How to bring severe social anxiety under control

How to bring severe social anxiety under control

Inspiration

According to the Anxiety and Depression Association of America, social anxiety disorder affects 6.8% of the U.S. population. That total equals out to a staggering 15 million people. Social anxiety goes beyond just a tendency to act shy around others. Indeed, it can completely debilitate the sufferer. The disease makes it almost impossible to enjoy social situations. People with social anxiety have an extreme fear of being judged or ridiculed by others. Moreover, everyday life can become a constant battle.

Many people who suffer from social anxiety feel powerless against their emotions and symptoms. However, the following simple practices can make a world of difference when you start feeling anxious in social situations.

Here are 5 Ways to Help Overcome Social Anxiety:

1. Try not to have an “all or nothing” mindset.

Justin Weeks, Ph.D, an assistant professor of psychology and director of the Center for Evaluation and Treatment of Anxiety at Ohio University, said “Dispute both bleak thoughts that undermine your performance and fuel your anxiety, and equally unrealistic thoughts that are irrationally positive.”

What does this mean? Basically, you should practice retraining your brain to not automatically think of the worst-case scenario, but also not get your hopes up too high. Having the mindset of a “realistic optimist” can make life exponentially easier. That’s because you won’t have unrealistic expectations. However, you also won’t dwell on every little thing that might go wrong.

2. Gradually increase your exposure to social situations.

This is what therapists call cognitive-behavioral therapy. And if you do choose to see a therapist, he or she can help you through the necessary steps of feeling more comfortable in public.

Dr. Weeks said it best: “We avoid what frightens us, and in turn, are frightened by what we avoid.”

The longer you evade social encounters, the more the fear will build up in your mind. Of course, gradual exposure will ease you into the situation so you don’t become overwhelmed, so try to first imagine yourself conquering your fear. Picture yourself assuredly delivering a speech in front of your class, or confidently walking up to a group of people at a party, or even just having a relaxed conversation at your home with friends.

While you imagine this scenario, don’t focus on how others might perceive you. Just picture what you would ideally look, feel, and sound like if you felt totally comfortable in this social situation that you fear. Then, just go from there. Talk to your barista at the local coffee shop when you stop by. Or go out with a trusted family member or friend to somewhere that makes you feel anxious, like a grocery store or mall.

It might feel uncomfortable or scary at first, but conquering the fears that you have implanted in your brain is a very necessary step on the path to recovery. Make sure to practice positive affirmations along your journey, because a positive mindset is a key to overcoming any challenge, no matter how big or small.

3. Practice deep breathing and meditation exercises.

An emerging body of research continues to prove that mindfulness can ease symptoms, or even completely reverse, social anxiety disorders. People who suffer from any form of anxiety focus their attention entirely on the future – how people will react to what they say, what people will think of them, if people will notice their blushing face or shaky hands in a group setting, etc. However, meditation and deep breathing exercises teach them to bring their attention back to the present moment and think of nothing else but their own breath.

After practicing this for a few weeks or months, it becomes second nature, and they can use these valuable tools when talking to people, giving a speech, or anything else that requires interaction with people.

4. Join a support group for social anxiety.

Oftentimes, people who suffer from mental disorders feel isolated, misunderstood, and abandoned. However, social groups catered to people with similar issues or backgrounds can make sufferers feel like they belong somewhere, and that people do understand what they’re going through. Research local support groups on Facebook or maybe even your area’s Chamber of Commerce website for more information.

5. Avoid focusing your attention inward as often.

As you may have heard before, we are our own worst critics. We analyze ourselves more than other people ever will. Thus, we create a lot of anxiety in our heads about how we appear to others. Some might call this “hyper-analyzing,” and it can become a very toxic practice if you make it a habit. To free yourself from these incessant thoughts, try to instead shift your focus to your current environment.

Listen to others fully when they speak to you, instead of wondering what you will say or fearing how you look or sound to others. Notice the color of the paint on the walls. Or observe how the smiles on others’ faces brighten up the room. Taking the attention off yourself for a while doesn’t mean that you don’t matter. Instead, it just gives you a chance to take in the entirety of a situation, rather than just your role in that situation.

