Social Anxiety Disorder Management

1) Challenge negative thoughts.

Source: http://www.bbncommunity.com

Step 1: Identify automatic negative thoughts.

• Negative thoughts that are triggered during social situations.
• Example: if you‘re worried about an upcoming work presentation, the underlying negative thought might be: “I’m going to blow it. Everyone will think I’m completely incompetent.”

Step 2: Analyze and challenge the negative thoughts

• Question your negative thoughts.
• Through logical evaluation of your negative thoughts, you can gradually replace them with more realistic and positive ways of looking at social situations.
• Example: “Do I know for sure that I’m going to blow the presentation?” or “Even if I’m nervous, will people necessarily think I’m incompetent?”

Step 3: Avoid cognitive errors.

1. Mind-reading: Assuming people know what you're thinking and that they are thinking negatively of you. 
2. Fortune telling: Predicting the future, usually while assuming the worst will happen. You just “know” that things will go horribly, so you’re already anxious before you’re even in the situation.
3. Catastrophizing: Blowing things out of proportion. If people notice that you’re nervous, it will be “awful,” “terrible,” or “disastrous.”
4. Personalizing: Assuming that people are focusing on you in a negative way or that what’s going on with other people has to do with you.

How can I stop thinking that everyone is looking at me?

In order to reduce self-focus, pay attention to what is happening around you, rather than monitoring yourself or focusing on symptoms of anxiety in your body:

• Look at other people and the surroundings.
• Really listen to what is being said (not to your own negative thoughts).
• Don't take all the responsibility for keeping conversations going—silence is okay, other people will contribute.

Adapted from: Moodjuice

2) Control Breathing

Source: Wehearit.com

Why breathing? 

• Many changes happen in your body when you become anxious. One of the first changes is that you begin to breathe quickly. 
• Overbreathing throws off the balance of oxygen and carbon dioxide in your body—leading to more physical symptoms of anxiety, such as dizziness, a feeling of suffocation, increased heart rate, and muscle tension. 
• Learning to slow your breathing down can help you bring your physical symptoms of anxiety back under control. Practicing the following breathing exercise will help you stay calm when you’re the center of attention.

Breathing exercises to help you keep your calm in social situations

1. Sit comfortably with your back straight and your shoulders relaxed. Put one hand on your chest and the other on your stomach.
2. Inhale slowly and deeply through your nose for four seconds. The hand on your stomach should rise, while the hand on your chest should move very little.
3. Hold the breath for two seconds.
4. Exhale slowly through your mouth for six seconds, pushing out as much air as you can. The hand on your stomach should move in as you exhale, but your other hand should move very little.
5. Continue to breathe in through your nose and out through your mouth. Focus on keeping a slow and steady breathing pattern of 4-in, 2-hold, and 6-out.

3) Face your fears.

Source: nonnetta.deviantart.com

Avoidance: Good or Bad?

• Avoiding social situations does more harm than good in the long run.
• Sure, in short-term it helps, buts its a ticking time bomb that accumulates inside of you and eventually; you'll implode. 
• The reason is, more you avoid, the more frightening it manifests into.
• Also, it prevents you form reaching your goals.

Create Exposure Hierarchy (Anxiety Ladder)

• Write down situations that cause you anxiety, in order of severity.
• List 10 anxiety-provoking situations, and rate them on a 100-point scale (zero being no anxiety; 100 being severe anxiety).
• Perform the easiest behavior, and keep moving up the list.

Working your way up the social phobia “anxiety ladder”

• Don’t try to face your biggest fear right away. It’s never a good idea to move too fast, take on too much, or force things. This will backfire and reinforce your anxiety.
• Be patient. Overcoming social anxiety takes time and practice. It’s a gradual step-by-step progress.
• Use the skills you’ve learned to stay calm, such as focusing on your breathing and challenging negative assumptions.

Create Objective Goals

• SADers tend to disqualify the positives when they feel anxious. 
• Might do great or seem normal in social situations but see their performance as abysmal. 
• Create objective goals when attempting to socialize or is to perform a social event. 
• Example: if you’re working in a group setting, the objective behavior would be to make three comments.
• Distracts mind: Focused on performance of actual behavior rather than being self-focused.
• Avoid focusing on other's behaviour: “You did what you wanted to in a situation. We can’t control what another person is going to do.”

Source: http://psychcentral.com/lib/6-ways-to-overcome-social-anxiety/

4) Build better relationship (interpersonal)

Source: www.500volunteers.com

• Take a social skills class or an assertiveness training class. These classes are often offered at local adult education centers or community colleges.
• Volunteer doing something you enjoy, such as walking dogs in a shelter, or stuffing envelopes for a campaign—anything that will give you an activity to focus on while you are also engaging with a small number of like-minded people.
• Work on your communication skills. Good relationships depend on clear, emotionally-intelligent communication. If you find that you have trouble connecting to others, learning the basic skills of emotional intelligence can help.

5) Change your lifestyle.

• Avoid or limit caffeine. Coffee, tea, caffeinated soda, energy drinks, and chocolate act as stimulants that increase anxiety symptoms.
• Drink only in moderation. You may be tempted to drink before a party or other social situation in order to calm your nerves, but alcohol increases your risk of having an anxiety attack.
• Quit smoking. Nicotine is a powerful stimulant. Smoking leads to higher, not lower, levels of anxiety.
• Get adequate sleep. When you’re sleep deprived, you’re more vulnerable to anxiety. Being well rested will help you stay calm in social situations.

*Note: Does not reduce anxiety, unless done with the other aforementioned treatment/managements.

6) Other interventions

If self-help fails, consider seeking professional. (also if you want to seek professional + selfhelp).

1. Cognitive Behavioral Therapy + Exposure Therapy.
2. Speech Therapy.
3. Group Therapy.
4. Medications. (Psychiatry).

Sources: http://www.helpguide.org/.

Introduction to Social Anxiety

What is social anxiety disorder (SAD)?

Credit: Maaike Verwijs

''The intense fear of certain social situations: especially situations that are unfamiliar or in which you feel you’ll be watched or evaluated by others.'' - Helpguide.org 

The main jizz of SAD is the fear of being: scrutinized, judged, embarrassed in public.
Afraid of peoples judgement and that you won't measure up in comparison to others.
Even though you probably realize that your fears of being judged are at least somewhat irrational and overblown, you still can’t help feeling anxious.

Symptoms of SAD.

Emotional: Excessive self-consciousness, intense worry for days/weeks/months for upcoming social situation, extreme fear of being watched/judged by others (esp. strangers), fear that you'll act in ways that would embarrass or humiliate yourself, and lastly fear that others will notice you're nervous.

Physical: Blushing, Shortness of breath, nausea, trembling, shaky voice, racing heart, tightness in chest, sweating, hot flashes, dizziness, sweaty palms, decreased saliva flow, chocking sensation, muscular tension, heaviness of bladder and constipation.

Behavioral: Avoiding social situations, staying quiet or hiding in background in order to escape notice, need to always bring buddy along wherever you go, drinking before social situations in order to soothe nerves.

The SAD Cycle

Source: http://tohno-chan.com/

Sources: Information (Helpguide.org).