Tag Archives: Social Anxiety Disorder

Don’t confuse social anxiety with being an introvert.

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Anxious woman

Social Anxiety
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Don’t confuse social anxiety with being an introvert.

By David Joel Miller, MS, Licensed Therapist & Counselor.

Having social anxiety does not make you an introvert.

Many people seem to be mistaking social anxiety for being an introvert. Several people have told me they think they are introverts because they are shy and anxious in social settings. I believe their problems are much more likely to be social anxiety than to be happening because they are introverts.

Social anxiety is a whole other thing. It’s my belief that social anxiety can occur in people who are introverts or extroverts with similar frequency. Let’s look at the difference between introverts and extroverts and what qualifies someone as socially anxious.

What’s the difference between being an introvert and an extrovert?

Introversion and extroversion are concepts from psychology. As with many traits that psychology attempts to measure, they exist on a continuum. Some people are incredibly introverted, some only a little, some are mildly extroverted, and others extremely extroverted.

A simple definition of the difference between introversion and extroversion is what activity energizes you. Introverts are energized by their time alone. While they may occasionally like socializing and may even have many friends, a real introvert needs time alone regularly to think, relax, and prepare for their next social activity.

Introverts are drawn to occupations where they work alone. They are much happier in their little cubicle than in a noisy, crowded situation.

Extroverts are energized by the time they spend with others. While they can tolerate small periods alone, extroverts, by their nature, are constantly seeking out others. Their time with groups interacting with others energizes them and is a part of having a flourishing life.

Some people are Ambiverts.

There are a lot of people who are in the middle between introverts and extroverts. The people who like a happy balance between their time alone and their time with others. I see more and more authors calling this substantial number of people who lie toward the middle of the continuum of introversion and extroversion Ambiverts.

Often, but not always, performers are extroverts. Many musicians love the opportunity to do a live show. Some of their most outstanding work is done while performing in front of a large audience. Cheers and applause give their lives meaning and purpose.

Occasionally, you’ll encounter a performer who has studied extensively and developed their talent, either as a musician, a singer, or some other specialty, and who becomes extremely anxious before each performance. While their talent may bring them praise and success, they dread those times when they must appear live on stage.

Being socially anxious has specific characteristics.

According to the latest copy of the diagnostic and statistical manual, the DSM-V TR, there are 6 specific characteristics of social anxiety. This book also includes a description of 5 other things that have to be ruled out to ensure that the person’s problems are actually caused by social anxiety and not something else. Diagnosing and treating social anxiety is a specialized area. Social anxiety may also look different in children than it does in adults. Please look at some of the other posts I’ve written on anxiety disorders. Here are some of the high points.

Being socially anxious is the fear of being negatively evaluated.

People with social anxiety are afraid of what other people may think of them, and they are terrified of being evaluated when they must interact with others. Something as simple as having a conversation, meeting new and unfamiliar people, or being watched while eating or drinking can be overwhelming for people with social anxiety.

Many people with social anxiety want to be more outgoing and have more friends. Socially anxious people are frequently lonely and wish they had more human contact. While introverts may have many friends, they just value their alone time. On the other hand, socially anxious people may desperately want to make new friends but are terrified that the other person will evaluate them negatively.

One of the great fears of the socially anxious is that their anxiety symptoms will show, and then they will be judged for being anxious. Their fear of being embarrassed or humiliated leads them to avoid others and to be extremely sensitive to the threat of rejection. Socially anxious people fear doing things or saying things that might offend others.

People with social anxiety almost always experience fear and anxiety in a variety of social situations.

There are treatments for social anxiety.

While being an introvert or an extrovert is a personality characteristic, there is no right or wrong way to be. Therapy can help overcome social anxiety. If you’re an introvert, enjoy your time alone, but try to balance it with time with family and friends. But if you’re socially anxious, get help to overcome this debilitating disorder.

Does David Joel Miller see clients for counseling and coaching?

Yes, I do. I can see private pay clients if they live in California, where I am licensed. If you’re interested in information about that, please email me or use the contact me form.

