Aunt Agatha Advocates: What is social anxiety disorder?

Written by: Heather Leong Ning Yan (20-E6), Kothandam Anusha (20-I1), Leow Jia Wen, Jolene (20-E1), Pheobe Ong Hong Ying (20-O1), and Sargun Kaur(20-E4)

Designed by: Leow Jia Wen, Jolene (20-E1)

“All I feel are the assaults of apprehension and terror at the thought that I am the only one who is entirely unlike the rest. It is almost impossible for me to converse with other people. What should I talk about, how should I say it? – I don’t know.” 

The above quote from Japanese novelist Osamu Dazai’s No Longer Human is eerie, but not unfamiliar to many of us. It reflects the experiences of some people suffering from an anxiety disorder, known as social anxiety disorder. 

Social anxiety disorder, sometimes referred to as social phobia, is a type of anxiety disorder that causes extreme fear in social settings. People with this disorder have trouble talking to people, meeting new people, and attending social gatherings (Higuera, 2018).

Social phobia is something that affects many people in Singapore. Ten percent of people in Singapore suffer from some kind of anxiety disorder, with one of the major types of anxiety disorders being social anxiety disorder (Lim, 2016). As such, we feel that it is important to address it, and how it might affect the lives of people who live with it. Furthermore, we want to provide some advice on what to do and what not to do while interacting with people who may suffer from social anxiety disorder. Social phobia is a sensitive topic, and by educating ourselves on it, we can make our school (and our society, by extension) far more welcoming and understanding of it.

How do people with this disorder cope?

There are various self-help strategies for people with this disorder to help themselves cope.

For example, deep breathing would help avoid the “fight-or-flight” response to stressful situations. In these situations, their body’s automatic systems are on high alert and signal their heart to beat faster and breathing rate to increase. By consciously becoming aware of their breathing and regulating its depth and rate, the likelihood of spiraling into a panic or anxiety attack is lowered. 

Secondly, guided imagery for social anxiety involves the use of visualization techniques to help their body enter a relaxed state. In other words, they close their eyes and imagine the sights and sounds of a place they find relaxing. Guided imagery can help with their anxiety by allowing them to manage negative emotions. In addition to the examples given above, it can also be used to visualize positive outcomes in various social and performance situations. Rather than imagining the worst, guided imagery gives them a chance to experience the best possible outcome before entering a situation.

Thirdly, in terms of social anxiety disorder, autogenic training may aid in relaxation and help to reduce symptoms of anxiety when combined with other forms of treatment. Just as with other forms of relaxation training, autogenic training may help them to feel calm and relaxed in social and performance situations. Autogenic training is a relaxation technique focusing on promoting feelings of calm and relaxation in one’s body to help reduce stress and anxieties. More specifically, it helps mitigate anxieties resulting from situations or conditions that may overwhelm a person  with stress, frustration, or sadness. It involves finding a quiet, comfortable place to relax, slowing down one’s breathing and then focusing attention on different areas of the body to restore a sense of calmness.

Some people who have SAD also suffer from a deficit in social skills. Fortunately, social skills can be learned as part of a social skills training program sometimes incorporated with treatment. A therapist may describe a particular skill, explain how to carry it out, and model the behavior to help someone with SAD improve in the following areas: Eye contact and body language, communication and carrying on a conversation, assertiveness, accepting and giving compliments, etc.

What should we not do around them/to them?

Anxiety is never a pleasant experience for both the person facing it and the people around them. As an onlooker, one might desperately want to help them out of the situation and hopefully solve all their problems. However, anxiety is an irrational disorder. It does not function the way getting stressed normally does. Hence, rational solutions will rarely help the person suffering through this. When trying to help someone going through an anxiety attack, it is good to be informed about the do’s and the don’ts that can aid and make their situation worse. 

As an observer, it is vital to watch what you say. Common responses such as “You really need to pull yourself together!” may seem normal to say. However, they are seen as insensitive and frankly only aggravates the situation. The natural response from observers would be to encourage the person to calm down. Ironically, this only makes it worse as the sufferer is desperately trying to calm down unfortunately is physically unable to.  

