Overcoming Social Anxiety: A Journey from Self-Doubt to Healing - Psychiatry

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Overcoming social anxiety can be a challenging journey, especially when it feels like your body is reacting in ways that you cannot control. From your description, it seems that your anxiety has persisted even after the physical issues that contributed to it, such as acne, have resolved. This is not uncommon; social anxiety often has deep psychological roots that can persist long after the original triggers have been addressed.


Understanding Social Anxiety
Social anxiety disorder (SAD) 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, which can further exacerbate feelings of isolation and self-doubt. The physical symptoms you experience—such as increased heart rate, sweating, or shaking—are common physiological responses to anxiety, often referred to as the "fight or flight" response.

Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is one of the most effective treatments for social anxiety. It focuses on identifying and changing negative thought patterns that contribute to anxiety. Here are some steps you can take to analyze your automatic thoughts and work towards overcoming your social anxiety:
1. Identify Automatic Thoughts: Start by keeping a journal where you note situations that trigger your anxiety. Write down the thoughts that come to mind in those moments. For example, if you feel anxious when someone approaches you, your automatic thought might be, "They are judging me."
2. Challenge Negative Beliefs: Once you identify these thoughts, challenge their validity. Ask yourself questions like, "What evidence do I have that supports this thought?" or "What evidence contradicts it?" This can help you see that your fears may not be as grounded in reality as they seem.

3. Find Core Beliefs: Core beliefs are the underlying assumptions you hold about yourself and the world. They often stem from past experiences and can be deeply ingrained. Reflect on your childhood and adolescence to identify any negative beliefs you may have developed, such as "I am unworthy" or "I will always be rejected."
4. Use Dynamic Psychology: Dynamic psychology, particularly the Core Conflictual Relationship Theme (CCRT) model, can help you understand how your past relationships influence your current feelings and behaviors. Consider how your interactions with significant figures in your life (like parents or peers) may have shaped your self-image and social fears.

5. Gradual Exposure: Gradual exposure to social situations can help desensitize you to your fears. Start with less intimidating scenarios and gradually work your way up to more challenging situations. This could involve practicing small talk with a cashier or joining a small group discussion.

6. Mindfulness and Relaxation Techniques: Incorporate mindfulness practices, such as deep breathing or meditation, to help manage anxiety symptoms in the moment. These techniques can help ground you and reduce the physiological symptoms of anxiety.


Seeking Professional Help
While self-help strategies can be beneficial, working with a mental health professional can provide you with tailored support. A therapist can guide you through the CBT process, help you explore deeper issues, and provide a safe space to express your feelings. If you haven’t already, consider reaching out to a psychologist or psychiatrist who specializes in anxiety disorders.


Medication
In some cases, medication may be necessary to help manage symptoms. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are commonly prescribed for social anxiety. Discussing this option with a psychiatrist can help you determine if it’s appropriate for your situation.


Conclusion
Overcoming social anxiety is a journey that requires patience and persistence. It’s important to remember that you are not alone in this struggle, and many people experience similar feelings. By actively working on your thoughts and seeking professional help, you can gradually reclaim your confidence and improve your social interactions. Remember, healing is a process, and it’s okay to take small steps towards your goals.