Is My Struggle with Social Situations Social Anxiety Disorder?

Q: Is My Struggle with Social Situations Social Anxiety Disorder?

Hello, Caiyun： Based on your description, it seems that your nervousness and even physical discomfort when presenting or interacting with others may indicate a tendency towards social anxiety, although it may not necessarily reach the level of "social anxiety disorder." This requ

Do I have social anxiety disorder?

Hello, doctor.
I've been a slow-moving person since childhood, and my communication skills are poor, making social interactions quite challenging for me.
Whenever there are three or more people gathered, I hardly ever speak.
I experienced bullying during my school years, which may have contributed to my tendency to get nervous easily and fear losing control in various situations.
I also fear being the center of attention and being judged.
If I have to give a presentation, I can't sleep the night before and just want to finish and get off the stage as quickly as possible.
I've always had a tendency to have diarrhea, and it worsened after entering the workforce.
A gastroenterologist diagnosed me with irritable bowel syndrome, but the doctor merely advised me not to be so nervous, without addressing my situation.
Because of this, I try to avoid traveling far.
After entering the workforce, I haven't made new friends, so I usually engage in activities alone.
Gradually, I've noticed that I avoid others' gazes; I used to be able to shop alone, but now I often feel that people around me are hostile and want to harm me.
I also feel like I'm on the verge of breaking down and losing control.
There have been several instances where I suddenly had difficulty breathing and wanted to escape home immediately.
I always thought that growing up and being in society would naturally improve my situation, but it hasn't gotten better.
I've tried to join gatherings based on my interests, but due to my fear of speaking, I haven't pursued them further, let alone activities aimed at socializing.
My friends from school have gradually drifted apart due to different social circles, making it even harder to meet up, and my social situation is worse than before.
I feel like I might have to live like this for the rest of my life.
Moreover, even now, my mom often complains about why I am so nervous when doing things and that I still seem clumsy at my age.
I feel very wronged; none of this is how I want to be, and it seems like my mom is blaming me.
I've read some psychology books that teach abdominal breathing and relaxation techniques, but when I'm panicking, my mind goes blank, and it's hard to remember to use those techniques.
At work, I often feel that my supervisor and colleagues are taking advantage of me due to my uneven work-life balance, so I frequently hide in the restroom to calm down, fearing that I might break down emotionally in front of my colleagues.
I've researched social anxiety disorder online, and it seems somewhat similar to my situation, but I can still go out alone as long as it's not too far from home, and I can manage talking to convenience store clerks.
However, I get more anxious in situations that require more interaction, like speaking to restaurant staff.
Given my situation, do you think I have social anxiety disorder, or is it just a personality issue? Would seeing a psychiatrist or undergoing psychological counseling be helpful? Thank you.

Cai Yun, 30~39 year old female. Ask Date: 2017/11/15

Dr. Wang Yazhen reply Psychiatry

Hello, Caiyun: Based on your description, it seems that your nervousness and even physical discomfort when presenting or interacting with others may indicate a tendency towards social anxiety, although it may not necessarily reach the level of "social anxiety disorder." This requires evaluation and diagnosis by a physician.
Perhaps your past experiences and current limitations have made you more prone to worry about others' reactions to you, leading to negative feelings that cause you distress.
I recommend that you first seek an evaluation from a psychiatrist to determine if your symptoms meet the criteria for an anxiety disorder, and discuss with the physician whether medication could help alleviate some of your concerns.
I also strongly suggest considering psychological therapy, particularly cognitive-behavioral therapy, to help you cope with anxiety and stress.
Thank you!

Reply Date: 2017/11/15

More Info

Based on your description, it sounds like you are experiencing significant challenges related to social interactions, which may indeed align with symptoms of Social Anxiety Disorder (SAD). Social Anxiety Disorder is characterized by an intense fear of social situations where one might be judged, embarrassed, or scrutinized by others. This fear can lead to avoidance behaviors and significant distress, impacting daily functioning and quality of life.

Your history of being bullied during school, coupled with your ongoing anxiety in social situations, suggests that your struggles may not merely be personality traits but rather a recognized psychological condition. The physical symptoms you describe, such as gastrointestinal issues and panic-like symptoms (e.g., difficulty breathing, feeling overwhelmed), are also common in individuals with social anxiety. These symptoms can be exacerbated by the anticipation of social interactions, leading to a cycle of anxiety and avoidance.

