- Recovery from social anxiety
- Things that can help you recover
- What we know doesn't work well
- What we know does work well
- Self-help resources
- Act now!
- Diagnosing social anxiety
- Social Phobia Inventory (SPIN)
- Helping agencies
- " class="BodyLink">Page 1: Social Anxiety Information
Recovery from social anxiety
The first appointment with your GP can feel difficult, especially if you view social anxiety as a 'weakness' (which it isn't!) so it can be helpful to write down what you want to talk about before you go. Make a note of any questions or worries you might have. Some people find it helpful to take a friend or family member along.
Social anxiety can make us feel alone and frightened, and it can be hard to summon the courage to get help. A quick 'phone call to your GP can get things moving and start you on the road to recovery.
Things that can help you recover
Social anxiety makes us want to avoid people or situations. It can be very hard, but facing our fears and staying with people is very helpful. Remaining in work or returning to work might be very hard too, but can help us keep a sense of control. Keeping a normal daily routine is usually much better than withdrawing. We might feel like shutting ourselves away, but doing so can make things worse.
When we avoid a situation, it's harder to gain control over our fear. Ask yourself, 'if I were to act opposite to how I feel, what would I do'? Make a note of your answer.
There are many different types of talking therapy; the most effective for social anxiety is probably cognitive-behaviour therapy (CBT). In CBT we learn about the ways in which our thoughts can make us more anxious. Your CBT therapist will help you learn new skills to deal with social anxiety and help you face up to things you might have avoided.
Other treatments are available for social anxiety, such as mindfulness, analytic therapies or counselling. Ask your health professional for advice, or choose a therapy that feels right and that works for you.
Dealing with things
Putting off problems can make them mount up. Are there things in your life you're putting off dealing with? Might an advocate or some extra support help? The Citizens Advice Bureau can help with a range of issues from housing to money worries. Doing things to address our problems helps relieve the burden and allows us to feel 'in control' again.
Ask yourself, 'what small thing could I do today that would help me begin to feel better about myself?' Make a note of your answer.
Gratitude is about expressing appreciation for what we have, as opposed to focussing on what we want. Studies show that when we deliberately attend to the things we are grateful for, we can increase our well-being and happiness. Gratitude is associated with increased energy, optimism, and empathy for others. The benefits build over time when we repeatedly notice the things for which we can be grateful.
Ask yourself, 'What might I be able to feel grateful for today?' Make a note of your answer.
Repairing or changing relationships
If you're struggling with a difficult relationship, or social anxiety is causing problems in your relationship you can find a list of national relationship helping agencies, or speak to your GP about other types of relationship counselling.
If there's someone whose behaviour frightens you, read our 'anger' information sheet.
Avoiding alcohol and drugs
Alcohol is a depressant - it lowers the mood. Other non-prescribed drugs can have similar effects and are best avoided. If you think alcohol or drug use might be a problem, you can contact DAN 24/7, the Wales Drug and Alcohol Helpline: DAN 24/7 website or call them on 0808 808 2234.
There are several different ways of dealing with social phobia. These may be used on their own or together, depending on our needs.
What we know doesn't work well
- Avoiding situations
- Blaming ourselves
- Thinking the worst
- Trying to hide the problem
- Feeling ashamed
- Focussing on our symptoms
What we know does work well
- Facing up to our fears
- Learning mindfulness and physical relaxation
- Accepting ourselves as we are
- Remembering and building on our successes
- Turning our attention outwards
Turning attention outwards
People with social anxiety tend to concentrate on their own experiences. They tend to focus on their anxiety symptoms, e.g. shaking, sweating, blushing or stammering. We intensify what we notice, so we need to:
- Pay close attention to what is happening around us
- Really listen to what is being said by other people
- Don't accept all the responsibility for keeping conversations going
- Remember that other people may be feeling anxious too
Checking our thinking
There are several ways of thinking which can make the symptoms of social anxiety worse. It's quicker and easier to change our thoughts than to change how we feel. Checking and changing our thoughts can be quite hard but helps us feel better in the long run. Persistence and practice are important.
Am I mind-reading? People with low social anxiety can assume other people are judging them. We might assume other people think we're boring, weak, stupid, ugly, unworthy or incompetent. Instead of finding out what the other person really thinks, we might 'project' our own negative views of ourselves onto other people, assuming they have a low opinion of us.
Am I fortune-telling? It's easy to forget about our successes and achievements and instead predict that something will turn out badly: 'It will be awful, I won't know what to say, I'll go red, sweat and stammer, I'll wish the ground would swallow me up'. Far from protecting ourselves from anything bad happening, we simply make ourselves more anxious.
Am I personalising? A form of grandiose thinking, if something happens we assume it's because of us. If we're out and hear people laughing our first thought might be: 'they're laughing at me'. We immediately become alarmed or defensive and may want to run away rather than share the joke.