Recently, I began working with a telehealth company called Grow Therapy. If you’d like to make an appointment to work with me, contact them, and they can do the required paperwork and show you my available appointments. The link for making an appointment to talk with me is David Joel Miller, LMFT, LPCC. 

Life coaching clients must be working toward a specific problem-solving goal. Coaching is not appropriate if you have a diagnosable mental health problem. Also, life coaching is not covered by insurance. If you think coaching for creativity or other life goals might be right for you, contact me directly.

Staying in touch with David Joel Miller.

Want the latest blog posts as they are published? Subscribe to this blog.

For more information about my writing journey, my books, and other creative activities, please subscribe to my blog at davidjoelmillerwriter.com

Seven David Joel Miller Books are available on Amazon now! And more are on the way.

For more about my books, please visit my Amazon Author Page – David Joel Miller.

For information about my work in mental health, substance abuse, and having a happy life, please check out https://counselorssoapbox.com

For videos, see Counselorssoapbox YouTube Video Channel

What is Social Anxiety Disorder (Social Phobia.)

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By David Joel Miller.

What is

What is Social Anxiety Disorder (Social Phobia.)
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Social Anxiety Disorder (Social Phobia.) Was 300.23 now F40.10.

Social Anxiety Disorder sometimes called Social Phobia is far more common and debilitating here in the United States than is generally recognized. The most recent estimates are that in excess of seven percent or over 22 million Americans have Social Anxiety Disorder. The U.S rate runs 3 to 6 times the rate reported in other countries.

Fully three-fourths of those who will revive this diagnosis first have symptoms during childhood from the fourth to the tenth grade. This results in significantly lower graduation rates by those with Social Anxiety Disorder. Lifetime someone with Social Anxiety Disorder is more likely to be lower-income and socioeconomic status.

The rates of Social Anxiety Disorder are highest among those who are single, unmarried, or divorced. The disorder may be severe when young and single, become milder when the person is married, and reemerge when they are divorced. The typical person with this disorder waits from fifteen to twenty years before seeking treatment.

The symptoms of Social Anxiety Disorder.

People with Social Anxiety Disorder become extremely, excessively, anxious when they will be in social situations where they may be judged or evaluated by others. While you are only required to be anxious in one social situation to be diagnosed with Social Anxiety Disorder most people with this condition are anxious in many situations.

Someone with Social Anxiety Disorder will report that they can’t relax around others. They may hide achievements that would get them noticed, avoid attention, avoid eating in front of others, and when in social situations they will listen instead of speak.

Other ways this disorder will manifest include, avoid confrontations, preferring to work alone, being afraid to ask questions, avoiding social gatherings, parties, etc. They will underachieve to avoid attention, may drop out of school, or not apply for a job or promotion.

Performance Anxiety is a special case of Social Anxiety Disorder.

People who are in the public eye are at extra risk for Social Anxiety Disorder. Many people are afraid of public speaking, this will not count towards Social Anxiety Disorder if you do not normally need to speak in public. But if your job requires public speaking, or being on stage and when you do this you become extremely anxious then that would be considered a case of Social Anxiety Disorder.

Children with Social Anxiety Disorder.

For children, we do not count situations in which they become anxious in front of adults. Children who develop the disorder also need to be excessively anxious in front of their peers.

Children may try to avoid social anxiety by crying excessively, having tantrums, being clingy, or going mute.

With Social Anxiety Disorder you can run or suffer.

Most people with Social Anxiety Disorder will go to great lengths to avoid social interactions. Some attempt to stay at home with parents well into adulthood convinced that they simply can’t venture out around strangers. They may settle for living in poverty, staying in abusive or dysfunctional relationships rather than attempt to move outside their residence.

Social Anxiety Disorder is neither brief nor temporary.

When we talk about Social Anxiety Disorder we are expecting a problem that is ongoing not a brief temporary fear of a social situation. Typically this has lasted for six months or more. Though clinicians are encouraged to use some judgment here. If you come in asking for help after only five months and three weeks you should get the help despite it being less than six months. In this disorder, the fear also should be far more severe than the situation would merit. If the danger is real and severe, this is not Social Anxiety Disorder.

