How Does Social Anxiety Affect Your Life ?

Social anxiety disorder affects approximately 15 million American adults and is the second most commonly diagnosed anxiety disorder following specific phobia. The average age of onset for social anxiety disorder is during the teenage years. Although individuals diagnosed with social anxiety disorder commonly report extreme shyness in childhood, it is important to note that this disorder is not simply shyness that has been inappropriately medicated.


Social anxiety disorder can cause tremendous suffering on the lives of individuals who deal with it. Symptoms may be so extreme that they disrupt daily life and
 can interfere significantly with daily routines, occupational performance, or social life, making it difficult to complete school, interview and get a job, and have friendships and romantic relationships. People with social anxiety disorder are also at an increased risk for developing major depressive disorder and alcohol use disorders. 

Despite the availability of effective treatments, fewer than 5% of people of with social anxiety disorder seek treatment in the year following initial onset and more than a third of people report symptoms for 10 or more years before seeking help. The defining feature of social anxiety is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. People with social anxiety disorder may worry about acting or appearing visibly anxious (e.g., blushing, stumbling over words), or being viewed as stupid, awkward, or boring. As a result, they often avoid social or performance situations, and when a situation cannot be avoided, they experience significant anxiety and distress. Many people with social anxiety disorder also experience strong physical symptoms, such as a rapid heart rate, nausea, and sweating, and may experience full-blown attacks when confronting a feared situation. Although they recognize that their fear is excessive and unreasonable, people with social anxiety disorder often feel powerless against their anxiety.

Social anxiety disorder can be overcome, although it takes both consistency and persistence.  A successful therapy program for social anxiety disorder must address the dozens of cognitive methods, strategies, and concepts that will allow people's brains (i.e., their brain associations or neural pathways) to literally change.  The brain is continually learning, and irrational thoughts and beliefs can change as a result of this cognitive process.  

A good therapy program will supply the necessary and specific strategies as well as indicate to people how and why they need to practice, work on, and begin to accept rational thoughts, beliefs, emotions, and perceptions.

Manage Anxiety Without Drugs

Anxiety is defined by the dual characteristics of physiologic hyperarousal and excessive emotional fear. Biofeedback has demonstrated value for hyperarousal reduction and offers a non-pharmacological approach to direct symptom reduction tailored to the individual’s psycho-physiological profile.

Heart Rate Variability (HRV) is one type of biofeedback. It uses finger or earlobe with sensors to measure the functioning of the heart by diaphragmatic breathing. Breathing activates Vagal nerve, which descends from the brain in the carotid sheath all the way to you diaphragm. The vagal nerve slows your heart rate. A stress response to anything such as a difficult conversation, traffic, or studying changes your heart rate independently of the breathing-related variation to irregular changes. In contrast, when we breathe even, natural, and smooth, you get smooth heart rate waves which are associated with health and peak performance.



Self-regulation is the primary goal of Biofeedback

When a person inhales, heart rate increases. When a person exhales, heart rate decreases. This is referred to as “heart rate variability.” Higher rate variability is associated with favorable holistic health. Clients are taught smooth diaphragmatic breathing, psychological mindfulness, and adaptive responsiveness.


One of the main advantages of using biofeedback for anxiety is managing it without medication or its side effects. It eliminate health problems that are stress- related or that have psychosomatic components. Biofeedback teaches awareness, relaxation skills and ways to manage anxiety & recognize, reduce, and control stress responses by returning the body to a healthier physiological state.

Social Anxiety & Eating Disorders

Social Anxiety & Eating Disorders

Many individuals with eating disorders experience significant anxiety. There is a strong correlation between individuals who have pre-existing anxiety and/or depression to develop eating disorders. 

Individuals with eating disorders often report that their anxiety generally centers on fear of humiliation when in public or social situations.  They fear being judged in both body shape and size and for how and what they eat. Often, shame and self-criticism that eating disorder sufferers typically feel with respect to their own body, is projected on to other people who they infuse with the power to hurt them or make them not feel safe or valued.

Patients also feel the need to accommodate other people’s feelings at the expense of their own, not feeling that they fit in, not being able to assert their point of view, essentially not feeling comfortable in their own skin when in the company of other people.  Some patients report that these feelings and interpersonal issues are significantly reduced or disappear in the safe world and solitude with food. 

Exploring how anxiety can be focused around interpersonal and relational issues in addition to a general state of free floating (likely, biologically driven) anxiety can be extremely useful in understanding a person and assessing outcomes.

It is important for health care practitioners to help patients distinguish from where their anxiety originates and then how to treat it – what is driving the anxiety bus – free floating, indiscriminate anxiety or specifically targeted to interpersonal or psychological forces. 

If you’re someone who has some concerns regarding anxiety and eating disorders, discuss them with your provider to evaluate your symptoms and/or to get the help you need.