These practices allow you to embrace the full experience of life instead of just a fraction of it spent inside your mind. Enjoy the life awaiting you with open, loving arms. You are valuable and deserve to live it!

Social Anxiety Disorder and Bullying- is there a link?

Social anxiety disorder, also known as social phobia, is a debilitating mental health diagnosis that affects millions of adults in the United States. According to the National Institute of Mental Health, approximately 6.8% of adults in the United States suffer from social phobia, and 29.9% of those cases are classified as severe.

What is social anxiety disorder? Social anxiety disorder is defined by the DSM-V as “marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.” People who experience social anxiety are plagued by fear of rejection, embarrassment, and humiliation, even when the situation is not something that healthy adults would consider daunting. Individuals with social phobia are diagnosed with social anxiety disorder if symptoms persist for more than 6 months and if it causes them significant distress. In children, these symptoms are considered social anxiety only if they occur in situations with their peers.

What causes social anxiety disorder? The average age of onset for social phobia is 13 years of age, and is typically preceded by a stressful or humiliating experience. While there may be some genetic causes, this information implicates that a traumatic childhood event may be a likely factor in the development of social phobias. Self-presentation theory suggests that anxiety is caused by the belief that, in social situations, there is a real or perceived risk involved when one does not make a good impression on others. The higher the perceived risk, the worse the anxiety becomes. School aged children are under great pressure to appear desirable to their peers and, if they do not, they risk becoming targets of bullying. Let’s explore the possible impact that bullying may have on the development of social anxiety disorder.

How to bring severe social anxiety under control

If the development of social anxiety disorder is influenced by experiences with bullying, what can be done to negate the effects? In a perfect world, the best solution would be to stop bullies in their tracks, before the damage can be done. However, that is not a feasible solution since adult authority figures are not always present when bullying takes place. A study conducted by DeRosier (2004) introduced an intervention in which participants had an active role in learning prosocial behavior and attitudes, behavioral and cognitive social skills, and strategies for coping with bullying and peer pressure. They learned these things through role playing, modeling, and other hands-on activities. The results showed that the children had higher self-esteem, greater social self-efficacy, and lower social anxiety.

The Penn Resiliency Program (Schneider, et. al, 2012) offers a similar solution- building confidence through cognitive restructuring and skill acquisition:

Cognitive restructuring: Middle school aged children viewed the last frame of a cartoon that had a character with either a smile or frown on its face, and were asked to come up with an explanation for that outcome. The purpose of this was to associate one’s behavior with the feelings that resulted. They also viewed skits in which characters attributed negative outcomes to either their own failings or to outside forces. This illustrated the different ways of explaining negative outcome, including the possibility that many things are not necessarily their fault or even within their control.

Skill acquisition: Sometimes changing one’s thought process alone is not enough to resolve negative feelings. The Penn Resiliency study also taught children valuable problem-solving skills that included being more assertive and negotiating with others. Once again, these skills were presented through the cartoon medium to help simplify things for the young participants.

Results: Children who experienced both cognitive restructuring and skill acquisition were able to be less pessimistic in terms of explaining negative outcomes and their depressive symptoms were reduced. These effects lasted for 3 years after the conclusion of the study.

Evidence suggests that an effective way to help school age children avoid and cope with bullying is to show them. Through modeling, role playing, and other hands-on approaches, we can teach children how to navigate through troublesome school experiences which, in turn, is likely to help some avoid developing social anxiety disorder that persists throughout adulthood.

References:

McCabe, R. E., Anthony, M. M., Summerfeldt, L. J., Liss, A., & Swinson, R. P. (2003). Preliminary Examination of the Relationship Between Anxiety Disorders in Adults and Self-Reported History of Teasing or Bullying Experiences. Cognitive Behaviour Therapy, 32(4), 187-193.

Craig, W. M. (1998). The relationship among bullying, victimization, depression, anxiety, and aggression in elementary school children. Personality and individual differences, 24(1), 123-130.

Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, D.C.: American Psychiatric Association. Retrieved February 9, 2017, from https://psicovalero.files.wordpress.com/2014/11/dsm-v-ingles-manual-diagnc3b3stico-y-estadc3adstico-de-los-trastornos-mentales.pdf.