Treatment for Social Anxiety Disorder.

Treatment for Social Anxiety Disorder can be very effective if the client can get to the treatment. One promising development has been the use of distance counseling over the internet for those too anxious to travel to the counselor’s office. Treatment has been effective both in reducing the Anxiety symptoms and in shortening the duration of the disorder.

There are other things that kind of look like Social Anxiety Disorder.

Professionals need to look at a bunch of other things and make sure that they are not sticking this diagnosis on someone when another diagnosis would fit better. The DSM-5 lists fifteen things that need to be ruled out before deciding on Social Anxiety Disorder. At the top of that list? Social Anxiety Disorder needs to be more severe and cause way more problems than just normal shyness.

As with the other things we are calling a mental illness, Social Anxiety Disorder needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnosis if this is a preference, not a problem. If the only time this happens is when under the influence of drugs or medicines or because of some other physical or medical problem this fear needs to be more than your situation would warrant. These other issue needs treating first, then if you still have symptoms you could get the Social Anxiety diagnosis.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Is your Anxiety a disease?

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By David Joel Miller

Anxiety provoking.

Anxiety.
Photo courtesy of Pixabay.com

Some fear is normal, too much is an anxiety disorder.

How can you tell if your fears and anxieties are normal or are they the signs of a more serious mental illness? In everyday language, there is not much difference between fears and anxieties. In technical, mental health terms there are some key differences between fears, anxieties, and the times your anxiety symptoms get out of control and get diagnosed as a mental illness.

Of all the mental illnesses, Anxiety disorders are the most common. In any given year one in five Americans will experience Anxiety so severe it should be diagnosed as an anxiety disorder. Prevalence rates around the world are very similar to the U. S. experience. Anxiety disorders are also the ones most likely to be seen by medical doctors as the symptoms often look like symptoms of physical illnesses.

Fear in the mental health sense is a reaction to a thing or situation that causes an immediate reaction. You see something, something happens and you get that feeling you need to do something now. The standard reactions are to freeze, flee, or fight.

Say you see a poisonous snake and you become very scared. This sounds rational. But if you are afraid to visit a school because they might have pictures of snakes up in the science classroom, that is excessive and should qualify you for some kind of mental health diagnosis. Which diagnosis? We are not there yet.

Anxiety, the mental health type definition, is a feeling of nervousness or uncomfortable about something that may happen in the future. People with anxiety disorders become so afraid that something will or might happen in the future that they have to alter their present to avoid these possibilities.

People commonly report that they have “Panic attacks” or “Anxiety attacks.” If the thing setting off the anxiety attack is something that has a real potential danger then having fear and freezing, fleeing, or fighting might all be reasonable adaptive behaviors. Attacks of a symptom do not always equal a mental illness.

While some anxiety disorders are brief most, to get diagnosed, need to be more than temporary conditions. The criteria for many anxiety disorders it’s that you must have had this anxiety for six months or more. Of course, during that time period, your anxiety may have episodes of getting stronger, and other times it may be less troublesome. If it has interfered with your life for 6 months or more you most likely have an anxiety disorder.

Not every case of nervousness or anxiety is the result of having an anxiety disorder. Someone who is depressed and has difficulty doing things they used to do is likely to become anxious. We include that kind of anxiety as part of the depression. Same thing when someone with a psychotic disorder becomes fearful and think people are watching them. That paranoia is part of the psychosis and does not get a separate diagnosis of an anxiety disorder.

What makes this fear diagnosable is when it begins to interfere with or change your behavior or upset you. If you can’t leave the house or work because of your anxiety, that is probably a diagnosable anxiety disorder. If your extreme fearfulness, anxiety, or hyper reactiveness start affecting your relationships, that is a probable diagnosis.

There are a number of different types of anxiety disorders depending on what is causing your fear or anxiety. Further complicating this picture is that many people who have anxiety disorders have more than one kind. Having multiple anxiety disorders is considered very common.

