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Social Anxiety Disorder (S.A.D.)
How to Fight the Fear

Do you spend your life in fear?
Do you spend your life in fear?

Social Anxiety Disorder or SAD is a condition where the fear of embarrassing or humiliating yourself is so intense, you avoid any social situation that may trigger it. The majority of people are afraid to get up and make a speech in public. But for someone with SAD, things that seem mundane to most people can be terrifying. Using a public restroom, eating or drinking at a restaurant, speaking up in a meeting or attending a party might cause crippling fear.

Physical symptoms include having an upset stomach or nausea, feeling dizzy or faint and shortness of breath. Some people get red faces or blush intensely. Your heart may start racing, your chest may tighten and you could begin to tremble or shake. Hot flashes and sudden sweating are also common.

Left unchecked, SAD can hinder career advancement because you're afraid to bring attention to yourself, even when you've done something good. It can lead to depression created by social isolation. As many as 20% of people suffering from SAD may self-medicate and become dependent on drugs or alcohol to deal with the situation.

Treatment options often include a class of drugs called SSRIs. (Selective serotonin reuptake inhibitors.) Luvox, Paxil and Zoloft are all FDA approved for treatment, but other drugs that work include Celexa, Prozac and Lexapro. Typically they slow the re-absorption of the chemical serotonin in the brain that helps regulate mood and anxiety.

Psychologists have identified another way to deal with the problem. It's called Cognitive Behavioral Therapy or CBT. You are given specific assignments that challenge how you think about and view the world, to alter your behavior.

Identify the roots of your negative thoughts and write them down. Maybe the reason you're afraid of speaking up at work is because you're afraid of saying something wrong. Then your boss will think you're incompetent, which will lead to your getting fired. You're making up the entire conversation in your head and ending it with the worst possible outcome.

Stop talking to people who aren't there. While you're at it, quit believing you can read minds. Unless someone is actively writing down everything they're thinking, you have no idea what's going through their head.

Other forms of “stinkin thinkin” include believing you know exactly how things will turn out, sometimes called fortune-telling. Guess what, you don't know the future. You should also avoid personalizing everything. Everybody in a party won't turn to judge you the moment you walk in. Most people are too busy dealing with their own issues to worry about what you might or might not be doing.

When you write down those negative thoughts, it gives you a chance to challenge your beliefs. Take that same work situation and write out happy endings. Instead of losing your job, write down that speaking out helps save the company money or expand sales. Then you get a raise and more job security.

Learn to take control of your physical reactions. Take deep breaths to calm down. Sit in a chair and practice relaxing various parts of your body. Concentrate on lowering your heart rate. Just the act of focusing intensely on yourself can help provide some relief because you forget about what's making you anxious.

Plan some sort of exercise program. Working out has been shown to reduce anxiety and increase feelings of well-being. Start by taking regular causal walks around your neighborhood. When you go to a gym, hire a personal trainer for a few sessions to show you how to do things. Wear headphones so you can concentrate on what you're doing and don't have to interact with other members until you feel more confident.

Set time limits. You don't have to hang out at a party for hours, just plan on stopping in for 20 minutes. The knowledge there's a limit to your exposure can help make situations more tolerable.

Even these steps may be too much for some people with SAD. Reach out to your doctor for an appointment to talk about what's going on. You can also call a mental health hotline like the one run by the National Alliance on Mental Illness (www.nami.org). Sometimes talking to a stranger is easier than someone you know. The key is deciding to do something today. You can't get better until you start.

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