Knowing this, the observer might attempt to reassure the sufferer that there is nothing to be worried about but this would only worry them more. Statements such as “Everybody is too busy with their own lives to focus on you” may lead to them thinking that everyone in the room was judging them negatively. Social anxiety being an all-consuming irrational disorder does not seize the taunting thoughts despite the sufferer knowing otherwise. 

As humans, observers would want to try to solve their issues leading them to want to find out more about the problem at hand. Asking questions such as “Why do you feel anxious?” is a common action taken by them. However, as illogical as anxiety can be, the sufferer often does not know what they feel anxious about to begin with making this a very uncomfortable situation for them to be in. 

What can we do to help people with this disorder?

When it comes to interacting with people that have social anxiety disorder, it is always good to not trigger their uneasiness, but instead help them with it. One of the easiest ways is to simply be friendly. While people suffering from SAD may seem aloof, that does not mean they do not want to have friends. Most of them still crave the friendships and bonds with other people, but are too anxious to initiate or maintain them. It will be easier for them if we reached out to them and got to know them instead, and we should always become a pillar of support for them throughout the friendship. 

Another important thing to note is to not criticise them. People with SAD are already highly critical of themselves on a normal basis and expect others to treat them the same way. In fact, research shows that having SAD is strongly related with believing oneself to be socially incompetent, even when others don’t perceive this same level of problem behavior. Try not to add to the problem by being overly critical yourself. Don’t tell the person that he is too quiet or that he just needs to loosen up, as your words will have a negative effect on them. Instead, try to provide a good and comfortable environment for them to reach past their comfort zone and accept their actions as for who they are. 

Thirdly, a good way to learn how to interact with people with SAD would be to educate yourself on this disorder, and through your new knowledge, be more aware of how to socially connect with people with SAD. Try to understand them by learning about the causes, symptoms, and treatments and what it’s like to live with social anxiety. Read books, watch movies, or learn about famous people with the disorder. Arm yourself with knowledge so that you can be more understanding and approach situations from a non-judgmental perspective, as well as to put yourself in their shoes when interacting with them. 

Next, if you suspect someone you know has social anxiety disorder but has not been diagnosed or received treatment, help that person get help. They may be too anxious to get help, which is where you can step in and lend a hand in improving their wellbeing. That might involve making a doctor’s appointment, tracking down a support group or finding a self-help program. A step like this would help ease their anxiety, and find ways to better cope with the disorder. 

Last but not least, it is important to help people that are suffering from SAD to know and be aware that they are suffering from it. Often people with SAD will deny their symptoms. This is because anxiety is humiliating and embarrassing for them, and the last thing they want is for it to be noticed. However, during times of personal crisis or when dealing with emotional upheaval, the person with social anxiety disorder might be more willing to talk simply because their anxiety becomes too much to handle. These are also good opportunities to suggest seeking support for their social anxiety. When a person has hit rock bottom, going up seems like the only reasonable next step. Helping them see their problems and talking to them about it will definitely help them for the better. 

Conclusion

Ultimately, it is important to understand and be aware of this condition. It can be isolating to fight social anxiety by yourself and not understand where the anxiety is coming from. By learning about the condition, we may perhaps help those who have it to better cope with it. Hopefully by showing our support and understanding we will be able to bring them at least some semblance of relief. 

Bibliography

  1. Higuera, V. (2018, September 03). Social anxiety disorder: Causes, symptoms & diagnosis. Retrieved February 24, 2021, from https://www.healthline.com/health/anxiety/social-phobia
  2. Lim, J. (2016). Anxiety in Singapore: Stats, Types and Who’s at Risk​. Retrieved February 24, 2021, from https://www.healthxchange.sg/wellness/mental-health/anxiety-singapore-stats-types-risk#:~:text=%E2%80%9CAbout%2010%20per%20cent%20of,%E2%80%9D%20says%20A%2FProf%20Lim

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