Do I Need to See a Doctor for My Social Anxiety?

Do I need to see a doctor?

Hello Doctor: Since I was in first grade, I have had a fear of unfamiliar environments, often taking several months to adapt.
I constantly worry that others will dislike or exclude me.
Whenever I hear about group activities, my fear intensifies.
This issue has persisted through every educational stage, from elementary school to vocational school.
In junior high, due to my fear of unfamiliar environments, it took me a considerable amount of time to start talking to my classmates.
Not long after, I became a target for the teacher's frustrations due to my academic struggles, often being called out of class for punishment, which led to ridicule from male classmates.
Additionally, since I was studying in a different district, I had very few close female friends in class.
By the third year, when it was time for the graduation trip, no one wanted to sit with me, and I often made excuses to take leave to avoid these situations.
Once I entered high school, it took me another two to three months to say my first word to a classmate.
Since I attended an all-girls school, the issue of cliques became even more pronounced.
To prevent a repeat of my junior high experiences, I tried hard to please others.
However, by the second year, a well-liked classmate inexplicably joined others in excluding me.
I even suggested to my parents that I should drop out, but they refused, so I reluctantly continued my studies.
After the third year, a few classmates began to talk to me and consider me a good friend, which significantly improved my situation.
After graduation, due to retaking exams, I ended up working with my classmates while attending tutoring classes.
Initially, things went well, but after a few months, I had a falling out with a classmate, and with the instigation of other part-time workers, our relationship deteriorated further.
I barely spoke at work, and this continued until we were accepted into vocational school.
After finally getting into a night program, it still took me a long time to engage with other students.
I thought I could have a normal experience in night school, but by the second year, a classmate accused me of speaking ill of him, leading several classmates who were previously friendly with me to exclude me again.
I found myself living alone once more, and even during group projects for our graduation thesis, no one wanted to work with me.
Eventually, I had to muster the courage to ask a group leader to let me join their group to resolve the issue.
In the second semester, my classmates realized I was not the person that classmate had described, and our friendships began to rebuild until graduation! After graduating, I either couldn't find a job or, when I finally did, I was let go shortly after because the company deemed me unsuitable.
I have had interpersonal issues since childhood, making it difficult for me to feel comfortable in any new job.
With multiple terminations, I fear my parents' criticism and the judgment of neighbors, so I sought work as a technician in a factory, unwilling to return to a corporate environment.
However, most factory technicians have only completed high school, and as someone with a vocational degree in information management, I often face comments like, "Why are you doing this job?" or "You should go back to the company and not compete with us for jobs."
It has been over three years since I graduated, and I spend more time at home than working outside.
My parents believe I am just too lazy to look for a job.
Whether I am walking outside or in a company, I feel like everyone is watching me, making me very uncomfortable.
Every time I start at a new company, I hesitate to move around, even avoiding meals or trips to the restroom! I am afraid to go shopping alone and only choose to go out when there are fewer people.
However, at home, I feel a sense of ease.
I am very distressed and do not know what to do.
My family keeps urging me to find a new job.
Could you please advise me on how I can overcome these obstacles? Thank you!

winney, 20~29 year old female. Ask Date: 2006/06/28

Dr. Su Zongwei reply Psychiatry

The interpersonal relationship issues you are facing have accumulated over many years and cannot be changed in just a few outpatient visits.
It may require psychological therapy or counseling, which can take 2-3 years or even longer to gradually improve.
Patience is essential.
You can start by consulting a psychiatrist for evaluation and then arrange for further psychological treatment.
Thank you.

Reply Date: 2006/06/28

More Info

It sounds like you are experiencing significant social anxiety, which has been affecting your life for many years. Your feelings of fear and discomfort in social situations, as well as the fear of judgment from others, are common symptoms of social anxiety disorder (SAD). It's important to recognize that you are not alone in this struggle, and many people face similar challenges.

First and foremost, seeking help from a mental health professional, such as a psychologist or psychiatrist, can be a crucial step in addressing your social anxiety. While it may feel daunting to reach out for help, professionals are trained to understand and treat these issues without judgment. They can provide you with coping strategies, therapeutic techniques, and, if necessary, medication to help manage your symptoms. Cognitive-behavioral therapy (CBT) is particularly effective for social anxiety, as it focuses on changing negative thought patterns and behaviors associated with anxiety.

You mentioned feeling uncomfortable in new environments and fearing that others will dislike or exclude you. These thoughts can create a cycle of anxiety that makes it even harder to engage with others. A therapist can help you challenge these thoughts and develop a more realistic perspective on social interactions. They can also guide you through exposure therapy, which involves gradually facing your fears in a controlled manner, helping you build confidence over time.

In addition to professional help, there are self-help strategies you can incorporate into your daily life. Here are a few suggestions:
1. Practice Mindfulness and Relaxation Techniques: Mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help reduce anxiety symptoms. These techniques can ground you in the present moment and help you manage overwhelming feelings.

2. Set Small, Achievable Goals: Start with small social interactions that feel manageable. This could be as simple as saying hello to a neighbor or making small talk with a cashier. Gradually increase the complexity of these interactions as you become more comfortable.

3. Challenge Negative Thoughts: When you notice negative thoughts about social situations, try to challenge them. Ask yourself if there is evidence to support these thoughts or if they are based on assumptions. Replacing negative thoughts with more positive or realistic ones can help reduce anxiety.

4. Join Support Groups: Connecting with others who experience similar challenges can provide a sense of community and understanding. Support groups, whether in-person or online, can offer a safe space to share experiences and coping strategies.

5. Educate Yourself: Understanding social anxiety can empower you to manage it better. Reading books or articles on the topic can provide insights and strategies that resonate with your experiences.

6. Limit Avoidance Behaviors: While it may feel comfortable to avoid social situations, this can reinforce anxiety in the long run. Gradually exposing yourself to social settings, even if it feels uncomfortable, can help desensitize you to the fear.

7. Communicate with Family: It may be helpful to have an open conversation with your family about your struggles. Educating them about social anxiety can foster understanding and support, which may alleviate some pressure you feel from their expectations.

In conclusion, while it may feel overwhelming, seeking help from a mental health professional is a vital step in addressing your social anxiety. Remember that you are not alone, and there are effective treatments available. With time, effort, and the right support, it is possible to overcome the barriers that social anxiety has created in your life. Don't hesitate to reach out for help; taking that first step can lead to significant positive changes.

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