Am I focusing on failure? Do I 'over-notice' the bad stuff? When we're anxious we automatically notice things that we perceive as threats. This is an important survival mechanism - we need to pay some attention to the things that threaten us. However this process goes too far when we recall and dwell on the bad things to the exclusion of our victories and successes.
If you're a naturally shy or quiet person, you might find it helpful to join a self-confidence or assertiveness course at an adult education centre. Relaxation exercises may also help you feel generally less anxious - you can get details of these from G.P. surgeries or your local leisure or community centre.
Social skills training helps to make people feel more relaxed and confident in company. It does this by teaching some of the 'social skills' that we tend to take for granted, like how to start a conversation with a stranger.
Graded exposure involves helping a person to relax while in the situation that they find frightening. It can be done in stages, each time making the situation a little more challenging. We need to stay in the situation that causes our anxiety until our anxiety levels have dropped by at least half to help 'desensitise' ourselves.
Cognitive behaviour therapy we can make ourselves more anxious by the way we think about things. CBT helps people change the way they think about themselves and other people and helps support new behaviours which test out and challenge our fears.
Beta-blockers are mostly used to treat high blood pressure. In low doses they can help control the rapid heartbeat and physical shaking which can be a symptom of social anxiety - they can be taken shortly before meeting people or before speaking in public. They shouldn't be taken by people who have asthma.
Antidepressants such as SSRIs have been found to be helpful in social phobia, but can sometimes cause headaches and dizziness in the first few weeks.
Anxiolytics like diazepam (Valium) were used in the past to treat all sorts of anxiety. We now know that they're addictive and don't help much in the long term. They shouldn't usually be used to treat people with a social phobia, except for very short periods of time. Newer drugs are much less addictive and many people find them very helpful. Your G.P. can advise you.
Support online several helpful online communities support people with social anxiety, such as those at SAUK (Social Anxiety UK). They can be very supportive as a 'stepping stone' to greater social contact.
Books can help. Your GP, practice nurse or primary care mental health practitioner will be able to recommend from a range of excellent and helpful material. Voluntary services such as Mind have a number of valuable resources, look up your local Mind service on the Internet and give them a ring.
The sooner you make progress, the sooner you'll feel better. If you've been affected by anything you've read here, contact your GP now. Don't delay in seeking help.
Speak with your GP or a health professional for extra information or to get on the road to recovery today.
Diagnosing social anxiety
These questions won't give you a diagnosis - that's something only a qualified professional can do - but they will give you an idea about your symptoms. Don't worry about the privacy of your results, they are confidential to you.
If you have read this far you probably already have a pretty good idea! Use the SPIN questionnaire to find out more.
Social Phobia Inventory (SPIN)
|Please indicate how much the following problems have bothered you during the past week. Mark only one box for each problem, and be sure to answer all items.|
|0 = Not at all, 1 = A little bit, 2 = Somewhat, 3 = Very much, 4 = Extremely|
|1||I am afraid of people in authority|
|2||I am bothered by blushing in front of people|
|3||Parties and social events scare me|
|4||I avoid talking to people I don't know|
|5||Being criticized scares me a lot|
|6||Fear of embarrassment causes me to avoid doing things or speaking to people|
|7||Sweating in front of people causes me distress|
|8||I avoid going to parties|
|9||I avoid activities in which I am the centre of attention|
|10||Talking to strangers scares me|
|11||I avoid having to give speeches|
|12||I would do anything to avoid being criticized|
|13||Heart palpitations bother me when I am around people|
|14||I am afraid of doing things when people might be watching|
|15||Being embarrassed or looking stupid is among my worst fears|
|16||I avoid speaking to anyone in authority|
|17||Trembling or shaking in front of others is distressing to me|
|Total score =|
|Score||Less than 20||21 - 30||31 - 40||41 - 50||51 or more|
The SPIN is a 17-item self-rating scale for social anxiety disorder (social phobia). The scale is rated over the past week and includes items assessing each of the symptom domains of social anxiety disorder (fear, avoidance, and physiologic arousal).
Privacy - please note - this form does not transmit any information about you or your assessment scores. These results are intended as a guide to your health and are presented for educational purposes only. They are not intended to be a clinical diagnosis. If you are concerned in any way about your health, please consult with a qualified health professional.
You can download a PDF copy of the Social Phobia Inventory (SPIN) form here: Social Phobia Inventory (SPIN) Form.pdf
You can find a list of national agencies that can help with social anxiety here: National Social Anxiety Agencies
This material is for information only and should not be used for the diagnosis or treatment of medical conditions. We have used all reasonable care in compiling the information but make no warranty as to its accuracy. We recommend you consult a doctor or other health care professional for the diagnosis and treatment of medical conditions, or if you are at all concerned about your health.