Since people with anxiety disorders have by definition “excessive” fear or anxiety it takes an outside observer, usually a therapist to evaluate the risk and see if this person’s fear is reasonable given their situation and their life experiences.

Most anxiety disorders start in childhood, often before the end of middle school. Over time and untreated anxiety disorders get worse. The stats say two of every three people with anxiety disorders are women. I believe this is partly cultural. Boys and men are taught to approach what they fear. Attack it. Women are supposed to get away. This results in anxious men becoming more violent or using a substance to cover up their anxiety and as a result, they get a behavioral or substance use diagnosis.

Physical sensations may be symptoms of anxiety.

Different people experience anxiety differently. Anxiety symptoms are frequently physical and many people interpret their anxiety symptoms as a physical illness.

If you experience an anxiety attack you may feel dizzy or light-headed. You may feel disoriented, have difficulty breathing or swallowing. The heart may race, you might sweat or tremble all over.  Despite the feeling you want to run your legs could become rubbery or jelly-like.

Some people experience gastrointestinal symptoms, constipation, diarrhea, nausea or feeling like you may vomit. Sleep disturbances, mind racing, and confused thoughts can result in Anxiety disorders getting confused with Bipolar Disorder and other mental illnesses.

Here is the most recent list of recognized Anxiety Disorders. These are necessarily brief, general descriptions of the disorders in plain language. For the specific criteria consult the relevant edition of the DSM.  For more on each separate disorder look for the articles I have written on specific disorders. I plan to write more of these posts on specific anxiety disorders in the future.

You will find the link to other articles on anxiety below.

Separation Anxiety Disorder.

This disorder customarily starts early in life. The child is afraid to leave or be away from a caregiver. They may think that something bad will happen to them or the caregiver if they are separated. We used to think of this mostly as a disorder of children and that they should “grow out of it.” We are starting to think that you can have this at any point in your life and that many clingy needy adults had this and or an attachment disorder since childhood.

Selective Mutism.

Someone who speaks normally at home but is afraid to or refuses to speak when in public or around strangers fits the description of Selective Mutism. The criteria for this disorder does not imply that the child is being poorly behaved but just that they are so afraid they can’t speak around strangers. The result is poor grades or school failure. As they get older this may lessen but again there are adults who just avoid speaking around strangers as much as possible.

Specific Phobia.

Spiders and snakes, blood, heights, or flying can all be objects of a specific phobia. With Specific Phobia we can point to things or situations that are the cause of the anxiety. People with specific phobias often had fears of several things or situations and may have other anxiety disorders as well.

Social Anxiety Disorder (Social Phobia).

In this disorder, the anxious person is afraid of social situations where others may watch them, evaluate them, or otherwise form an opinion about them. The fear here is about doing something “wrong” or being judged. This is about having your peers think poorly of you, what you wear, or how you do things. In severe cases, people avoid eating in public or going to social gatherings.

Panic Disorder.

Panic disorder involves many of the physical symptoms we talked about above. The person having a panic attack may have shortness of breath or chest pain and think they are having a heart attack. Having had one attack people become afraid to leave the house for fear they will have another and not be able to get help in time.

Agoraphobia.

Agoraphobia translates as “fear of the marketplace” mostly this involves crowded situations. Fear of buses, standing in lines, crowded places, stores, and similar situations. In severe cases, the person becomes unable to leave the house to go shopping and either needs someone to go with them or just go at times the store will be very empty.

Generalized Anxiety Disorder.

This involves being over-anxious all the time. A person with Generalized Anxiety Disorder is anxious all the time about most anything. There may be real-life causes for this anxiety, like living through a war or being assaulted or harmed. The professional has to look carefully to separate this from PTSD or other Trauma and Stressor-related disorders.

There are also diagnoses for anxiety problems caused by drugs, medications, medical conditions, or other factors.

For more on Anxiety, treatments for anxiety and related issues see:

counselorssoapbox.com Anxiety Post list.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel