Suffering From Social Anxiety? 3 Ways To Cope

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Everyone, even natural-born extroverts, feels shy once in a while; in fact, 90 percent of people will describe themselves as shy at some point during their lives. But there's a world of difference between shyness and introversion, and yet another distinction to be made between introverts and those who suffer from social anxiety.

Society anxiety is the third most common psychological disorder, after depression and alcoholism. It affects 13 percent of the population and can be triggered by social interactions ranging from simply meeting someone else's eyes to being the center of attention. As with any type of anxiety attack, the emotional and physiological symptoms can include fear, nervousness, a racing heart, sweating, dry throat and mouth, and even muscle twitches and dysmorphia—but intense anxiety is the most common symptom.

Telling someone with social anxiety to "just relax and enjoy yourself" is like telling someone suffering from clinical depression to "just snap out of it." From their perspective, a party is essentially a minefield.

That's not to say, however, that social anxiety is immutable—though introversion is, according to Arnie Kozak, Ph.D., a licensed psychologist, clinical assistant professor of psychiatry at the University of Vermont College of Medicine, and author of The Awakened Introvert: Practical Mindfulness Skills to Help Maximize Your Strengths & Thrive in a Loud & Crazy World.

"Introversion is a basic dimension of personality and cannot be changed," says Kozak. "Social anxiety is a condition that arises from learning, self-applied pressures for performance in social situations, and perhaps a genetic predisposition. Social anxiety can be changed."

Kozak says comfort in social situations is only one of many aspects of introversion, and introverts might land anywhere along a continuum from very comfortable to very uncomfortable in this arena. "For some, this discomfort arises from the overstimulation in social gatherings," he says. "For others—those with social anxiety—the discomfort arises from the fear of being seen and judged."

Here are three ways to address social anxiety—whether or not you consider yourself an introvert:

1. Cognitive-behavioral therapy

In terms of therapeutic approaches, cognitive-behavioral therapy (CBT) is "the treatment of choice for social anxiety," says Kozak. He says the advantage of CBT is its ability to prompt people with social anxiety to notice and challenge the difficult thoughts that arise in such situations.

Michel Mennesson, M.D., a psychiatrist at Newport Academy, cites CBT as one of his preferred methods for treating adolescent anxiety—whether or not it's catalyzed by social interactions. "When a teenager has distorted self-perception, such as perceiving themselves as being unlikable or unlovable, or having significant body image issues,"—which can catalyze social anxiety—"CBT can be used to address these distorted beliefs," Mennesson says.

2. Breath regulation

Barbara Nosal, MFT, LADC, executive director of Clinical Services at Newport Academy, finds the breath to be a perennially powerful tool in the face of anxiety. "Concentrating on the breath helps you become centered in the present moment," she says, as well as providing a host of benefits for both mind and body. Slowing and deepening the breath activates the nervous system's relaxation response, slowing the heart rate and increasing oxygen intake and circulation—which, in turn, increase calmness and clarity. Over time, conscious regulation of the breath has been shown to improve heart-rate variability, a biological measure of stress resilience.

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3. Mindfulness

Bringing nonjudgmental attention to one's thoughts and sensations is an especially effective tool for riding the emotional wave precipitated by social anxiety. "With mindfulness, introverts with social anxiety can learn to observe their experience without reacting to it in a way that makes it worse," Kozak says.

"They can feel the arising of heat, pressure, and tension in the body and bring their attention to rest in the body and on their breath. This helps to take attention away from maladaptive thoughts about how they are going to be embarrassed, and so forth." Mindfulness practice can be helpful in both creating calm before a challenging event or encounter and restoring equilibrium afterward, Kozak says.

While the tendency to gravitate toward social situations might never come naturally to some, the ability to enjoy them—or to experience them as simply neutral—can be cultivated over time. You don't have to be the life of the party to thrive at the party.

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