Is Social Anxiety Disorder Preventing You from Seeking Mental Health Treatment?

Social anxiety disorder can be a profoundly isolating experience not just because you may avoid social contact, but because you may feel there is something fundamentally different about you, something shameful and wrong. It is a kind of psychological isolation that is just as impactful as physical isolation. Your experience seems to be so at odds with the people around you, the people who can do all the things that frighten you as if they are ordinary—interacting with strangers, giving public presentations, going to parties, talking to the cashier at the grocery store, signing your name on a delivery slip. The loneliness of the disorder often comes in part because your own anxiety is constantly contrasted by an ostensible lack of anxiety in others, the ease with which they move through the world.

However, social anxiety disorder is not a wild departure from the “normal” human experience—in fact, it is but an augmented version of perfectly natural emotions. People, after all, are inherently social beings. Our species has survived in part due to our drive to be a part of a larger collective and the desire to belong is deeply ingrained in us. As Stefan Hofmann, director of the Social Anxiety Program at Boston University, explains:

Social anxiety is a result of the fear of a possibility that we will not be accepted by our peers. It’s the fear of negative evaluation by others, and that is [part of] a very fundamental, biological need to be liked. That’s why we have social anxiety. [I]t would be very abnormal not to be socially anxious.

In other words, social anxiety is an evolutionary trait, something that reflects our primal drive toward belongingness. While the days of needing the protection of a larger social group may seem long gone, belonging in fact remains vital to our psychological and physical health—social integration has been shown to improve outcomes for everything from diabetes to cardiovascular disease, depression to schizophrenia. It makes sense, then, that humans have an innate anxiety about social rejection—we depend on social belonging for our wellbeing and compromising our access to that belonging can be severely detrimental.

Social anxiety disorder, however, exists on the outer limits of the social anxiety spectrum. For about 7% of people, social anxiety passes the threshold from a natural fear of social rejection into a new territory where fear of rejection interferes with wellbeing and the ability to participate in the social world. It transforms from protective to destructive and, thus, into a disorder. However, it’s important to remember that your experience is not a stark departure from “normal”—it is part of the same continuum. In fact, social anxiety disorder itself occupies a range—not a point—on that continuum, ranging from high to low functioning. Wherever you fall on the continuum, it’s important to know that you are not alone in your fears, even if those fears are augmented in intensity and shape your life in a way that is different than most.

Understanding that social anxiety disorder is within the range of normal human experience can help some people break through some of the shame that so frequently accompanies the illness and open up space for a sense of belonging to a larger community. This in and of itself can make the prospect of seeking treatment less intimidating. The commonality of social anxiety means that virtually everyone—including medical professionals—has some innate understanding of your fears, even if they do not experience them in the particular way you do.

It’s also important to know that social anxiety treatment can be tailored to your individual needs. There is no one set formula for treating social anxiety disorder and each person’s treatment process may look very different depending on their specific struggles. For example, while Cognitive Behavioral Therapy (CBT) is one of the most commonly used and effective therapies for social anxiety disorder, your symptomatology may make it difficult to immediately participate if you have anxieties about talking to people. In these cases, less verbal therapies, such as Somatic Experiencing or Eye Movement Desensitization and Reprocessing (EMDR) can sidestep your most pressing fears, give you a way into the therapeutic process, and help you diminish the intensity of your symptoms. As you build your inner resources, you can more fully participate in talk-based therapies such as CBT, giving you a comprehensive treatment experience by drawing on the strengths of each to create a greater whole. Through a variety of modalities, you can develop the skills you need to disrupt damaging patterns of thoughts and behavior and establish greater psychological tranquility. These therapies may be combined with medication to achieve the best outcomes.

While for some social anxiety disorder appears to emerge spontaneously, for others it is rooted in specific events, such as childhood trauma. In these cases, it is critical to address the underlying causes of your anxiety and resolve your traumatic memories. Experienced and compassionate mental health professionals understand that this can be a delicate process and will work with you to design a plan that allows you to safely explore these events without shame or judgment. A variety of modalities are available to ensure that you are able to address painful memories in a way and at a pace that is comfortable and meaningful for you.