Luming Hao had always been the type to keep to himself. When he was in high school, his family moved a few times, and each time he found it hard to make new friends. “Approaching groups of people seemed super scary,” he remembers, “I always thought I was just bad at that kind of thing.” It was sophomore year when he first noticed that his discomfort around other people was more than just a feeling–it also manifested itself in physical symptoms. When he had to speak up in class, his heart would race. Sometimes, when Luming was especially nervous, his eyes would well up. But he’d brush it off, thinking, “Oh, I’m just tired” or “I didn’t get enough sleep.”
It wasn’t until years later, when the tears came again during a work meeting, that he started to recognize a pattern. As part of his job as a software engineer, Luming attended weekly meetings where each member of the team stood up and reported on their plan for the week. Luming distinctly recalls that on that particular day, he noticed feeling less nervous than he usually did. But then, it was his turn to speak. “I was talking, and I noticed my voice shake. Then my vision started started blurring,” he said. He worried everyone else in the meeting noticed the tears too and was judging him. He went home feeling embarrassed and defeated.
That was when Luming started to think about looking for help. He looked online and discovered that there was a term for what he was experiencing: social anxiety.
What is social anxiety?
Social anxiety is when you feel nervous, tense, or uncomfortable in social situations because you’re worried other people are judging you. Almost everyone has experienced feelings of social anxiety at one point or another. Life is rife with moments of self-consciousness–from job interviews to first dates, we all occasionally feel nervous around other people. But social anxiety becomes a problem when it’s so frequent or intense that it gets in the way of important things in your life. You might not apply for a dream job because it requires an interview, or you might find it hard to be around even family and friends because you’re so worried about what they think of you.
If social anxiety has prevented you from doing the things you want, like making new friends or going on dates, you’re not alone. Social anxiety is one of the most common mental health conditions in the U.S., affecting 15 million adult Americans each year. According to the National Institute of Mental Health, 1 in 8 Americans experience social anxiety during their life(about 30 million).
Recognizing if you have social anxiety
While social anxiety always involves a fear of being judged negatively, the actual situations that cause this anxiety can vary greatly from person to person. Many people with social anxiety feel nervous in most situations that involve interacting with or performing in front of other people. But some people only experience social anxiety in particular situations, like speaking in front of others or hosting an event. For example, a person who is typically very outgoing and comfortable talking to strangers at parties might only have social anxiety when giving presentations. In fact, public speaking is one of the most common specific forms of social anxiety.
Common situations in which people experience social anxiety:
- Speaking in front of a group
- Talking to strangers
- Being the center of attention (like when you are hosting a dinner)
- Speaking to authority figures (like your boss)
- Answering the phone
- Eating or drinking in front of others
- Talking to someone you find attractive
Signs and Symptoms of Social Anxiety
People often think social anxiety is just a feeling, but it actually has four components: thoughts, feelings, physical sensations, and behaviors. You might recall from Luming’s story that he started to recognize his social anxiety when he noticed his nervousness was also accompanied by physical symptoms like trembling and crying. When you’re anxious, the four components interact with and build upon each other, causing a cycle of anxiety. For example, here’s how your anxiety might manifest itself if you’re nervous about giving a presentation at work:
Thoughts: Often, your anxiety will begin with a negative thought, like “I’m going to screw up” or “people will think I’m stupid.”
Feelings: These thoughts cause you to feel negative emotions, like stress or worry.
Physical Response: Your body reacts to your negative thoughts and feelings with a physical response like blushing, sweating, or shaking.
Behaviors: To reduce your anxiety, you do conscious or unconscious things like averting your gaze or hiding behind the podium (to prevent people from seeing you shake). Acting this way may make you think everyone else notices you look stiff (an anxious thought), which can then cause you to feel even more stressed (an anxious feeling).
People with social anxiety often don’t realize when their behavior is being driven by anxiety. There are three types of behaviors that people with social anxiety tend to exhibit:
- Avoidance behaviors: when you stay away from situations that make you anxious. For example, you might turn down opportunities to give presentations at work.
- Escape behaviors: when you leave situations that make you anxious, like leaving a concert or party after just a few minutes because of your anxiety.
- Safety behaviors: Actions you take to reduce your anxiety in social situations, like drinking to feel more comfortable or playing a game on your phone at lunch. In the example above, averting your gaze or hiding behind the podium during the presentation are safety behaviors.
What to do if you have social anxiety
If you think you have social anxiety, the most important question to ask yourself is whether it prevents you from achieving your goals. For example, we mentioned earlier that a large majority of people report a fear of public speaking. You might be one of them. But if your job or goals don’t require public speaking, then being afraid of it might not be a big deal. On the other hand, if your fear is keeping you from getting the promotion you want, or getting in the way of an important personal goal like giving a speech at your sister’s wedding, then you might consider looking for help.
Cognitive Behavioral Therapy (CBT) is widely recognized as the most effective treatment for social anxiety. It’s endorsed by leading mental health organizations, including the U.S. National Institute of Mental Health (NIMH) and the U.K. National Health Service (NHS). CBT is a set of activities proven to reduce your anxiety through repeated practice. It consists of two main parts: cognitive therapy and behavioral therapy.
The cognitive part of CBT is based on the idea that it’s not a social situation that makes you anxious, but your interpretation of that situation. For example, if you’re having dinner with a friend and she leaves early, you can interpret this several ways. You might think she found dinner with you boring (leading you to feel anxious), or you might think she had a long day and was tired (and feel neutral). People with social anxiety tend to interpret situations in a disproportionately negative way. CBT teaches you to recognize and embrace the existence of alternate interpretations, allowing you to identify if there are other possible explanations that are less likely to trigger your anxiety.
