Anxiety and Fear: Coping Strategies for Social Situations

Anxiety, fear, and restlessness?

Hello, doctor.
I often experience sudden feelings of fear, unease, or anxiety, especially in group settings where it becomes more severe.
I feel very awkward, have a strong desire to escape, and am fearful of people, making it difficult for me to engage with others as comfortably as they do.
However, I am not afraid to go out; sometimes when I am with friends, I still experience this discomfort...
to the point where my hands feel uneasy.
This even happens during significant events like graduation ceremonies...
I find it hard to focus and participate because I am overly concerned about others' actions, especially when they are directed at me.
I can dwell on a casual remark for a long time; even a trivial matter can become a source of distress and suffering for me.
I often enjoy imagining scenarios that don't exist, which makes me feel happier and more relaxed.
For instance, I might envision a situation where my teachers like and care about me...
I can control my thoughts to some extent, but I often find myself wanting to think about these things, and sometimes I suddenly start imagining them, even talking to myself.
I always feel that others are better than I am...
I struggle to face reality...
Am I lacking in self-affirmation? These feelings have been prevalent since my sophomore year in high school.
Thank you.

ci, 10~19 year old female. Ask Date: 2016/07/16

Dr. Huang Weiqin reply Psychiatry

Dear Inquirer,
Hello! Based on your description, it seems you may be experiencing a lack of self-confidence.
If you are still a student, I recommend that you consider visiting the counseling center during school hours for a session with a counselor to work on self-development and self-affirmation.
If, after counseling, you continue to experience anxiety related to social interactions or fear of engaging with others, it would be advisable to seek support from friends or family to accompany you to a psychiatric or psychosomatic clinic for a professional evaluation and treatment.
I hope this response is helpful.
Thank you for your inquiry, and I wish you peace and good health.

Reply Date: 2016/07/16

More Info

Hello, thank you for sharing your experiences and concerns regarding anxiety and fear in social situations. It sounds like you are dealing with significant social anxiety, which can be quite challenging and distressing. Understanding the nature of your anxiety and developing effective coping strategies is essential for managing these feelings and improving your overall well-being.

Social anxiety disorder (SAD) is characterized by an intense fear of social situations where one may be judged or scrutinized by others. This fear can lead to avoidance behaviors, making it difficult to engage in everyday activities, such as attending gatherings, participating in conversations, or even speaking in front of others. The symptoms you describe, such as feeling awkward, wanting to escape, and being overly concerned about others' perceptions, are common among individuals with social anxiety.

One effective approach to managing social anxiety is through Cognitive Behavioral Therapy (CBT). CBT focuses on identifying and challenging irrational thoughts and beliefs that contribute to anxiety. Here are some steps you can take to analyze your automatic thoughts and work towards changing them:
1. Identify Automatic Thoughts: Start by keeping a journal to record situations that trigger your anxiety. Note your thoughts and feelings during these moments. For example, if you feel anxious at a gathering, write down what you were thinking at that time. This will help you recognize patterns in your thinking.

2. Challenge Negative Thoughts: Once you identify your automatic thoughts, evaluate their validity. Ask yourself questions like: "Is this thought based on facts or assumptions?" "What evidence do I have that supports or contradicts this thought?" This process can help you see that many of your fears may be exaggerated or unfounded.

3. Find Core Beliefs: Core beliefs are deeply held convictions about yourself and the world. They often stem from past experiences and can influence your thoughts and behaviors. Reflect on your childhood and significant experiences that may have shaped your beliefs about yourself. For instance, if you believe you are unlikable or inadequate, consider where this belief originated and how it may not reflect reality.

4. Use Dynamic Psychology: Understanding your core conflictual relationship themes (CCRT) can also be beneficial. This involves recognizing patterns in your relationships and how they relate to your anxiety. For example, if you often feel rejected or unworthy in social situations, explore how these feelings may connect to past experiences with authority figures or peers.

5. Practice Relaxation Techniques: Incorporating relaxation strategies, such as deep breathing, progressive muscle relaxation, or mindfulness meditation, can help reduce physical symptoms of anxiety. These techniques can ground you in the present moment and alleviate the overwhelming feelings that arise in social situations.

6. Gradual Exposure: Gradually exposing yourself to social situations can help desensitize your anxiety response. Start with less intimidating situations and gradually work your way up to more challenging ones. This process can help build your confidence and reduce avoidance behaviors.

7. Seek Professional Help: If your anxiety continues to interfere with your daily life, consider seeking support from a mental health professional. A therapist can provide guidance tailored to your specific needs and help you develop coping strategies.

8. Self-Compassion and Affirmations: Practicing self-compassion and positive affirmations can help counteract negative self-talk. Remind yourself that it’s okay to feel anxious and that you are not alone in your experiences. Affirmations like "I am enough" or "I can handle this situation" can help reinforce a more positive self-image.

In conclusion, social anxiety can be a debilitating condition, but with the right strategies and support, it is possible to manage and overcome these feelings. Remember that progress takes time, and it’s essential to be patient with yourself as you work through these challenges. You are not alone in this journey, and seeking help is a courageous step towards healing and self-acceptance.

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