Expert Answers: Living in fear of people and places

"Regular" social anxiety is known to all of us as an uncomfortable feeling of nervousness. Many people have particular worries about social situations, such as public speaking or talking to authority figures, or experience more general feelings of shyness or a lack of confidence.

For some, however, these social anxieties and fears can become much more troubling and difficult to cope with. Everyday tasks which most people take for granted – such as working, socialising, shopping, speaking on the telephone, even just going out of the house – may be a wearing ordeal marked by persistent feelings of anxiety and self-consciousness. Public performances or social gatherings may be out of the question.

When the social anxiety becomes this bad, sufferers could be diagnosed with Social Anxiety Disorder, also known as Social Phobia.

Shyness is not a criteria for diagnosis. Sufferers differ in how naturally reserved or outgoing they are. Individuals who are particularly socially inhibited, avoidant and sensitive to criticism or rejection, may meet the criteria for Avoidant Personality Disorder, now seen by many as only the more extreme or generalised end of an "SA spectrum".

Sufferers typically experience excessive feelings of nervousness or dread in relation to feared social situations. They may experience specific physical symptoms, such as trembling, rapid breathing, sweating or blushing.

At the extreme, panic attacks can occur. Sufferers tend to be very self-conscious and worried about whether others might be evaluating them negatively. They tend to ruminate over past social incidents, worrying about how they might have come across.

At a deeper level, sufferers can experience chronic insecurity about their relationships with others, hypersensitivity to criticism, or fears of being rejected by others.

Many people can go through this kind of experience during adolescence, but for SA'ers, the problems can persist well beyond those years. Over time, many sufferers come to avoid the situations they fear or become very inhibited or defensive in situations, often leading to depression and loneliness.

If you have experienced or do experience feelings such as these, you could well have Social Anxiety or the more severe form – Social Anxiety Disorder.

Experiencing these kinds of feelings and thoughts can be very isolating, you can feel like the only person in the world with these kinds of problems, but one of the most reassuring things that many people gain from joining the SAUK community is that they are not alone, that others have experienced and continue to experience the same thoughts and feelings.

Do not despair in your situation, there is help available, work continues within the field of Social Anxiety and many techniques and methods are now employed in helping people cope with and overcome the thoughts and feelings that drive Social Anxiety, and support is always available through the SAUK Forum and Chatroom, try to remember, you are

not alone.

http://www.social-anxiety.org.uk/

Paul Charlson

GP from Brough

This is clearly a really unpleasant and difficult problem for you.

I think you need help and this must start with a proper assessment of your difficulties.

Your GP is the best person to perform this task.

I think you may have a depressive illness with phobic elements or perhaps you have a longer standing issue such as Autism spectrum disorder, or simply it is your personality type.

While labels are not important, they do provide a basis for developing a management plan for your problem.

I suspect some psychological therapy and possibly some medication would be helpful.

Do not despair, there is help available. In the meantime, do not try to fight your problem but accept it is an issue which you are addressing and try to adapt to it as best you can. This will reduce your stress levels.

Elaine Douglas

A chartered psychologist who specialises in family and child relationships

I think that you are suffering from something called social phobia which means that a person is extremely uncomfortablemixing with others.

They get very stressed (even at the thought of going out and meeting people) and, as a result, can suffer from high anxiety or panic attacks.

When this happens they start to avoid any situation that creates this kind of discomfort. They can misinterpret situations, they can misjudge what others are thinking or feeling and, as a result, believe things that are notreally happening.

I think that you need some professional help. A good counsellor or psychologist will help you. Someone who practises Cognitive Behavioural Therapy (CBT) would be very useful as this is an excellent technique used with people like yourself who are suffering from depression and anxiety.

If you are not quite ready to see someone, then I would suggest that you have a look at good self-help books that look at managing depression and stress.

Cary Cooper

Professor of Organisational Psychology and Health at Lancaster University

It seems to me that you truly lack self-confidence, which is contributing to your anxiety levels.

I think it would be a good idea to go to your GP and get referred to a clinical psychologist, who would help you explore why this might be the case.

You will be able to explore with him or her why you are having these panic attacks, what underpins them and how you might be better able to manage them in the future.

I think it will be difficult to sort this out on your own, so in my view you do need to go to get some help to explore your behaviour and the best way to deal with it – I am sure they will be able to help you.

Dr Carol Burniston

Consultant Clinical Child Psychologist

You sound very anxious in social situations and you may be experiencing panic attacks. This is making you introspective and having a negative effect on your mood.

When we feel overwhelmed by our own emotions, we forget to think about

other people or activities and become even more insular.

I would urge you to see your doctor and ask for a referral to a recognised therapist who will help you to overcome your difficulties and start to have a more fulfilling life again.

Psychological therapies will be available in your area, and one of the most effective types of therapy for this type of problem is Cognitive – Behavioural (CBT). It helps you to understand and challenge some of the thoughts and beliefs you have which are affecting the way you behave.

The progress you make will be gradual, but as your confidence increases, you will feel more optimistic. You can obtain more information about anxiety, panic attacks and types of therapy from www.rcpsych.ac.uk