How to Deal with Anxiety and Relationship Problems


There is a wealth of information about anxiety and how it impacts emotional, psychological, and physical health. Anxiety can cause the person to feel overwhelmed, panicked, and a general sense of unease. These symptoms can affect not only your well-being but it can take over many other areas of your life such as work, family members, friends, and your intimate relationship. Are you feeling stressed on your relationship or contemplating ending it? If so, anxiety may be playing a role on putting your relationship at risk.


1.     Anxiety destroys trust and connection

If you’re feeling overwhelmed, worried about your recent argument, or trying to “fix” things as soon as possible you might not have time to notice on what is happening in the now. The fear and worries can cause you to be less attuned to your needs and your partner’s needs. The inability to be present in the moment can muddle your insight and awareness on how to take care of yourself and the relationship. When we ruminate about problems in a state of chaos we feed the anxiety.


Shift your focus on being instead of doing. It is difficult to listen to your thoughts & physical signs when you are not slowed down. Pause, think, and feel, instead of assuming and letting your anxious thoughts take over. Help yourself find the evidence before you jump into conclusions. Once you’re in a calmer place, you can start to share openly with your partner on what happens to you when you’re feeling worried. Be intentional about building trust and connection by reaching out to your partner: be vulnerable, help your partner understand what anxiety feels and looks like. Instead of attacking or withdrawing strive to deepen your connection with your partner.


2.     Anxiety fogs your brain

Asking someone to share what they are feeling in a state panic, is easier said than done. Anxious people find it extremely difficult to give themselves or partner attention or space that is needed. In the heightened state of anxiety, some might try to avoid it while others believe “fixing the problem” immediately.

Taking a short break can be beneficial for you and your relationship. Resisting your feelings can feed and intensify anxiety, therefore acknowledging them can ease some of the tension you might experience. Approach a conversation with partner with kindness, and discuss some of the thoughts or fears that drain your energy.

3. Anxiety is the enemy of self-compassion


Because anxiety brings an overactive fear response, ruminating about it may leave you with very little time to practice self-care. Some anxiety is healthy for everyone. However, if your anxiety causes you to reject/avoid things that are beneficial for you, it can create more suffering for you and your relationship. Could it be that the anxiety is real but not true?

Quite your mind to hear your own wisdom. Anxiety rubs people of joy. Practicing being with your uncomfortable thoughts, pausing, and listening to your anxiety might be just what you need to remove those invisible chains your anxiety creates. The deepest gift we can give ourselves is the quality of non-doing presence. So…. notice your anxiety, and come back to it with a lot of kindness. Intentionally turn your attention to whatever opens your heart by looking for what you love and practice. Practice being present for yourself and your partner and then practice some more and remember- where attention goes energy flows.

How to Screen for Social Anxiety?

How to Screen for Social Anxiety?


If you have noticed some anxiety or think you might suffer from social anxiety, but are on the fence contacting a health care professional you can use the questions below as a guidance to share the results with your provider when you're ready to get some help.

Are you bothered by the following?

An intense and persistent fear of a social situation in which people might judge you

Yes    No

Fear that you will be humiliated by your actions

Yes    No

Fear that people will notice that you are blushing, sweating, trembling, or showing other signs of anxiety

Yes    No

Knowing that your fear is excessive or unreasonable

Does a dreaded situation cause you to...?

Always feel anxious?

Yes    No

Experience a panic attack, during which you suddenly are overcome by intense fear or discomfort, including any of these symptoms:

Yes    No

Pounding heart

Yes    No


Yes    No

Trembling or shaking

Yes    No

Chest pain

Yes    No

Nausea or abdominal discomfort

Yes    No

Feelings of unreality or being detached from yourself

Yes    No

Fear of losing control or “going crazy”

Yes    No

Fear of dying

Yes    No

Numbness or tingling sensations

Yes    No

Chills or hot flushes

Yes    No

Go to great lengths to avoid participating?

Yes    No

Social anxiety may also be connected to other diagnoses such as depression. In addition, substance abuse, in particular alcohol is used most of the time as a way to cope with social anxiety. The questions below can help distinguish between social anxiety, depression, and/or substance abuse.

Have you experienced changes in sleeping or eating habits?

Yes    No

More days than not do you feel sad or depressed?

Yes    No

Are you not interested in life?

Yes    No

Do you feel worthless or guilty?

Yes    No

During the last year, have the use of alcohol or drugs been helpful to cope with?

Yes    No

Has your use placed you in a dangerous situation, such as driving a car under the influence?

Yes    No

Have you gotten arrested?

Yes    No

Do you continue despite problems you might have because of the use? 

If you answer yest to most of these questions, it is highly recommended you reach out to a health care provider to get treatment for a more fulfilling life. 


Anxiety & Sleep Problems

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Is Anxiety Interfering With Your Sleep?


Over 18% of nation’s population experience anxiety disorders, and the majority of them have sleep –related problems. The lack of sleep can increase not only anxiety but other mood related issues such as depression, anger, irritability, and/or muscle pain. If anxiety or disrupted sleep crops up occasionally, these simple strategies may help you relax your body and mind so you can get the sleep that you need.

