Social Anxiety: Seeking Professional Guidance

Social Anxiety Disorder: Request for Doctor's Assessment

Hello, doctor.
Actually, I've been thinking about this issue since middle school.
Ever since I was bullied back then, I feel an inexplicable fear or anxiety when I see strangers, making it difficult for me to engage in conversation with them.
However, after making some good friends in high school, the situation improved significantly.
I still often find myself unsure of what to say during conversations.
Once I entered college, the new environment triggered various feelings of unease.
When I see my classmates, I constantly feel anxious about how to talk to them, thinking they look intimidating, and worrying about whether I might get hurt.
Many times, I feel so anxious that I give up on getting to know them.
Sometimes, I muster the courage to talk to someone, but during the conversation, I often say the wrong things, feel extremely nervous, and don’t know how to continue.
I tend to shrink back and often go off-topic.
When I realize I’ve made a mistake or stumbled over my words, I just want to quickly abandon the conversation and leave the situation.
Sometimes, when I have to give a presentation, I try to be funny, even though I’m so nervous that my face turns red and I feel disoriented.
I do my best to end the presentation on a humorous note.
I often wonder if I’m really just being foolish or if I’m intentionally portraying myself as foolish.
There have been times when I’ve questioned what my personality is really like, feeling so anxious that I cry.
For a period, I felt like I wasn’t myself anymore.
Eventually, I couldn’t bear these feelings any longer, so I searched online for information about these symptoms and found this specialty.
I would like to ask the doctor a few questions: 1.
Am I overthinking this, and I don’t have any illness at all? Or do I actually have a condition that I’m unaware of? 2.
If it is indeed a condition, does it require treatment? If I don’t seek treatment, will the situation worsen?

Wayne, 10~19 year old female. Ask Date: 2017/09/27

Dr. Wang Yazhen reply Psychiatry

Hello Wayne, based on your description, it closely aligns with the symptoms of social anxiety disorder.
Indeed, this social anxiety can be triggered by experiences of bullying.
Given that you are troubled by this condition, I recommend seeking an evaluation from a psychiatrist to discuss a diagnosis and whether medication might be used to alleviate your anxiety, or if cognitive behavioral therapy could help improve your anxiety symptoms.
You may choose one approach or a combination of both.
As for the question of whether it will worsen, it is difficult to answer as it varies from person to person.
Thank you!

Reply Date: 2017/09/27

More Info

Social anxiety disorder (SAD) is a common mental health condition characterized by an intense fear of social situations where one may be scrutinized or judged by others. Your experiences, including feelings of fear and nervousness around strangers, difficulty in conversations, and the tendency to avoid social interactions, are indicative of this disorder. It’s important to understand that you are not alone in this struggle, and many individuals face similar challenges.

Understanding Your Condition
1. Self-Perception and Anxiety: Your concern about how you come across to others and the fear of making mistakes in conversations are typical symptoms of social anxiety. This disorder often leads individuals to engage in negative self-talk and irrational thoughts, such as believing that others are constantly judging them. These thoughts can create a cycle of anxiety that reinforces the fear of social interactions.

2. Impact of Past Experiences: The bullying you experienced in middle school likely contributed to your current feelings of anxiety. Traumatic experiences can significantly affect self-esteem and social confidence, leading to heightened sensitivity in social situations. It’s not uncommon for individuals with a history of bullying to develop social anxiety, as they may internalize negative beliefs about themselves.

Seeking Professional Guidance
1. Diagnosis: It’s crucial to seek a professional evaluation from a mental health provider. They can help determine whether you have social anxiety disorder or if your symptoms are related to other issues. A thorough assessment typically involves discussing your symptoms, their duration, and their impact on your daily life.

2. Treatment Options: If diagnosed with social anxiety disorder, treatment is highly recommended. Cognitive-behavioral therapy (CBT) is one of the most effective treatments for SAD. CBT focuses on identifying and challenging negative thought patterns and gradually exposing individuals to feared social situations in a controlled manner. This process can help reduce anxiety over time.

3. Medication: In some cases, medication may be prescribed to help manage symptoms. Selective serotonin reuptake inhibitors (SSRIs) and other anti-anxiety medications can be effective in reducing anxiety levels. However, medication is often most effective when combined with therapy.

Addressing Your Concerns
1. Am I Overthinking?: It’s common for individuals with social anxiety to feel that they are overthinking situations. However, your feelings are valid, and they indicate that you may be experiencing a mental health condition. Recognizing that your anxiety is not simply a character flaw but a treatable condition is an important step.

2. Will It Get Worse?: Without treatment, social anxiety can worsen over time. Avoidance behaviors may increase, leading to more significant difficulties in social and occupational functioning. Seeking help early can prevent the escalation of symptoms and improve your quality of life.

Moving Forward
1. Finding Support: Consider reaching out to a mental health professional who specializes in anxiety disorders. They can provide you with the tools and strategies needed to manage your symptoms effectively. Support groups can also be beneficial, as they provide a safe space to share experiences and learn from others facing similar challenges.

2. Self-Help Strategies: In addition to professional treatment, there are self-help strategies you can implement. Practicing mindfulness and relaxation techniques can help reduce anxiety in the moment. Journaling your thoughts and feelings can also provide insight into your triggers and help you process your emotions.

3. Gradual Exposure: Start small by gradually exposing yourself to social situations that cause anxiety. This could be as simple as initiating a conversation with a classmate or participating in a group discussion. Celebrate small victories to build confidence over time.

In conclusion, it’s essential to acknowledge your feelings and seek the appropriate support. Social anxiety disorder is a treatable condition, and with the right guidance and strategies, you can learn to manage your symptoms and improve your social interactions. Remember, you are not alone in this journey, and help is available.

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