Women seeking substance abuse treatment often have diverse and complex medical and social problems. Co-occurring disorders in women tend to be associated with severe psychological distress, high rates of trauma and interpersonal violence, medical problems, few vocational skills, low income and severe addictions.
Potentially dangerous behavioral traits are often noticed and even reported, sadly to no avail. In other instances, people notice something is awry; but for some reason, dismiss this behavior and fail to notify anyone about their suspicions.To some extent, both of these scenarios played out in the case of 19-year-old Nicolas Cruz.
As many as one in four addicts who seek recovery services have previously tried to quit their drug, alcohol or behavioral addiction. Twelve-step recovery programs, which are based on the well-known Alcoholics Anonymous (AA) model, are successful for many people. However, some people seeking help to overcome their addiction struggle to find inspiration in the 12 steps.
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Janice was asked to offer a reading at her friend’s wedding. She wanted to say yes, but she was so self-conscious in everyday social situations she feared a major social occasion like a wedding would be too difficult to manage.
The bride was very disappointed and a little angry, but she had no idea her friend was living in a world of social anxiety disorders that led her to feel extreme fear about being judged by others.
Janice had hidden the extent of her problem from friends but it had gotten worse in the past six months. Talking to new people at work was more challenging and anytime her boss assigned her a task that involved performing an action in front of others, such as handing out copies of a report, it terrified her. She had a persistent fear that her every movement was being watched and judged by others.
After finally consulting a therapist, Janice was able to understand more about social anxiety disorders. Sometimes referred to as social phobia, social anxiety can be a crippling mental health disorder.
The DSM-5 describes social anxiety disorder as “A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way or show anxiety symptoms that will be embarrassing and humiliating.”
Signs of Social Anxiety Disorders
It may be time to get evaluated for social anxiety disorders if you have some of the following symptoms:
- Self-consciousness and embarrassment or awkwardness in front of others
- Nausea, blushing, sweating, trembling or rapid heartbeat in social settings
- Inability to think of things to say (i.e., mind going blank)
- Intense fear of judgment from others
- Intense fear when having to deal with or meet new people
- Avoiding social situations
How to Treat Social Anxiety Disorders
Psychotherapy is often the first line of defense to help with social anxiety disorders. Cognitive behavioral therapy, known as CBT, has proved useful for treating anxiety disorders. It can help change the way you think, behave and react to certain situations. It’s also found effective in group settings.
Common Anxiety Disorders
Social anxiety disorder is one of several anxiety disorders that can be long-term and impact your daily life. Here are the most common:
Generalized Anxiety Disorder (GAD)
Feeling a certain amount of anxiety or anxiousness is normal and can happen in even mundane experiences, such as having to jam on the breaks to miss a speeding car or if you are running late to a job interview. Happy occasions like planning a wedding can create anxiety as well, but that is a short-term or situational condition.
Generalized anxiety disorder is a more persistent, long-term condition that involves:
- Feeling on edge
- Overwhelmed with worry
- Fatigue and difficulty concentrating
- Sleep problems
- Anxiety attacks
This is a condition that lurks as an underlying state of anxiety and can quickly and unexpectedly lead to recurrent panic attacks. Panic attacks are overwhelming moments of fear that includes physical sensations that can be very frightening, including:
- Heart palpitations, pounding heart or rising heart rate
- Shortness of breath
- Choking sensations
- Sweating or trembling
- Feeling totally out of control
- Fear about when the next panic attack will happen
- Fear of places where panic attacks have happened in the past
- A sense of impending doom
Post-Traumatic Stress Disorder (PTSD)
This is often associated with members of the Armed Forces who’ve been in active combat, but it can affect anybody who has experienced or witnessed a traumatic event. It can also impact people who have witnessed or heard of a loved being injured or hurt. It’s reported that 7.7 million Americans age 18 and older have PTSD. The symptoms include:
- Irritability and angry outbursts
- Difficulty concentrating
- Startling easily
- Trouble sleeping
- Hypervigilance or always being on alert
A phobia involves an irrational and excessive fear of a specific object, activity or situation. You may be aware that your fear is blown out of proportion but feel unable to control it. Distress can lead you to avoid anything that can trigger it. A deep fear of going into the ocean due to extreme worry over drowning ― or sharks ― can mean you’ll never set foot on a beach or in a sunny place. Or, it could be a specific phobia, such as agoraphobia; you may be deathly afraid of crowds, being in closed spaces, using public transportation or being alone outside of the home, so you never allow yourself out in the world.
Obsessive Compulsive Disorder (OCD)
This involves intrusive thoughts that create anxiety and extreme discomfort. You may have disturbing images that you cannot get out of your mind. This condition also is known for urges and compulsions that cause people to engage in repetitive behaviors; for example, excessive hand washing and checking for locked doors continuously.
Separation Anxiety Disorder
This takes root in the earliest months of life when an infant has issues attaching to a primary caregiver because that person is distant, dismissive, unavailable or leaves them alone too much. The infant becomes clingy for fear their caregiver won’t come back. As the child grows, they become persistently anxious and worried about intimate relationships and fear being away from the person or people they love. A baby may become agitated if the person leaves the room; as an adult, it might manifest as anxiety when the person doesn’t get an expected text message or call from the person they love.
Anxiety Disorder Treatment
The first step is recognizing when you are dealing with social anxiety disorders or other anxiety disorders and seeking proper mental health care. Psychotherapy tailored to the specific disorder is a key approach to healing.
“What Are Anxiety Disorders” – American Psychiatric Association
“Social Anxiety Is More than Just Shyness” – National Institute of Mental Health (NIMH)
“Social Anxiety Disorder (Social Phobia)” – Mayo Clinic
“Anxiety Disorders” – National Institute of Mental Health (NIMH)
“Types of Anxiety Disorders” – Mental Health America (MHA)
“Surviving Anxiety” – The Atlantcic
“Symptoms of Post-Traumatic Stress Disorder” – U.S. Department of Veteran Affairs
Although men are slowly becoming more receptive to the idea of seeking help for mental health problems (e.g. stress, anxiety, depression and trauma), they still tend to try and handle things on their own. Even when they feel overwhelmed by pressures at home and work, they often think they should keep a stiff upper lip and carry on. The tendency to stay strong and appear to have everything under control while struggling internally is not good for men’s mental health.
Individuals with avoidant personality disorder struggle with a number of persistent symptoms that get in the way of having social relationships. In the United States, anywhere from 1% to 5.2% of the adult population suffers from avoidant personality disorder. However, many of these individuals continue to fight every day to have meaningful experiences, especially at work.