Schneider, F. W., Gruman, J. A., & Coutts, L. M. (2012). Applied social psychology: understanding and addressing social and practical problems. Los Angeles: Sage.

DeRosier, M. E. (2004). Building Relationships and Combating Bullying: Effectiveness of a School-Based Social Skills Group Intervention. Journal Of Clinical Child & Adolescent Psychology, 33(1), 196-201.

[Untitled illustration of bullying]. Retrieved February 10, 2017 from http://simpleacts.org/bullying-prevention/category/anti-bullying/

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According to the Centers for Disease Control and Prevention (CDC), more than 7% of children in the U.S. between the ages of 3 and 17 have been diagnosed with anxiety. Children with mental disorders experience unique struggles that affect how they learn, socialize, and develop into adults. Fortunately, there are effective treatment options and resources for parents to help their children.

To learn more, check out the infographic below created by Wake Forest University’s Online Master’s in Counseling program.

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Children with Anxiety: Signs & Statistics

Rates of anxiety have reached alarming heights in recent years, especially in children. Among children ages 3 to 17, 73.8% with depression also have anxiety. 37.9% of children ages 3 to 17 with anxiety also have behavior problems. Unfortunately, only 59.3% of children in that age range with anxiety have received treatment.

A greater percentage of adolescents ages 12 to 17 have anxiety compared to kids in the 3 to 5 and 6 to 11 age groups. While Caucasian children have higher anxiety symptoms in high school, African American children have a higher rate in elementary and middle school.

There are several notable signs associated with anxiety that parents should track. These include excessive worrying, restlessness, difficulty focusing, excessive irritability, recurring panic attacks, avoiding social situations, and irrational fears.

Treating Anxiety

Cognitive-behavioral therapy and various medications have been studied extensively and proved effective in treating anxiety in children.

Cognitive Behavioral Therapy (CBT): CBT is based on the principle that actions and beliefs are affected by feelings. The exposure and response prevention technique used by CBT exposes children to things that trigger their anxiety in a safe and controlled setting. During treatment, children can unlearn detrimental coping behaviors like seeking assurance, escaping, avoidance, and ritualistic behavior like hand washing. Over time, children learn how to respond to triggers without feeling anxious.

Studies have shown CBT is most effective when patients are also taking medication. Studies also show that CBT can be an effective way for children to learn how to manage anxiety. CBT is also considered to be most effective for treating severe anxiety. It’s also considered helpful for separation anxiety, phobias, social anxiety, and obsessive-compulsive disorder (OCD).

CBT does carry a few drawbacks. For instance, the therapy may not be suitable for patients with learning difficulties or other complex mental health conditions. CBT also doesn’t address problems in systems or families that can’t be changed by the patient.

Medication: Medication prescribed to help children with anxiety falls into two categories. The first category is antidepressants. While they’re fast-acting compared to other medications, some may be unsafe for children and teens with major depression. The second category is Benzodiazepine, which is a medication noteworthy for its ability to reduce intense activity without any serious side effects. The main drawback to using Benzodiazepine is that it’s not effective for long-term use.

Attention Bias Modification Treatment (ABMT): ABMT is a newer, promising treatment option that’s also been found effective by numerous studies. The treatment is built on the notion that individuals with anxiety tend to excessively focus on threatening information. Computer-based attention training programs are designed to help reshape this attention bias toward threatening information and reduce anxiety.

In a study of six children, ABMT helped significantly decrease anxiety and depressive symptoms. Results like this give it promise as an effective option for patients who didn’t respond to CBT. However, it’s still a relatively new treatment option and it needs more research.

Tips and Resources for Parents

Parents can take steps to help reduce their children’s anxiety. In addition, reading the latest research can offer valuable information about new treatment options.

Tips for Parents with Children Suffering from Anxiety

Parents should encourage children to face their fears. They should also assure children that they don’t have to be perfect and emphasize positivity instead of criticism. Additionally, they should schedule calming activities for their kids. Parents can also demonstrate positive ways to respond to anxiety-provoking situations. Rewarding brave behavior is also important for parents to help children cope with anxiety, as is maintaining a bedtime routine. Parents should also encourage expression of anxiety as opposed to suppression and denial. Additionally, parents can help children learn how to solve problems. Finally, parents can practice relaxation exercises with children.

