Written by Eli Lebowitz
Social anxiety disorder is more than occasional shyness or social discomfort. Social anxiety will cause them to avoid at least some social situations. In most cases there will be many situations they avoid such as conversations with other people, eating or drinking in public, answering the phone, or speaking in class. If they cannot avoid the situations they fear and have to endure them, people with social anxiety will experience these situations as extremely distressing.
Here are a few pieces of advice to help your patients deal with social anxiety.
Social Anxiety Disorder vs. Occasional Social Anxiety
If the anxiety is taking a significant toll on their life, limiting their ability to function academically or otherwise, then that may be social anxiety disorder. People with social anxiety disorder will experience a lot of anxiety, distress, and worry about how they are perceived. They’ll usually be very worried about embarrassing themselves, and they may fear that their anxiety is making them look silly, for example by blushing or trembling. Psychologists will generally not diagnose social anxiety disorder unless the condition has lasted at least six months.
If a person feels uncomfortable in new situations, or takes time to ‘warm up’, or just prefers small groups, that is not social anxiety disorder.
How to Help Patients & Their Support Systems Be Successful
Help your patient get support by encouraging the people around your patient to be there for them and advise them not to tease or mock a person with social anxiety disorder.
We all have things we are anxious about and what is easy for you may seem terrifying for somebody else. Most people with social anxiety disorder already know that their fear is irrational and excessive, so just telling them that again and again is not likely to help.
Help the patient’s support system remember that having social anxiety disorder does not mean that patients don’t want friends. Most people with social anxiety disorder feel lonely and would like to have friends and social interactions. They’re just anxious about them.
Don’t give up and try to find ways to create social interactions that feel ‘safe’. A frat party may be out of the question, but a coffee with a friend or two might be doable. Or for some people it may be the other way around. Let your friend know that you won’t judge them and just want to be their friend. Give them time. If you asked a question and did not get an answer right away, wait before you jump in or give up.
Talk about what helps you when you feel uncomfortable. Many people with social anxiety disorder worry about ‘having something to say’ or ‘how to start a conversation’ so offer tell the support system for the patient to share their own best tips. And that they should be prepared for their loved one with social anxiety not to accept them right away.
Tell the families and friends of your patient to encourage them to get help when they need it.
Therapy and medications for social anxiety disorder can be very effective. Find out about resources and offer to go along for a first visit if they want support. Respect their privacy but make it clear you want to help.
How Cognitive Behavioral Therapy Can Help
Cognitive behavior therapy (CBT) is an evidence-based treatment for social anxiety disorder. In CBT patients learn to identify their anxious thoughts and to challenge them. They learn skills to help themselves feel less anxious so they can cope with stressful situations rather than avoiding them, and they practice gradually and systematically facing their fears.
Starting small is best.
Perhaps doing something that is only a little stressful, and practicing it until it becomes easy for the patient. They’ll learn how to recognize how their brains and bodies react before they move on to more difficult tasks. They’ll practice coping until they are no longer as anxious about social situations and the disorder is no longer impairing their lives in a meaningful way.
Dr. Lebowitz helps mental health professionals build treatments that work. Check out his current courses here.
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