An estimated 15 million American adults have social anxiety disorder, and 36% of them suffer with symptoms for 10 years or more before seeking help.1Epidemiological studies have shown that social anxiety disorder is the third leading psychological disorder in the U.S.2\u00a0Its onset is almost universally in childhood or adolescence.3\u00a0Social anxiety disorder(also known as social phobia), like all mental health disorders, can wreak havoc on the lives of those who suffer from it. It often involves significant shyness and a debilitating fear of certain types of social situations, making it particularly disruptive. If left untreated, the consequences can severely impact every aspect of life, often leaving people feeling hopeless and depressed. Social Anxiety Symptoms Symptoms vary from person to person, but the following are some of the most common for people with social anxiety disorder.1,2 \tBlushing \tExcessive sweating \tNervousness \tDry throat and mouth \tTrembling \tMuscle twitching \tNausea or other abdominal distress \tRapid heartbeat \tShortness of breath \tDizziness or lightheadedness \tHeadaches \tFeeling detached \tLoss of self-control Social Anxiety Implications Isolation\/difficulty making friends Social anxiety disorder causes many, if not most, social interactions to be extremely uncomfortable. The mere thought of meeting new people or speaking in front of others triggers significant anxiety. As a result, most people decide to withdraw and isolate themselves. When people summon the nerve to socialize, their anxiety often undermines well-meaning efforts. The discomfort and awkwardness they exhibit makes people around them feel uncomfortable. Interactions that are less than satisfactory cause pain and embarrassment \u2014 and tend to be indelibly etched in the person\u2019s memory. Damaged self-esteem Typically, people with social anxiety disorder already have low self-esteem, although suffering from the disorder itself can lead to significantly low self-esteem. Every humiliating or embarrassing interaction reinforces one\u2019s self-doubts and beliefs about being a flawed human being. The longer one suffers from social anxiety disorder, the more deeply ingrained these negative thought patterns become. \u201cUnderachiever\u201d status Social anxiety prevents people from reaching their full potential and attaining goals. A person could do an excellent job at work, but is afraid to talk to his boss about advancement possibilities within the company. He is overlooked for the promotion and it goes to a colleague who demonstrates self-confidence and assertiveness. Achieving milestones in life involves a good degree of risk-taking, but doing so is too frightening a prospect for people with social anxiety. Instead, they choose the path of least resistance, which may give others the impression that they are unmotivated or lack ambition. Harsh inner dialogue Most people with social anxiety disorder subject themselves to a harsh inner dialogue. Self-deprecating thoughts (e.g. \u201cWhy can\u2019t I be like everyone else?\u201d or \u201cWhy am I such a loser?\u201d) run rampant and mental self-flagellation can be brutal. People with this disorder start believing these damaging thoughts, which reinforces and perpetuates the fear of social situations. Impaired social skills A large part of developing good social skills comes from interacting with others based on feedback received. When people act appropriately, they are rewarded with positive interactions from others. Conversely, when they behave awkwardly, show ineptitude, or say or do inappropriate things, there are negative consequences. While social interactions often involve more complex factors, accurately interpreting \u201cfeedback\u201d is much easier for some people and a struggle for others. Social anxiety limits interactions, therefore people with this disorder never get the opportunity to develop finely tuned \u201cpeople\u201d skills. Skewed perceptions One of the greatest fears is being humiliated, scrutinized or criticized by others. Therefore it is not uncommon for people with this disorder to have a distorted view of interactions with others. Constructive feedback from a boss may be perceived as harsh criticism. A person may misinterpret group laughter as a personal attack. This hypersensitivity causes people to see everything from a highly skewed viewpoint. Little things that others can easily brush off are very uncomfortable or hurtful. Difficulties being assertive In order to successfully navigate life, some degree of assertiveness is necessary. Although a lot of people have difficulty with this, for people with social anxiety, the concept, much less the action of asserting oneself, seems nearly impossible. Sadly, a lack of assertiveness can lead to relationship problems, lost opportunities and a host of other problems. Social Anxiety \u2014 Substance Abuse Problems About 20% of people with severe social anxiety also suffer from\u00a0alcohol abuse\u00a0or substance dependence. A recent study found that the two disorders have a stronger connection among women. Alcohol is often abused because it helps intensely shy or awkward people feel less inhibited. A few drinks may \u201cloosen people up\u201d and transform them from scared wallflowers into social butterflies \u2014 perhaps even the life of the party. Alcohol or other substances also provides a temporary escape to numb the emotional pain associated with social anxiety disorder.4 Social Anxiety \u2014 Suicide More than 90% of suicidal deaths involve a diagnosable illness such as severe clinical depression or other mental disorder in combination such as anxiety disorders, substance abuse and other treatable mental disorders.5\u00a0A prospective study of more than 3,000 patients (ages 14 to 24) showed that adolescents with social anxiety disorder have a higher risk of developing depression as young adults. Furthermore, in adolescents who have both depression and social anxiety disorder, there is a higher risk of subsequent depressive illness with a greater number of suicidal thoughts and attempts.3 Social Anxiety Disorder Self-Help Tips SAD can be seriously debilitating and professional treatment is often a necessity. Many people with SAD also benefit from practicing\u00a0self-help strategies\u00a0to ease some of the crippling side effects of the disorder. These techniques are often incorporated into formal therapy. Take Baby Steps Setting incremental goals