Mental Health

Social Anxiety Disorder

Mr. Hershel Wertheimer

Executive Director of Hamaspik Kings County

I’ll just go over and talk to him. He won’t bite. I’m going…. Ugh! Why am I blushing? Let me walk over to the buffet and get a drink, so I look casual. Wait. Maybe I should go directly to him? He’s almost leaving! But…what will he think? That I just wanted to say hi? 

Actually, why do I want to go over to him? Oh yeah, I want to be friendly with him. He seems like a great person to know. But who says I need to push myself for this? True, I don’t have to, but if I don’t push myself a little, I’ll never talk to anybody! I must go over to him!

“Careful, that cup is overflowing!”

Oops.

***

You’ve just gotten a taste of what it’s like to cope with social anxiety disorder (SAD), an issue that plagues roughly 7% of Americans. 

Social anxiety disorder (feeling angst/anxiety among other people) is one of the most common problems in the world of mental health. People who are dealing with social anxiety only experience anxiety when they’re with other people, such as when going to an event or wedding. Some even have difficulty in small groups. 

People are social creatures, and a large part of our lives revolve around relationships. This makes it that much harder to cope with social anxiety, because while it might impact just one area of a person’s life, it will present itself multiple times each day.  

Symptoms of Social Anxiety

Below is a partial list of symptoms that can help you identify if you’re dealing with social anxiety:

  1. Fear or angst before a social situation in which the person thinks he might be judged or observed by others, such as when having a conversation with or meeting strangers, eating or drinking in front of others, speaking in a public setting, etc. 
  2. Fear that one will behave in a way that will cause others to judge him negatively and lead to embarrassment. Often, the anxiety is about dealing with social anxiety itself, which means the person is afraid his anxiety will be obvious and will cause him embarrassment. 
  3. Actively avoiding situations that cause anxiety (for example, avoiding going to a wedding), and when he must go, feeling intense fear and angst. 
  4. Anxiety that’s disproportionate to the “social risk” that the situation poses (it’s normal to feel nervous before giving a speech, but not before going to PTA). 
  5. Symptoms that last for at least six months. 
  6. The anxiety negatively impacts a person’s ability to function. 

Social anxiety affects both children and adults. It’s important to be mindful of two additional points when it comes to children:

  1. A child who is anxious about dealing with adults does not necessarily suffer from social anxiety. A child will be diagnosed with social anxiety only if he feels anxious when dealing with children his own age. 
  2. Anxiety symptoms usually present differently in children than in adults. It will usually manifest in crying, throwing tantrums, freezing, not speaking in public situations, etc. 

By the Numbers

Approximately 7% of the US population suffers from social anxiety. The condition is more prevalent in children and teens than in adults, with 2-5% of the adult population affected. In many parts of the world, the prevalence is lower; for instance, in Europe, only 2.3% of the population is dealing with social anxiety. 

Women are more prone to this condition than men, with a ratio of 2.2 women for every 1.5 men. Symptoms typically appear between the ages of 8 and 15 in 75% of those affected, and it rarely begins in adulthood. Often, those who suffer from social anxiety were shy and reserved as young children, and their shyness gradually evolved into anxiety as they grew older. In some cases, the disorder develops as a direct result of difficult social experiences, such as bullying.

How to cope with social anxiety

  • According to the research, only half of the people with social anxiety seek treatment. Unfortunately, many of them mistakenly believe this is who they are, and that there’s no way for them to change. When social anxiety presents in children, parents sometimes believe that they’ll outgrow it, while the children continue to suffer. 
  • Social anxiety is treated with talk therapy, with cognitive behavioral exposure therapy showing the most promising results. In many cases, medication is prescribed as well. 

If you think you might be suffering from social anxiety, seek out a professional who will be able to guide you toward overcoming social anxiety and attaining healing. 

Overcoming Social Anxiety in Real Life

Motty Solomon, LMHC, Sipuk’s clinical director, describes how this disorder plays out in real life. He shares the experiences of a recent client dealing with social anxiety (all details have been changed):

When Yanky* used to enter a wedding hall, he’d immediately feel overwhelmed. He disliked going to weddings and tried to avoid them; when he had to attend, he found it very challenging. He never took the time to consider why it was so hard for him, he just knew that going to weddings caused him anxiety. 