It's important to note that while some individuals may experience mild social discomfort, those with Social Anxiety Disorder often find that their fear is disproportionate to the actual threat posed by social situations. The fact that you feel intense anxiety about speaking in groups, fear being judged, and experience physical symptoms like breathlessness indicates that your anxiety is affecting your life significantly.

In terms of treatment, both psychotherapy and medication can be effective for Social Anxiety Disorder. Cognitive Behavioral Therapy (CBT) is particularly beneficial, as it helps individuals challenge and reframe negative thoughts about social situations and gradually face their fears in a controlled manner. Exposure therapy, a component of CBT, involves gradually exposing oneself to feared social situations to reduce anxiety over time.

Medication, such as selective serotonin reuptake inhibitors (SSRIs) or beta-blockers, can also be prescribed to help manage symptoms. SSRIs can help alleviate the overall anxiety, while beta-blockers may help with the physical symptoms of anxiety, such as rapid heartbeat and shaking, particularly in performance situations.

Regarding your concerns about whether to seek help from a psychiatrist or psychologist, it is advisable to consult a mental health professional. They can provide a comprehensive assessment and help determine the best course of action for your specific situation. Many people find that therapy can provide them with coping strategies and tools to manage their anxiety more effectively.

As for your feelings of inadequacy and frustration, it's essential to recognize that these feelings are valid and common among those dealing with social anxiety. It may also be helpful to communicate with your family about your struggles, as their understanding and support can be crucial in your recovery journey. However, this decision should be made based on your comfort level and readiness.

In summary, your experiences suggest that you may be dealing with Social Anxiety Disorder rather than just personality traits. Seeking professional help through therapy or medication can provide you with the support and strategies needed to manage your anxiety and improve your quality of life. Remember, you are not alone in this struggle, and there are effective treatments available to help you navigate your challenges.

Similar Q&A

Do I Have Social Anxiety? Recognizing Symptoms and Seeking Help

Hello: These issues have been troubling me for a long time! I suspect that I have social anxiety disorder. Since middle school, I have rarely talked to classmates at school, sometimes going an entire day without speaking to anyone, because I always feel that what I say will be di...

Dr. Ding Shuyan reply Psychiatry
Hello, based on your description, it does sound somewhat similar. However, the internet is not suitable for diagnosing medical conditions; it would be more accurate for you to see a doctor. In fact, many people experience what you described, just to varying degrees, and it often ...

Overcoming Social Anxiety: Seeking Help and Finding Solutions

Hello Dr. Chen: As the title suggests, I believe I have social anxiety disorder. I have listed my symptoms and examples... 1. I am hesitant to go shopping alone because I have to speak to the store staff; even ordering food is difficult for me to initiate. 2. I am very afraid of ...

Dr. Chen Wenyu reply Psychiatry
Hello, Xiao Pang: Some anticipated anxiety and negative thinking may appear to others as "overthinking." In fact, the individual often knows they are overthinking, but how can they stop themselves from doing so? In your case, social anxiety disorder involves not only an...

Understanding Social Anxiety: Overcoming Challenges in Social Situations

Hello, doctor. I apologize if my question seems a bit strange. I have been introverted and quiet since childhood. I can interact normally with my family, but at school, I hardly speak—usually only responding or nodding, and I rarely say more than ten sentences from kindergarten t...

Dr. Liang Sunyuan reply Psychiatry
Hello, Bao Bao: Your situation may indicate a social anxiety response, but you can still continue to engage in social activities, which shows that there is no significant impact on your social functioning. Laughing occasionally during games is perfectly fine as long as your frien...

Is It Social Anxiety or Just My Personality?

Since entering the workforce, I have mostly worked alone in a retail environment. Due to long working hours, I have few friends aside from my family, but I have no issues interacting with customers. Recently, I have noticed a strong aversion to interacting with people outside of ...

Dr. Wu Menghuan reply Psychiatry
Hello: Everyone has a different personality; some people are naturally extroverted, enjoy meeting new friends, and thrive on social interactions, while others are more introverted and prefer solitude. "Anxiety" is a common experience for everyone. When we face uncertain...