Social Anxiety Disorder
Hello, doctor.
I've noticed that I start feeling very anxious a week before I have to give a presentation, and it even affects my sleep.
I'm really afraid of speaking in front of others, and I know that this anxiety is an overreaction.
I believe it may be related to my experiences of being bullied in elementary school.
I have sought counseling from a school psychologist, but when I talk to strangers, my mind goes blank, and I don't know what to say.
I feel pressured to attend counseling, so I canceled after going once or twice.
Last semester, I dropped a course that required presentations, but I will encounter more courses that require me to present in the future, and I don't know what to do.
I've already tried diaphragmatic breathing and practiced multiple times before presenting, but my anxiety has not improved.
Fina, 10~19 year old female. Ask Date: 2021/06/09
Dr. Lin Mianzhang reply Psychiatry
Hello Fina: It's completely normal to feel nervous before going on stage; most people experience this to varying degrees.
However, if you find yourself feeling anxious starting a week prior, to the point that it affects your sleep, I would recommend seeking help from a psychiatrist to discuss ways to improve this situation.
Generally, if you only feel nervous right before a presentation and your mood is stable otherwise, the doctor may prescribe you a medication to take as needed before your performance, which can help you feel calmer while presenting.
However, if you tend to feel anxious regularly, additional medications or psychological therapy may be necessary to assist you.
Wishing you a speedy recovery!
Reply Date: 2021/06/09
More Info
Overcoming social anxiety, particularly in the context of public speaking, can be a significant challenge for many individuals. Your experience of heightened anxiety leading up to presentations, coupled with the impact on your sleep and the feelings of pressure during counseling sessions, is not uncommon among those who struggle with social anxiety disorder (SAD). It’s commendable that you are seeking help and looking for strategies to manage your anxiety.
Understanding Social Anxiety
Social anxiety disorder is characterized by an intense fear of social situations where one may be judged, embarrassed, or scrutinized by others. This fear can manifest in various ways, including physical symptoms like sweating, trembling, and a racing heart, as well as cognitive symptoms such as negative thoughts and self-doubt. Your mention of past bullying experiences may also play a role in your current anxiety, as such experiences can contribute to a lasting fear of social interactions.
Strategies for Overcoming Public Speaking Anxiety
1. Gradual Exposure: One effective method for overcoming social anxiety is gradual exposure. Start by practicing speaking in low-pressure environments. This could involve speaking in front of a mirror, recording yourself, or presenting to a small group of friends or family. Gradually increase the size of your audience as you become more comfortable.
2. Cognitive Behavioral Therapy (CBT): Since you have already sought counseling, consider focusing on CBT techniques. CBT helps individuals identify and challenge negative thought patterns. For instance, if you think, "I will embarrass myself," try to reframe it to, "I might feel nervous, but I can manage it." Working with a therapist who specializes in CBT can provide you with structured guidance.
3. Mindfulness and Relaxation Techniques: While you mentioned trying abdominal breathing, incorporating mindfulness practices can also be beneficial. Mindfulness helps you stay present and reduces anxiety by focusing your attention on the moment rather than on potential negative outcomes. Techniques such as meditation, progressive muscle relaxation, or yoga can help calm your mind and body.
4. Visualization: Before your presentation, visualize yourself succeeding. Picture the audience responding positively, and imagine yourself speaking confidently. This mental rehearsal can help reduce anxiety and improve your performance.
5. Practice, Practice, Practice: The more you practice, the more comfortable you will become. Rehearse your presentation multiple times, and if possible, do it in the actual space where you will be speaking. Familiarity with the environment can reduce anxiety.
6. Seek Support: If you find it challenging to engage with a therapist, consider joining a support group for individuals with social anxiety. Sharing experiences with others who understand your struggles can provide comfort and encouragement.
7. Professional Help: If your anxiety continues to interfere with your daily life and academic performance, it may be beneficial to seek a mental health professional who specializes in anxiety disorders. They can provide tailored strategies and possibly recommend medication if appropriate.
8. Focus on the Message, Not the Audience: Shift your focus from how you are perceived to the message you want to convey. Concentrating on the content of your presentation can help alleviate some of the pressure you feel about being judged.
Conclusion
Overcoming social anxiety, especially in public speaking situations, is a journey that requires patience and persistence. It’s important to acknowledge your progress, no matter how small, and to be kind to yourself throughout this process. Remember that many people experience similar fears, and with the right strategies and support, you can learn to manage your anxiety effectively. If you continue to struggle, don’t hesitate to reach out for professional help, as they can provide you with the tools necessary to succeed.
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