Useful Resources

There are several key resources parents can utilize to help them develop positive strategies that can help their children cope with anxiety. WorryWiseKids.org allows parents to access useful information and tips on parenting children with anxiety. Anxiety and Depression Association of America enables parents to read up on the latest studies and treatments being developed to fight anxiety. American Academy of Child & Adolescent Psychiatry is a nonprofit organization engaging in research and advocacy for children, adolescents, and families affected by mental health disorders. Finally, the Association for Behavioral and Cognitive Therapies is an organization with an online referral service that provides access to mental health professionals across more than 100 specialties.

Empowering Children to Face Their Fears

Though statistics of anxiety among children can be disheartening, mental health professionals should encourage parents to take steps to empower their children and pursue a healthier future together.

My 22-year-old daughter is truly wonderful. She is bright and beautiful and kind and considerate — all of those qualities I prayed for in a daughter. I am a lucky mom. She has recently moved out to a nearby city, and she is succeeding in a job she trained for in college. Perfect, right?

Well, not really.

Since she was 17 or so, my daughter has experienced extreme periods of self-doubt and anguish, partnered with contrasting episodes of extreme determination and competitiveness. It is a continuous roller coaster — well, two roller coasters if you can imagine it, running side by side. When one climbs the other dips, sometimes simultaneously. That’s what it’s like for her, what her life is like. And because I am her mother and I love her, my life is like that too.

I really believe that a mother’s first instinct is to help her child. And along with that we try to take away their pain. And we will do or say anything to try and help our children reach a conclusion or a solution, a compromise or even reconciliation. We want them to feel better. As babies they receive a cuddle and a spoonful of medicine. As adults they get advice and soothing words. And maybe we offer a distraction.

But this is the last thing my adult child with anxiety and depression wants or needs. She doesn’t want me to tell her everything is going to be OK or that she is better and bigger than her problem. At least in the case of my daughter, she doesn’t want me to try and evaluate the situation, or to feed her compliments, or to try and distract her from the pain.

For a long time I didn’t know this. And I failed miserably.

Until the day she started sending me blogs about what to say when she turns to me. And what not to say. And I have these handy lists saved in my phone to refer to when I text with her. And when I forget or falter, she lets me know. And I go back to the prompts. And it works. She doesn’t want or need me to solve her problems. She just wants to know I am here. And I am listening. And I care about her. This time. And the next time and the next time.

My point is, listen to your child. They can tell you how to be. And that’s helpful because, even though we always think we know better, we don’t.

Listen. And believe. And care. And stay on track.

It’s OK. I am sorry you are going through this. I am hear. I care.

We want to hear your story. Become a Mighty contributor here .

How to bring severe social anxiety under control

While some people think of anxiety as an uneasy feeling in the pit of their stomach or the fear they feel when standing atop a high building, severe anxiety symptoms can be much worse and downright terrifying. Symptoms of severe anxiety can create the feeling of a heart attack or even make you feel like you’re dying.

Perhaps the anxiety disorder best known for severe effects is panic disorder. A panic attack can create severe anxiety symptoms in a matter of minutes and patients are often rushed to the Emergency Room because they feel they are dying. It’s important to remember though, panic attack symptoms typically peak within ten minutes and then begin to fade.

Physical Symptoms of Severe Anxiety

Anxiety is not just about feeling anxious – it is also about the real, physical symptoms caused by an anxiety disorder. The deep fear and anxiety of a person is reinforced by severe, physical symptoms of anxiety.

Physical symptoms of severe anxiety are common in panic attacks and include: 1

  • Palpitations, pounding heart or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Shortness of breath; feeling of being smothered or choked
  • Chest pain
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Becoming detached from oneself and the environment
  • Numbness or tingling sensations
  • Chills or hot flashes

If you suffer from panic attacks, learn how to deal with panic attacks and get panic attack treatment.

Psychological Symptoms of Severe Anxiety

Intense fears of losing control, going crazy or dying are common psychological symptoms of severe anxiety. There are additional symptoms, though, depending on the type of anxiety disorder.

Post-traumatic stress disorder can produce symptoms of severe anxiety including:

  • Psychologically reliving the traumatic event
  • Overreacting with intense fear to anything reminiscent of the traumatic event
  • Feelings of a shortened life
  • Looking for and seeing danger everywhere
  • Overreacting with fear when startled

Behavioral Symptoms of Severe Anxiety

Behavioral symptoms of severe anxiety often take the form of avoidance. Because severe anxiety symptoms are so terrifying, people will do almost anything to avoid feeling them. This might include:

  • Not going to specific places
  • Not seeing certain people
  • Not having specific experiences

These severe symptoms of anxiety can even escalate until the person refuses to leave the house or talk to most people.

Other severe behavioral symptoms of anxiety include those seen in obsessive-compulsive disorder (OCD). People with OCD become obsessed with ideas such as: 2

  • Contamination
  • Safety
  • Order
  • Doubt

Once an obsession takes hold, the person feels an overwhelming urge to perform an action, a compulsion, also known as a ritual. Examples of severe compulsions include:

Have you ever walked into a crowded room full of strangers and felt hyper aware of your every move? I imagine that’s what social anxiety feels like, only on a much smaller scale. It’s the constant paranoia that someone might catch you tripping over your words, that your inability to keep up with a conversation makes you come off as unintelligent; a constant fear that someone, somewhere is judging you, no matter how hard you try to present yourself without a flaw. The thing is, humans are believed to be naturally social beings, so does social anxiety ever go away if it’s something you aren’t born with, but rather something you can develop overtime?

According to the Social Anxiety Institute, the fear of being judged and/or negatively evaluated by other people has been ranked the third largest mental health care problem in the United States, with 7 percent of the population currently experiencing some form of the psychological disorder. The term "social anxiety" the organization explains, is a generalized disorder that refers to people who feel uncomfortable in social situations, but there are more specific kinds of social anxiety like the fear of public speaking, or eating in front of others.

Being socially anxious has nothing to do with your persona; you can be an extrovert and still be socially anxious. The reason why you might be so concerned with the opinions of others, Australian depression and anxiety resource Beyond Blue explains, could be because as a child you were shy and wanted other’s acceptance, social phobia could run in the family, or it could be that you were embarrassed publicly and have never fully recovered from the trauma.

It sounds pretty crummy, I know, but the good news is social anxiety is not something you are born with, therefore it is something you can work through and overcome. Depending on how intense someone’s fear of social interaction is, it could take time, and it definitely takes a decent amount of effort, but social anxiety can go away, and here are some of the ways experts suggest working through it.

Problem solving is a process, and the first step to solving a problem is to be able to identify, without a doubt, what the problem actually is. As previously stated, social anxiety could be a general discomfort in social situations, but it can also get more specific than that.

If you are someone who feels nervous eating in front of others, or freezes up when you have to give a public presentation, these are all very specific problems you can tackle. Make a list of what kind of situations bring you the most anxiety, and go from there.

Looking for anxiety help? Here is help that’s practical and powerful. It’s the highlights of what I learned from my patients in 30 years working as a psychologist to help people overcome fears and phobias. And it’s free. Come get some!

Three things to know

First, three things you need to know about anxiety disorders:

  •  Anxiety Disorders are very common
  •  Anxiety Disorders are difficult, but very solvable problems
  •  Anxiety Disorders are counter-intuitive problems, and this is what makes them difficult

How to bring severe social anxiety under control

Anxiety Disorders are surprisingly common. About 40 million Americans struggle with an anxiety disorder. Many of them are under the mistaken belief that they’re the only one, or one of a very few. Not true!

Why do anxiety disorders seem to be so uncommon? Two reasons.

1. Many people who experience them feel embarrassed and ashamed, and keep their fears and phobias a secret.

2. There are few observable signs of an anxiety disorder.  A person experiencing high anxiety often believes everyone can see there’s “something wrong” with them, but it’s usually pretty hard to tell, because anxiety disorders are principally an internal reaction.

Does it matter that they’re common problems? Yes, because people with anxiety disorders often believe it’s their fault somehow, or that they’re an unusual oddball. Noticing how common these problems are can remind you that these are problems that occur to lots of people through no fault of their own. The shame and blame people often experience is just another symptom of an anxiety disorder, and not a valid judgement of your personal strengths and weaknesses.

Anxiety Disorders are solvable problems , and generally respond well to treatment. Today we have good treatments, based on exposure, acceptance, and cognitive behavioral methods, which offer recovery to many. Unfortunately, only about a third of those who need anxiety help actually get such treatment.

Treatment, or well-informed self-help work, is usually necessary because anxiety disorders don’t typically “go away” on their own, nor do people’s instinctive efforts to oppose them help people recover. In fact, it’s quite common for people to notice “the harder I try, the worse it gets”.

This is because anxiety disorders are counter-intuitive problems which don’t respond well to intuitive solutions. If you want to solve a counter-intuitive problem, you need a counter-intuitive solution. You need to fight fire with fire.

What is a counter-intuitive problem? Let’s say you adopt a new puppy, and no sooner do you bring her home than she gets off the leash and runs down the street. How will you get her back? If you chase that puppy, who’s got four legs to your two, the results will be poor. Run away from that puppy. Now you’re playing “chase the owner” and all ends well. Counter-intuitive.

You wade into the ocean, and a large wave comes toward you? If you turn and run for shore, the wave will probably knock you down. You’ll swallow saltwater and sand. Instead, dive into the base of the wave and let it pass right over you. Counter-intuitive.

You drive on an icy road, and skid toward a phone pole? If you steer away from that pole, you’ll probably be talking to your insurance agent soon. Steer into the skid and aim for the pole, you’ll straighten out and be okay. Counter-intuitive.

The difficulty with counter-intuitive problems is that when you’re trying so hard to solve a problem, and failing, your natural instinct to “try harder” will make things worse. This can frustrate you and fool you into thinking there’s something wrong with you. Nope! There’s something wrong with the method you’re trying. It’s like putting out fires with gasoline!

Anxiety Help

This site can give you much of the anxiety help you need. Most of this website consists of free articles and videos that will:

  • Help you understand how anxiety disorders “work”
  • Give you important first steps you can use to rein in an anxiety disorder
  • Show you how to help yourself recover

If you like what you find here, and feel the need for more, you can also find my anxiety self-help books available here for purchase, and a contact form if you are interested in getting professional treatment from me.

People with bipolar disorder often experience social anxiety. Learn why this can be a dangerous combination and how it changes your treatment.

How to bring severe social anxiety under control

How to bring severe social anxiety under control

Bipolar disorder, which is sometimes called manic-depressive illness, causes severe mood swings that can make daily functioning difficult. At times, these shifts in mood and energy level can be overwhelming. Extreme social anxiety, the fear of being criticized or embarrassed in social situations, can be a separate anxiety disorder, or it can occur with bipolar disorder. When they exist together, they can be a dangerous mix.

People with bipolar disorder experience mood swings that range from severe sadness and hopelessness to overly high levels of energy, restlessness, and irritability, known as mania. Here are some clues that suggest you may have social anxiety along with bipolar disorder:

  • Presence of panic attacks and fear of social situations along with mania or depression
  • Symptoms that started during childhood or early adulthood and sleep problems that are present when you are no longer in a manic mood
  • Poor response to the usual treatments for bipolar disorder

Impact of Social Anxiety on Bipolar Disorder

Research shows that about 20 percent of people with bipolar disorder experience panic attacks, compared with less than 1 percent of people without a mood disorder. Research also shows that social anxiety rarely exists by itself. Various studies have found that about 80 percent of people with social anxiety have at least one other mental disorder during their lifetime.

These are some of the dangers of having both bipolar disorder and social anxiety:

  • A recent study found that people with both anxiety and bipolar disorder are more likely to display suicidal behaviors than people with bipolar disorder alone.
  • People with both bipolar disorder and social anxiety are more likely to abuse alcohol and drugs, which may make symptoms of both disorders worse.
  • Social anxiety makes bipolar disease more difficult to treat.
  • People with both disorders score worse on measurements of daily life functioning than people with bipolar disorder alone.

Why Do Social Anxiety and Bipolar Disorder Occur Together?

It is clear that there is a relationship between social anxiety and bipolar disorder, but it is not clear whether one leads to the other, or if they have common causes and exist together.

Here is what some research shows:

  • People with bipolar disorder may have traumatic experiences caused by their mania early in life that lead to a fear of social situations.
  • People who have bipolar disorder may abuse alcohol or drugs to control some of their symptoms. Abuse and addiction can make social anxiety disorder worse.
  • Both disorders may run in families, since studies show that family members of people with bipolar disorder also have a higher rate of anxiety disorders.

Treatment of Bipolar Disorder With Social Anxiety

If you have social anxiety and bipolar disorder, both disorders need to be addressed for treatment to be successful. This often requires a combination of drug treatment and talk therapy. In most cases, treatment of both disorders can be successful.

Treatment options include:

  • Mood-stabilizing medications. These drugs are usually used first to treat the bipolar part of the disorder. Examples of mood stabilizers used for bipolar disorder include lithium, valproate, and olanzapine.
  • Antidepressants. These medications work well for social anxiety disorders, but they must be used very carefully with bipolar disorder, since they can make some bipolar symptoms worse. For this reason, doctors may avoid antidepressants or use them only in lower doses.
  • Benzodiazepines. These drugs may work well for anxiety and are safe for bipolar disorder, but can cause physical dependence and must be used with caution by anyone who has a history of substance abuse.
  • Psychotherapy. Talk therapy has been shown to be very effective for treating social anxiety disorder, so one option may be to use a mood stabilizer along with cognitive-behavioral therapy (CBT). CBT teaches people with social anxiety to change their thought patterns and to replace poor responses with more healthy responses. Other types of talk therapy that may help include family therapy and relaxation training.
  • Lifestyle changes. Keeping a regular schedule, getting enough sleep, and avoiding events that cause stress can be helpful for both disorders. Getting regular exercise and avoiding alcohol and drugs are also very important.

Bipolar disorder and social anxiety disorder frequently occur together. The addition of social anxiety causes an increased risk of suicide and of alcohol and drug abuse, and generally makes dealing with bipolar more difficult. The good news is that both disorders can be treated. With the right combination of drugs, lifestyle changes, and psychotherapy, most people with these disorders do recover.

It may not be easy at first to seek help for a condition like social anxiety disorder, which can make you reluctant to speak to strangers. But if you’re at the point where you avoid social contact and it’s started to control your life, you should talk to a mental health professional. There are a lot of treatments that can help.

Social anxiety disorder, also called social phobia, causes overwhelming fear of social situations, from parties and dating, to public speaking and eating in restaurants. When you cut yourself off because of social anxiety, you might feel depressed and have low self-esteem. You might have negative or even suicidal thoughts.

If you’ve been avoiding certain social situations for at least a few months and have been under severe stress because of it, it’s time to get treatment.

Social Anxiety Therapy

The best way to treat social anxiety is through cognitive behavioral therapy or medication — and often both.

You generally need about 12 to 16 therapy sessions. The goal is to build confidence, learn skills that help you manage the situations that scare you most, and then get out into the world.

Teamwork is key in social anxiety therapy. You and your therapist will work together to identify your negative thoughts and start to change them. You’ll need to focus on the present instead of what happened in the past.

You might do role-playing and social skills training as part of your therapy. Maybe you’ll get lessons in public speaking or learn how to navigate a party of strangers. Between sessions, you’ll practice on your own.

A big part of getting better is taking care of yourself. If you exercise, get enough sleep, and limit alcohol and caffeine, you’ll be more focused for the mental challenges of therapy.

Medications

Your doctor may suggest antidepressants to treat your social anxiety disorder. For instance, they may prescribe drugs known as SSRIs (selective serotonin reuptake inhibitors), such as:

Your doctor may also suggest antidepressants called SNRIs (selective serotonin and norepinephrine reuptake inhibitors). Some examples are:

Keep in mind that medicine alone won’t be a quick fix for your anxiety. You’ll have to wait for it to take effect — 2 to 6 weeks is a good guideline. And it might take a while to figure out side effects and find the right fit. Some people are able to wean off medication after a few months, and others need to stay on it if their symptoms start to come back.

You might find that the first course of treatment eases all of your anxiety. Or it might be a longer journey. But taking those first steps will lead you to a less stressful life.

Sources

Mayo Clinic: “Social Anxiety Disorder.”

Foundation for Social Anxiety: “Evidence-Based Treatment for Social Anxiety.”