Sleep Hygiene

A healthy bedtime routine allows your body and mind to slow down. Take at least half an hour before bed to play quiet music, take a bath, or read a book. Deem the lights one hour before you go to sleep; Avoid electronics an hour or more before your sleep; Spend a few minutes before bed using diaphragmatic breathing to help relax.


Regular exercisers fall asleep faster and sleep more soundly. In fact, even a single moderate-intensity workout can improve sleep among people with chronic anxiety. Here are some recommendations for the ones who don’t enjoy going to the gym: Stretch often, simple yoga exercises throughout the day will do the trick; Go for a walk; Be active at home by using an indoor trampoline

Steer clear of stressful activities before bed.

Leave the bill paying for earlier in the day, stay away from heated social media exchanges, and skip the evening news.

Put your to-dos on paper.

Instead of letting your brain swirl with all the things that you don’t want to forget to take care of, write them down so your brain can relax and let go.

It’s not always easy to tell if your symptoms are an indication of an anxiety disorder or just the normal amount of worry. Certain situations, especially the ones we don’t like, can cause our anxiety symptoms to spike. Moving, changes in relationships, financial troubles, and speaking in public can all trigger these spikes. If your anxiety has spiked out of control, or has become debilitating to you by interfering with your daily life, it might be time to seek professional help.

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What Are Social Anxiety Symptoms?

Social anxiety disorder affects approximately 15 million American adults and is the second most commonly diagnosed anxiety disorder following specific phobia. The average age of onset for social anxiety disorder is during the teenage years. Some might dread meeting new people, dating, being on a job interview, answering a question in class, or having to talk to a cashier in a store, others might avoid only some of the scenarios above. Most people with social anxiety do not talk about it and might not understand why they feel fine in certain situations but not in others. Some might feel physical symptoms of anxiety in situations such as giving a speech, playing a sports game, or dancing or playing a musical instrument on stage.

Here are some of the symptoms of social anxiety when performing in front of others:

  • Extreme fear of other people judging them
  • Staying away from places where there are other people they might feel judged by
  • Blush, sweat, tremble, or feel a rapid heart rate
  • Show a rigid body posture, make little eye contact, or speak with an overly soft voice
  • Find it scary and difficult to be with other people, especially those they don’t already know, and have a hard time talking to them even though they wish they could
  • Be very self-conscious in front of other people and feel embarrassed and awkward

The defining feature of social anxiety disorder is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. Because people with social anxiety disorder may worry about acting or appearing visibly anxious, they often avoid social or performance situations, and when a situation cannot be avoided, they experience significant anxiety and distress.

Although they recognize that their fear is excessive and unreasonable, they often feel powerless against their anxiety. The first step to effective treatment is to have a diagnosis made, usually by a mental health specialist. Without treatment, social anxiety disorder can prevent a person from reaching their full potential.

Making your first appointment when struggling with Anxiety

You may feel anxious about contacting a psychologist. That anxiety is perfectly normal. But having the courage to make a call is the first step in the process to empower yourself and bring a sense of relief to get the help you need.

Once you connect, they’ll lead a brief conversation to get a better sense of what you need and whether they are able to help and when you can make an appointment. Before you take the first available appointment here are some factors you should consider:

  • Know when you're at your best morning, afternoon, or evening, and schedule your appointment accordingly.
  • Consider work schedule and if you have to take time off from work, you might want to schedule your first appointment later in the day so you don't have to go back to work afterward. If you have an upsetting topic to discuss, you may be tired, emotionally spent, puffy-eyed or distracted after your first session.
  • Unless it is a family session, choose a time when you will have child care available.
  • Try to schedule your session at a time when you won't have to rush to your appointment or to your next commitment after the session. 

Hope this helps alleviate the anxiety of taking the first step. Best of luck!

When should you consider psychotherapy?


Because of the many misconceptions about psychotherapy, you may be reluctant to seek help. It may be stigma, your own judgment, or you may feel nervous about trying it. Overcoming these blocks may be worth it because any time your quality of life isn’t what you want it to be, psychotherapy can help.

Some people seek psychotherapy because they have felt depressed, anxious, or angry for a long time. Others may want help for a chronic illness that is interfering with their emotional or physical well-being. Still, most people have short-term problems they need help navigating. They may be going through a divorce, having relationship concerns, feeling overwhelmed by a new job or grieving a family member's death.

You could benefit from therapy if you have any of the following concerns:

  • You feel an overwhelming, prolonged sense of helplessness and sadness.

  • Your problems don't seem to get better despite your efforts and help from family and friends.

  • You find it difficult to concentrate on work assignments or to carry out other everyday activities.

  • You worry excessively, expect the worst and are constantly on edge.

  • Your actions, such as drinking too much alcohol, using drugs or being aggressive, are harming you or others.

The treatment you receive will depend on a variety of factors: current psychological research, your psychologist's theoretical orientation and what works best for your situation. The most important factor to consider is whether your psychologist has the expertise  in the area you need help with and whether your psychologist feels he or she can help you.