Doctors and counsellors tell Tejaswini Mittal how to deal with social phobia
Khushi Kumar, a 14-year-old school-goer always loved sharing her stories and views in front of her classmates. She was confident and outgoing, and everyone loved her for it. However, this time, as she waited for her turn to present her first assignment in Class X, she couldn’t stop trembling. Her classmates were reading out the stories they had written in their creative writing class for a peer review and she was next.
She kept her head down, hoping that the teacher would skip her name, but no such luck. It was now her turn, she made it to the front of the classroom and began reading out her story. The beginning was smooth, but she eventually began to fumble over her words. Feeling the eyes of her classmates on her, she felt like an animal put on display at the zoo, under the scrutiny of her peers.
“I’m sorry, I can’t do this” she said and promptly went to sit back down on her seat. She was disappointed and felt like everyone was judging her, silently making fun of her in their heads. Especially her friend Maanvi who had turned to another classmate Ria after a huge fight with her. Ever since, Khushi had started feeling more nervous and jittery around other people as Maanvi, her only support system for the last three years suddenly wasn’t there for her anymore. She had no other actual friends and was completely alone which affected her in ways that she couldn’t point out yet.
Social phobia, which is also known as Social Anxiety Disorder (SAD), is a serious mental health problem in the country. SAD is caused by the effects of not fitting in, being bullied, rejected or ignored. Shy adolescents or avoidant adults have emphasised unpleasant experiences with peers or childhood bullying or harassment. Popularity is also found to be negatively correlated with social anxiety, and children who are neglected by their peers report higher social anxiety and fear of negative evaluation than other categories of children. It is an intense, persistent fear of being watched and judged by others. This fear can affect work, school, and other day-to-day activities.
With regard to Khushi’s situation, some people with the disorder do not have anxiety in social situations but have performance anxiety instead. They 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.
According to National Comorbidity Survey, social phobia has an incidence of 2.79 per cent and prevalence of 1.47 per cent in India. A survey conducted by them where mental disorders were studied in a large sample of 1,0148 adolescents aged 13 to 17 years clearly showed that the level of social anxiety was higher in children in their early teens, standing at 11.94 per cent in 14 years old, 17.02 per cent in 15 years, 6.4 per cent in 16 year olds and 0.0 per cent in 17 year-old teenagers. This shows that the incidence of social anxiety is high in the mid-teens. It is what Khushi is experiencing without any knowledge of it yet.
One doesn’t get social anxiety in one go. It manifests itself in small ways, like sudden shyness in talking to new people, having trouble in opening up in a group; it just keeps building up. “Social anxiety can often be mistaken for common shyness,” says Dr Mitali Suri, a psychology teacher at The Heritage School, Gurgaon.
“Many people suffering from social anxiety often believe that the fear they are experiencing is just shyness and that they will eventually overcome it as time passes. However, social anxiety disorder needs to be properly treated or it can last for many years or a lifetime and prevent a person from reaching his or her full potential,” she tells you.
There are two main methods that can be used to treat social anxiety disorder. Psychological counselling or psychotherapy are the most common methods which helps to improve the symptoms in people with social anxiety. Here, one learns how to recognise and change negative thoughts about oneself and develop skills to help them gain confidence in social situations. “Any anxiety can be worked on by building self-acceptance, by accepting the fact that no one is perfect, and we are human beings who make mistakes, by taking initiatives even though we know we can make mistakes,” says Dr Vasudha, a counsellor.
Cognitive behavioural therapy is the most common type of counselling for anxiety. It is an experience-based therapy wherein the patient is eventually taught to face the situations they fear the most. It helps in building confidence and cope with anxiety-inducing situations.Another method used to treat social anxiety is medication, which can be prescribed by one’s psychiatrist. These medications generally include anti-anxiety or antidepressants.
“If your treatment isn’t proving effective immediately, don’t give up. Different people have different ways of overcoming their anxiety and all those ways take a different amount of time. It may take months or years, but it will eventually happen. Try to bring about a change in your environment and yourself,” says Dr Vasudha.
Many people with social anxiety also find support groups helpful. In a group of people who all have social anxiety disorder, one can receive unbiased, honest feedback about how others in the group see one. This way, one can learn that their thoughts about judgment and rejection are not true or are distorted. One can also learn how others with social anxiety disorder approach and overcome the fear of social situations.