Overcoming Social Anxiety: Coping with Fear in Crowded Situations

Q: Overcoming Social Anxiety: Coping with Fear in Crowded Situations

Hello： It seems that this symptom has caused you considerable distress. <br>I suggest shifting your focus to more neutral matters, such as paying closer attention during meetings to what your superiors are advocating, and contemplating the purpose behind their messages and the ef

Social Anxiety Disorder, Agoraphobia

I am currently a high school student, and every time I find myself in a crowded situation, I feel extremely anxious, as if everyone is watching and paying attention to me.
This is especially true during flag-raising ceremonies, where my face involuntarily trembles, and I experience palpitations.
I often find myself fidgeting with my hair and touching my collar to distract myself and temporarily stop my face from shaking.
My legs also tremble, and I can only take 37 steps to alleviate the shaking.
To make matters worse, I stand at the front of the line in my class, right in front of the principal, the director, and the instructor, and I fear that one day I will be called out, which terrifies me.
Additionally, I am a transfer student, and since I don't know anyone in class, it's inevitable that I feel nervous.
However, I always have the sensation that someone is watching me, which causes my face to shake and triggers severe palpitations, making me very uncomfortable.
This continues until the end of class, and the next period brings the same feelings until school is over.
While in class and on the school bus, I often hear girls softly calling my name, and I wonder if I am experiencing auditory hallucinations.
In my previous school, there were indeed girls who called out to get my attention, but in this new school, I am not sure.
Whenever I face situations with many people, my face and legs start shaking involuntarily, and I experience palpitations.
Recently, even when I walk alone on the street, I feel as though someone is observing me, and I encounter the same issues.
I have never written about this before, fearing that doctors might not understand my condition.
I am currently very afraid of facing crowds.
This problem has existed for a while, but it has worsened over time.
The only time I can relax is when I am with my family.

opopjim, 10~19 year old female. Ask Date: 2016/08/30

Dr. Liang Sunyuan reply Psychiatry

Hello: It seems that this symptom has caused you considerable distress.
I suggest shifting your focus to more neutral matters, such as paying closer attention during meetings to what your superiors are advocating, and contemplating the purpose behind their messages and the effects they hope to achieve.
This may help reduce your awareness of your own physical condition and further decrease anxiety.
However, since there are symptoms suggestive of hallucinations, if the symptoms persist without improvement, it is advisable to seek medical assistance.
Wishing you all the best.

Reply Date: 2016/08/30

More Info

Social anxiety is a common issue, especially among adolescents, and it can significantly impact daily life and interactions. Your experiences of feeling observed, trembling, and experiencing heart palpitations in crowded situations are indicative of social anxiety disorder (SAD). This condition can manifest in various ways, including intense fear of being judged or scrutinized by others, leading to avoidance of social situations or significant distress when faced with them.

Firstly, it’s essential to understand that you are not alone in feeling this way. Many people experience similar feelings of anxiety in social situations, particularly in environments where they feel they are being watched or evaluated. The symptoms you describe—trembling, heart palpitations, and the urge to distract yourself—are typical responses to anxiety. These physical reactions can be overwhelming and may lead to a cycle of avoidance, where the fear of anxiety symptoms causes you to avoid situations that trigger them, further reinforcing the anxiety.

Here are some strategies that may help you cope with social anxiety:
1. Cognitive Behavioral Therapy (CBT): This is a highly effective treatment for social anxiety. CBT helps you identify and challenge negative thought patterns and beliefs about yourself and others. By reframing these thoughts, you can reduce anxiety and improve your confidence in social situations.

2. 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. For example, you might begin by speaking to a classmate in a quiet setting before progressing to larger groups.

3. Mindfulness and Relaxation Techniques: Practicing mindfulness can help you stay grounded in the present moment and reduce anxiety. Techniques such as deep breathing, progressive muscle relaxation, or meditation can help calm your mind and body before and during social interactions.

4. Focus on Others: Shifting your focus from yourself to others can alleviate some of the pressure you feel. Instead of worrying about how you are perceived, try to engage with those around you. Ask questions, listen actively, and show genuine interest in others. This can help take the spotlight off you and reduce anxiety.

5. Seek Support: Talking to someone you trust about your feelings can be incredibly helpful. This could be a family member, friend, or school counselor. They can provide support and encouragement as you navigate your anxiety.

6. Professional Help: If your anxiety is significantly impacting your life, consider seeking help from a mental health professional. They can provide a proper diagnosis and develop a treatment plan tailored to your needs. Medication may also be an option if your anxiety is severe.

7. Practice Self-Compassion: Be kind to yourself. Understand that it’s okay to feel anxious and that many people experience similar feelings. Acknowledging your feelings without judgment can help reduce their intensity.

8. Limit Caffeine and Sugar: Both can exacerbate anxiety symptoms. Consider reducing your intake to see if it helps with your overall anxiety levels.

9. Journaling: Writing down your thoughts and feelings can help you process your emotions and identify triggers for your anxiety. It can also serve as a tool for reflection and growth.

10. Set Realistic Goals: Instead of aiming for perfection in social situations, set achievable goals. For example, aim to speak to one new person each week or participate in a class discussion.

In conclusion, overcoming social anxiety is a gradual process that requires patience and practice. It’s important to remember that seeking help is a sign of strength, and there are effective treatments available. You deserve to feel comfortable and confident in social situations, and with the right support and strategies, you can work towards achieving that.

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