When we started to dig deeper together, we realized that the main element that bothered him when entering a hall wasn’t the food, the decor, or even the music. It was the people.

Inexplicably, he felt as if he needed to impress every participant. When he said mazel tov, it needed to be done in a way that wouldn’t make anyone think less of him. When he entered the ballroom, he needed to find a seat immediately so that nobody would notice that he didn’t yet have a seat. 

All of this weighed heavily on him. 

Once COVID hit, he began to realize how much easier his life was without having to interact with others regularly. It was such a relief for him that even once life got back to normal, he continued to stay at home as much as he could. 

At this point, it was obvious that something needed to change, and his wife insisted he seek help. 

Throughout our weekly therapy sessions, we worked on overcoming social anxiety, and slowly made progress. We finally reached the point when Yanky said, “I never knew how much I missed out in life by avoiding people!” Now weddings are no longer a fearful burden, but something he enjoys.

Auditory Sensitivity

My child is sensitive to loud noises
(e.g., sirens, vacuum cleaner).

My child seeks out specific sounds or types of music and appears calmer when listening to them.

Tactile Sensitivity

My child is irritated by certain fabrics or tags in clothing.

My child seems indifferent to sensations that are usually painful or to extreme temperatures.

Visual Sensitivity

My child is sensitive to bright or flashing lights.

My child tends to avoid eye contact.

Taste/Smell Sensitivity

My child constantly prefers bland foods and rejects foods with strong flavors or spices.

My child seeks out strong or unusual smells, such as sniffing food or objects.

Proprioceptive Sensitivity

My child prefers tight hugs or being wrapped in a blanket.

My child is unaware of body position in space (e.g., often bumps into things).

Social Sensitivity

My child becomes anxious or distressed in crowded spaces.

My child is hesitant or resistant to climbing or balancing activities (e.g., jungle gyms, see-saws).

Movement Sensitivity

My child dislikes fast or spinning movements

Vestibular Sensitivity

My child becomes anxious or distressed in crowded spaces.

My child is hesitant or resistant to climbing or balancing activities (e.g., jungle gyms, see-saws).

Please answer all questions before submitting.

Your Child’s Score is

  • 0-15

    Low Sensory Sensitivity

  • 16-30

    Moderate Sensory Sensitivity

  • 31-45

    High Sensory Sensitivity

  • 46-60

    Very High Sensory Sensitivity

0-15: Low Sensory Sensitivity

  • Interpretation: Your child exhibits low levels of sensory sensitivity, usually falling within the typical developmental range.
  • Recommendation: Generally not  a cause for concern. If you have specific worries or notice a sudden change in behavior, consult a healthcare professional for a comprehensive evaluation.
  • 0-15

    Low Sensory Sensitivity

  • 16-30

    Moderate Sensory Sensitivity

  • 31-45

    High Sensory Sensitivity

  • 46-60

    Very High Sensory Sensitivity

16-30: Moderate Sensory Sensitivity

  • Interpretation: Your child displays moderate sensory sensitivity, which may warrant intervention.
  • Recommendation: Consider sensory-friendly activities, sensory sensitive toys, or sensory sensitive clothing like noise-canceling headphones and weighted blankets to improve comfort. If symptoms persist, consult health care professionals.
  • 0-15

    Low Sensory Sensitivity

  • 16-30

    Moderate Sensory Sensitivity

  • 31-45

    High Sensory Sensitivity

  • 46-60

    Very High Sensory Sensitivity

31-45: High Sensory Sensitivity

  • Interpretation: Your child has higher than average sensory sensitivity that may interfere with daily functioning.
  • Recommendation: Seek a detailed evaluation by health care professionals for sensory integration therapy options and potential environmental modifications.
  • 0-15

    Low Sensory Sensitivity

  • 16-30

    Moderate Sensory Sensitivity

  • 31-45

    High Sensory Sensitivity

  • 46-60

    Very High Sensory Sensitivity

46-60: Very High Sensory Sensitivity

  • Interpretation: Your child demonstrates high levels of sensory sensitivity that could significantly interfere with daily life.
  • Recommendation: If your child displays this level of sensory sensitivity, it’s highly recommended that you consult with a health care professional for a multi-disciplinary assessment. You will probably be directed towards early intervention programs and specialized support.

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