The behavioral part of CBT involves gradually facing the situations that make you anxious in order to overcome your fear of them (this exercise is called an “exposure”). You probably imagine the worst-case scenario will happen if you confront these situations, so you tend to avoid them. However, when you actually place yourself in the situations you fear, you have two critical realizations: first, that the bad outcome you fear happens less often than you think, and second, even if it does, you can handle it. It’s key that exposures are gradual: you start small with a situation that causes some anxiety but is doable, and then work your way up to situations that make you really anxious. For example, if giving a presentation makes you extremely anxious, to the point where you might even call in sick to avoid it, your first exposure would be a similar but less anxiety-inducing situation like telling a story to a group of friends. Once you learn to get comfortable in these practice situations, you’ll be able to take your newfound confidence to more difficult situations you greatly fear or have been avoiding.
Overcome social anxiety with Joyable’s online CBT program
We’ve talked about how common social anxiety is, and how there’s a proven solution to treat it (CBT). However, the shocking truth is that 85 percent of Americans who struggle with social anxiety each year don’t get help. Why? Sometimes it’s a lack of awareness that prevents people from seeking help. Sometimes, sadly, it’s stigma. But even for those who know they have social anxiety and want help, there are huge cost and access barriers preventing them from getting treatment. The average cost of a single 45-minute session with a therapist is $161 in the U.S., and even if you can afford that, you might not be able to find an available therapist nearby. There aren’t even close to enough therapists to treat the number of people struggling with social anxiety; about a third of the U.S. population (roughly 99 million people) lives in a mental health desert where there is a shortage of mental health professionals.
That’s why we created Joyable. Joyable makes an effective, affordable solution for social anxiety accessible to all. We offer an online CBT program with the guidance of a personal coach to help you overcome your social anxiety. Because it’s an online program with check-ins by phone, text, or email, you can use Joyable from the comfort and privacy of your own home. Research shows that online CBT is just as effective as in-person therapy, and for many, it’s a lot more affordable. Because Joyable is self-paced, you can do activities when it’s convenient and when you’re motivated to work on your anxiety, rather than having to conform to someone else’s schedule.
Overcoming social anxiety is hard work. With Joyable, you don’t have to do it alone. When you start the program, you’re paired with a personal coach. Your coach is your advocate and accountability partner. They’re trained in CBT and help guide you if you have a hard time challenging your negative thoughts. They also give you an extra push when you need it to face situations you fear.
For Luming, his coach Julia was the best part of the Joyable program. Julia provided motivation and guided him through planning exposures, especially when he struggled to understand what they were at first. “It felt like she was lighting a path through an otherwise dark forest,” he said. He noted that without her continued encouragement, he “might have quit.” Before Luming started the program, he dreamed of changing jobs and moving to New York City, but his social anxiety thwarted him. When putting together his resume and portfolio, his head filled with negative thoughts like, “this sounds pretentious” or “they’re going to think it’s stupid that I decided to include this project.” Even if he managed to put together a decent portfolio, Luming was sure it wouldn’t matter because he’d fail any interview he got anyway. With Julia’s guidance, Luming reinvigorated his job search and treated each phase–from phone screens to in-person interviews–as an exposure. He found preparing for and debriefing the interviews with Julia extremely helpful, and his confidence grew.
When I talked to him, Luming was in his new apartment in New York City. He had just moved there to start a great job, and he sounded optimistic. I asked him what he had learned and what advice he would give someone who had been in his shoes a few months ago–struggling with social anxiety and not knowing what to do about it. He said not to lose hope or to worry that you’d need to invest years into therapy without seeing progress. “It’s really helpful to see [that there are] patterns” of negative thinking, he said. “You can identify that this is something that happens to other people. Since there’s a pattern to it, there’s [a solution], CBT, that really works for this.”
Tips for people with Social Anxiety
Here are some CBT-based tips for dealing with anxiety in the moment:
- Remember everyone is self-conscious. Social anxiety is common, and many people experience it. If you’re at a party and feel really anxious about introducing yourself to new people, remember that other people might feel the same way.
- Pause to examine the evidence. When you’re feeling anxious, take a moment and try to identify the anxious thoughts running through your head. Challenge them by asking questions like: “What evidence do I have this is true?” and “Is there another explanation for what happened?” If someone responds curtly to you, you may have the anxious thought that “they think I’m boring.” What if you challenged that thought and instead considered another explanation: maybe they were in a hurry, or maybe they were already on their way to talk to someone else when you approached them.
- Imagine the worse-case scenario. Often, people with social anxiety think making a mistake will cause far worse consequences than it actually would. If you’re worried about something like stumbling over your words–ask what would really happen if you stumbled over your words. Would people really laugh at you? They’d probably barely notice it or quickly forget about it and continue the conversation.
- Remind yourself anticipation is worse than reality. Often, our worries about an upcoming situation are worse than the situation itself. If you’re worried about striking up a conversation because you think you’ll have nothing to say, remind yourself that you only have to start with hello, and once you begin the conversation, it gets a lot easier.
- Bring a cheat sheet. Before going into an anxiety-inducing situation, anticipate what anxious thoughts you’ll have and challenge them on a piece of paper. Bring this slip of paper with you to the event (or save it on your phone) so if you start feeling nervous, you can look at it to remind yourself of your thought challenges and calm yourself down.
- Consider getting help. If you find social anxiety is really impacting your life (for instance, getting in the way of your career or relationships, or making it hard to go to social events you want to attend), consider seeking out help through an evidence-based solution like CBT.
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