can set the stage for bigger leaps into socialization later on. Instead of planning on spending an entire evening at a party, tell the hosts you will drop by for a little while \u2013 if you feel comfortable, you can always stay longer. For example, try committing to attend a party for an hour versus forcing yourself to stay the whole night. Or spend time in social settings with supportive and understanding people versus a huge group of complete strangers. When you set and attain goals, even small ones, the sense of accomplishment can help you take bigger steps toward overcoming social anxiety. Venture Into Social Situations Strategically Choose a gathering in which you know and feel comfortable with the setting and at least some of the people attending. When you arrive, find a quiet place to gather your thoughts. Talk with a few close friends before diving into the full party crowd. Surrounding yourself with people you know or with whom you\u2019re comfortable can serve as a buffer. Use a Calming Mantra or Slow Breathing When you feel anxious, repeating a calming word or phrase helps refocus attention from undesirable anxious thoughts to a calm, reassuring state of mind. Simply choose any word you like, even a made-up one. In much the same way as a mantra, slow breathing can be calming, energizing and help you feel grounded in the present. Plan an Escape Route Knowing you can easily leave a situation can help alleviate social anxiety because you won\u2019t feel trapped in a situation. Choose to drive yourself rather than with friends or if you did carpool, having the Uber or Lyft app on your phone can ensure a quick getaway if the situation becomes too uncomfortable. Be a Good Listener Being a good listener reduces the feeling you need to steer the topic of conversations. Gravitating toward the proverbial extrovert (life of the party) who needs to entertain people is another tactic. They love a good audience and will appreciate when you laugh appropriately at their jokes and nod in agreement. Avoid Excessive Drinking Alcohol is often abused because it helps intensely shy or awkward people feel less inhibited.\u00a0Drinking excessively\u00a0in a social situation may feel like it loosens you up, but the risks are too high. Alcohol increases anxiety, irritability and depression and may lead to a co-occurring substance use disorder and major depression. Social Anxiety Treatment Center Lantana Florida More than 1,000 outcome studies have been done on the use of CBT as a primary and adjuvant therapy for psychiatric disorders, and it has been found to be highly effective for social anxiety disorder.6\u00a0Social skills training may be incorporated into CBT, focusing on building stronger conversational and listening skills, as well as assertiveness. Some psychiatrists prescribe antianxiety medications or antidepressants, but medication alone is generally not as effective as psychotherapy, especially when it is the only treatment. Many studies have shown cognitive-behavioral therapy (CBT) is superior to other psychological treatments and\/or combined treatment with medications. Research on alternative options for individuals who do not respond efficaciously to CBT continues. Among these are metacognitive therapy (MCT) and mindfulness-based cognitive therapy (MBCT). CBT focuses on cognition rather than metacognition and is based on the theory negative beliefs (e.g. \u201cI\u2019m a failure\u201d) give rise to self-processing and social anxiety. The metacognitive model theorizes that metacognitive beliefs (e.g. \u201cI cannot control my thinking\u201d) are a more significant contributing factor in SAD. Studies on Social Anxiety A\u00a0small-scale 2018 study\u00a0found MCT substantially reduced all measures of social anxiety symptoms at post-treatment and at six-month follow-up. Moreover, MCT appeared to be associated with changes in underlying cognitive style (e.g. worry and self-focus attention) and metacognitive beliefs implicated in the cause and maintenance of SAD, according to the metacognitive model. Researchers concluded MCT appeared to be a suitable treatment associated with positive outcomes for individuals with different presentations of SAD. Recent evidence suggests that unlike other anxiety disorders, SAD displays unique characteristics of depressive symptoms and low positive affect (PA). Past research suggested MBCT may mitigate PA deficits and this approach has been gaining empirical support for use in anxiety and mood disorders. A small 2018 pilot study\u00a0suggested MBCT may be efficacious in mitigating social anxiety symptoms, and this therapeutic effect may be associated with improvements in PA. Due to the small sample size, researchers noted the need for larger-scale studies to further explore the efficacy of MBCT in the treatment of SAD, as well as generalized anxiety disorder. If you or someone you love is suffering from social anxiety disorder, rest assured that there is hope. Life is too short to suffer from the serious emotional problems related to this disorder.\u00a0Contact\u00a0a mental health professional today for an evaluation. Proper treatment can make a world of difference, opening up a whole new life for people who have suffered in silence from this treatable disorder. References \tSocial Anxiety Disorder. Anxiety and Depression Association of America website.\u00a0http:\/\/www.adaa.org\/understanding-anxiety\/social-anxiety-disorder\u00a0Updated June 2016. Accessed June 17, 2016. \tSocial Anxiety: Symptoms and Treatment. Social Anxiety Association website.\u00a0http:\/\/socialphobia.org\/social-anxiety-symptoms-and-treatment\u00a0Accessed June 17, 2016. \tStein MB, Fuetsch M, M\u00fcller N, H\u00f6fler M, Lieb R, Wittchen HU. Social anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults.\u00a0Arch Gen Psychiatry. 2001;58(3):251-256. doi:10.1001\/archpsyc.58.3.251. \tSocial Anxiety Disorder and Alcohol Abuse. Anxiety and Depression Association of America website.\u00a0http:\/\/www.adaa.org\/understanding-anxiety\/social-anxiety-disorder\/social-anxiety-and-alcohol-abuse\u00a0Accessed June 17, 2016. \tSuicide and Prevention. Anxiety and Depression Association of America website.\u00a0http:\/\/www.adaa.org\/understanding-anxiety\/suicide\u00a0Updated May 2016. Accessed June 17, 2016. \tWhat is Cognitive Behavioral Therapy (CBT)? Beck Institute website.\u00a0https:\/\/www.beckinstitute.org\/get-informed\/what-is-cognitive-therapy\/\u00a0Accessed June 15, 2016.