally find their way through the social ecosystem without too many problems. people with social anxiety can't. their fear of failure and/ or ridicule is crippling. [oh, and if you're one of those blustery types who says that you don't care what anyone thinks of you, because you just do what you want, consider that the need to assert your superiority over something may well be a defense mechanism in and of itself.]

the term "social anxiety disorder" is tossed around a lot and, like obsessive compulsive disorder, it gets pretty heavily abused. often, people refer to themselves as having social anxiety because they don't like to be in a crowd. [in all my years on this planet, i have yet to meet anyone who likes being in a crowd. the reactions generally range from barely tolerant to outright rage.] there is also the potential to equate social anxiety with shyness, which is tricky, because people who have social anxiety are shy, they're just shy on a level that goes beyond the usual "takes a while to come out of their shell" way. [side note :: the western obsession with individuality seems to put us at a far greater risk than cultures that have a more collectivist mindset. the pressure to be our own, individual person creates a bizarre side effect: the inability to be our own, individual person among others.]

while people with social anxiety can have panic attacks in situations where they might feel exposed, there's no rule that says that panic and social anxiety go together [or that panic and any kind of anxiety go together for that matter]. a person can feel troubled and emotional and uneasy without breaking into full-blown panic and that doesn't mean the problem is any less serious. [some argue that people with panic disorder don't even realise that their attacks are stress induced and believe them to be caused by a physical problem outside the brain. i don't personally agree with that hypothesis, but it's an opinion that comes from folks who are more versed than i am in the world of psychology.] so having a complete meltdown is not a prerequisite for being considered socially disordered.

so how do you tell the difference between acceptable shyness and a disorder? well, my smart-ass answer is that you don't, a doctor does. but a useful way of approaching things, if you don't yet want to involve a doctor, is to try to track situations where you feel stressed and unable to function, and to take special note of things that you may avoid doing/ feel unable to do because of that stress. being unable to bring yourself to sing karaoke might not be something that compromises your future [if you have a voice like me, it's something that might save it]. being unable to voice an opinion in a group at work, on the other hand, could keep you from being able to progress in a field that you really love. and avoiding certain activities altogether stops you from experiencing any of the enjoyment and benefits you might get from them.

a lot of the time, social anxiety triggers visible physical symptoms, like profuse sweating, stammering, flushing and trembling. and while we all get those sometimes, they shouldn't be overwhelming and they shouldn't be so obvious that other people are worried. but even if the signs are physical, if the unpleasant symptoms you associate with interacting with others are powerful enough to stop you from doing something you actually want to, or feel you need to, do, they're worth talking to someone about.

unfortunately, a number of people, professionally trained people, think that the best way to work through this is to just confront the fear head on. [do they tell that to people who have a fear of death, i wonder?] that's a pretty ugly way in which a professional can be wrong and, given that interactions with professionals or authority figures are often difficult for people with social anxiety disorder, it's something that likely prolongs a lot of people's suffering.

why? because the problem in social anxiety disorder isn't with the social interactions per se, but with the thought patterns surrounding them. encouraging people to put themselves in situations that scare them is only helpful if those fears have a solid rational base, e.g., "i am afraid of the ocean because i don't know how to swim." someone with that sort of fear might be terrified to take swimming lessons, but, through careful and controlled exposure, could learn to overcome the fear. however, if i am left flushed and shaking at the thought of being around strangers and having to talk to them, chances are i don't fear what they are actually going to do to me. i don't go to meetings in the office thinking that if they don't like my plan for the upcoming quarter, they're going to skin me alive. instead, i fear on some level that they find me ridiculous or ignorant, and that on its own, even if they have no power to do anything else to me [and even if i am not eager to impress those specific individuals], is enough to make me ill. people who have social anxiety are often well aware that their fears are not rational [as in, they know that nothing bad is really going to happen to them], but that's sort of like me saying i understand the process of nuclear fusion in theory: neither one of these things is going to have an effect on real world events. a therapist who insists that all a person needs to do is face their fears, without any other help, is not someone who should be entrusted with healing your brain. [keep in mind that, at the other end of the spectrum, there's no evidence whatsoever that medication alone helps with social anxiety in anything but the immediate short term. if all your doctor wants you to do is medicate before a potentially stressful situation, tell them to prescribe something in a single malt, since that's going to have a lot fewer additional ingredients for your system to process.]

so, no matter how uncomfortable you feel about standing your ground against someone in a position of authority, never let yourself be bullied into a course of treatment that doesn't feel right. ask questions. ask all the questions. ask for better answers from better people if you don't like the ones that you're getting. you have the right to live with manageable levels of stress in regular situations. social anxiety is a burden, but it's actually one that's very responsive to therapy [which, unlike drugs or just thrusting yourself into a situation you fear, actually will address the thought patterns that are associated with your stress]. so grab life by the horns, or the reins, or whatever part you feel would make the best sort of statement. make eye contact with people you don't know for just long enough to seem confident but not creepy. smile at someone you've just met and be comfortable in the knowledge that they aren't judging you because they couldn't care less about your existence and won't even remember your name in twenty minutes. march into work tomorrow and tell the coworker whose desk is located closest to the meeting room that you've vomited in her filing cabinet for the last time. you are wounded, but you can heal. 


m said…
hi, thank you for this post. i experience social anxiety and i'd like to deal with it somehow but i don't know how i could even start doing that, i was wondering if you have any suggestions? even the thought of telling someone about my experiences is exhausting, i feel so tired and humiliated already. it's like i've failed as a person... i'm a 24-year-old woman and i haven't made new friends in ten years, and i seem to have lost all conviction that i'll be able to make friends in the future which means that my future seems unbearably bleak. what will happen if my current friendships eventually fade away, i don't know. it's like i've locked myself in a cycle of self-defeating thoughts and isolating myself and there's no way out.

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