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Shyness
& Social Anxiety
Meeting new people and developing friendships is an important part of
college. Many people experience some degree of nervousness or awkwardness in
relating with unfamiliar people such as professors, classmates, students in the
dorm and other acquaintances. They may consider themselves to be "shy." But we
now know that many "shy" people actually have "Social Anxiety Disorder."
Individuals who struggle with Social Anxiety Disorder experience a level of
anxiety and fear about social situations that goes beyond minor or temporary
feelings of discomfort. Social Anxiety Disorder (SAD) is characterized by
intense self-consciousness and embarrassment in social settings. People with SAD
have intense, overwhelming fears of being watched or judged by others. Physical
symptoms of anxiety, such as blushing, perspiring, and shaking are common. These
feelings and physical sensations often lead the person with SAD to become
anxious for days or even weeks before social events. Social Anxiety Disorder is
not equivalent to shyness. Unlike shyness, Social Anxiety Disorder is
persistent, intense fear and anxiety that does not diminish in social situations
and that greatly interferes with the ability to function academically, socially,
and at work. People who struggle with SAD often avoid activities such as
speaking in class, joining clubs or sports teams, attending parties, initiating
romantic relationships, and approaching professors. Some SAD sufferers avoid
eating in public, writing in front of others, or using a public restroom as they
fear scrutiny and feeling ashamed in these situations. Prevalence rates for
Social Anxiety Disorder range from 2-13%. The overwhelming anxiety associated
with SAD often begins during the teenage years, and may follow shyness and fear
as a child. SAD frequently co-occurs with other mental health disorders,
including other types of anxiety disorders, depression and substance abuse. SAD
often occurs in more than one family member, and probably is caused by a
combination of life experience and heredity.
Counseling
Many people who struggle with Social Anxiety Disorder avoid seeking
psychological treatment. The symptoms of the disorder lead SAD sufferers to fear
many interpersonal situations, including counseling. This is unfortunate, as SAD
can be effectively treated with therapy, or a combination of therapy and
medication. Counseling for SAD typically involves examining and changing the
negative and self-defeating thoughts that are part of the disorder. These
thoughts are usually irrational, and treatment helps the client understand that
his or her fears are exaggerated and unrealistic. For example, if a person has a
great fear of speaking in class, the therapist will explore the client’s fears
about what would happen (e.g. “I’m going to stammer and my voice will shake,”
“People will think I’m stupid”). The therapist helps the client in substituting
more positive, realistic beliefs (e.g. “People are concerned with the class, not
with me.” “It is perfectly acceptable to not know all the answers.”). The
therapist might also assist the client in using and practicing social skills,
such as making appropriate eye contact, smiling, and asking questions to get to
know others better. Another way counseling may help is in exploring social
experiences earlier in life that may have contributed to the client viewing
interactions with others as frightening or potentially humiliating. Many college
students have had negative experiences during elementary, middle or high school
years. When facing a new social situation, the individual with SAD may come to
expect a repetition of negative, uncomfortable experiences with others. Therapy
investigates the client’s assumptions about social interactions, such as the
expectation that others will be judgmental or critical, or the excessive need
for others’ approval. The client in treatment for SAD learns to develop
different, more realistic expectations about social situations.
Medication
Research has shown that Selective Serotonin Reuptake Inhibitor (SSRI)
medications, (e.g. Prozac, Zoloft, Paxil, Luvox) help to reduce symptoms of
Social Anxiety Disorder. These drugs usually take from between 3 to 12 weeks to
begin working. The SSRI medications are usually used for at least 6 to 12 months
and withdrawn slowly. Short-acting anti-anxiety medications (e.g. Ativan) can
also help with short-term relief from Social Anxiety Disorder symptoms, but are
less desirable for long term use than the SSRI’s because of the risk of becoming
“habituated” (needing to take more of the drug to achieve the same effect).
Where To Go For Help On Campus
Experienced, caring psychologists are available at the University Counseling
Center for confidential help for Social Anxiety Disorders. Groups are available
as well. To make an appointment, stop by 206 Health Services Building or call
610-519-4050.
For more information on Social Anxiety Disorder
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or reprinted without permission of Villanova Counseling Center.
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