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Most of us would admit to feeling shy from time to time, or anxious about public speaking: the larger the crowd the greater the terror. It’s also not unusual to feel awkward while making small talk with unfamiliar (or uninteresting) people. But a significant number of people find these situations utterly mortifying.
Social anxiety disorder (or SAD) is diagnosed when the fear of criticism or rejection by others becomes chronic and debilitating. People with SAD see themselves as incompetent and inferior, and others as judgemental and hostile. They believe they will be rejected when others see how anxious and awkward they are, or hear the stupid or boring things they say.
While criticism is an occasional and unpleasant part of life for most of us, people with SAD believe they will be criticised and rejected virtually every time they are around other people. They also believe that there is a high personal cost to being criticised – if others criticise me then I am a failure.
SAD dictates what courses can be studied (those that don’t require speaking in front of the class), what jobs can be applied for (able to be done alone and preferably from home), what hobbies can be engaged in (solitary ones), and who fits the bill as a potential life partner (those not requiring a chaperone to parties and work functions).
Without a strong sense of self (who I am) and self-acceptance (I am worthwhile, even with all my foibles) it is exceedingly difficult to express our preferences and get our needs met by others. Unsatisfying relationships with domineering friends and partners are therefore common for people with SAD. Low self-esteem, social isolation and depression can follow.
In some ways, the digital age makes life easier for people with SAD. A full day’s work can be done online without seeing another person. Social media create the illusion of friendship with just a few simple clicks. But the very human need for genuine connection remains unmet.
What are the symptoms?
Sweating, blushing, heart palpitations, trembling and an urge to escape are common physical symptoms of social anxiety. People with SAD become highly self-conscious and imagine that others can clearly see these signs of anxiety. They expect to be judged as weak and incompetent as a consequence.
Avoidance is the most popular strategy for managing social anxiety. That prevents any possibility of being criticised but also robs sufferers from discovering that criticism is far less likely (and less traumatic) than expected.
When social situations can’t be avoided more subtle ways of trying to prevent criticism are relied upon, such as using alcohol as a social lubricant, mentally rehearsing conversations, or staying quiet. But these strategies can backfire and actually cause the criticism they were trying to prevent.
How common is SAD?
The most recent Australian National Survey of Mental Health and Wellbeing found that 8.4% of adults will meet criteria for SAD in their lifetime. That’s one in 12, or around 1.3 million Australians.
Yet sufferers believe they are alone. Shame prevents people from discussing their fears, which reinforces the sense of isolation.