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Severe Social Anxiety

By Dominica Applegate

Kayla spotted the pile of new school clothes sprawled out on the kitchen table. As she began looking through the bright colored shirts one by one, she sighed, and disappointment gripped her heart.

Kayla, 14, is an only child, quite introverted, and addicted to her computer and television. Seeing the clothes on the table reminded her that her freshman year would begin in two weeks and her heart skipped a couple beats. School clothes shopping had never appealed to her so her mother completed the task each year. She knew Kayla preferred white or black shirts, but always tried to slide in bright colored fabrics as well.

"Mom, you know I don't like wearing colored shirts! Why did you get these for me?" Kayla asked as she looked at a blue blouse on the table.

"Kayla, these are so cute! Why don't you try some new styles this year?"

Kayla looked at her mom in disgust, rolled her eyes, and hastily walked away. "She just doesn't understand." Kayla thought to herself.

Ever since Kayla can remember she has struggled with extreme social anxiety. When her mother would take her to playground, her stomach would be in knots and she would cling to her mother, afraid that the other children might not like her or make fun of her. School was a dreaded task as fear would knot her chest day in and out thinking that everyone was watching her, just looking for ways to humiliate her.

"I don't know why I even have to go to school! Why can't I be home schooled like the Volk family?" Kayla yelled back at her mother as she trudged upstairs to go to her bedroom.

Kayla threw herself down on her bed, frustrated. She'd hardly slept the past week due to agonizing social anxiety about her upcoming freshman year. The thought of getting on the school bus in the morning almost made her want to die. Walking the crowded halls, trying to find her classrooms, and feeling like a bug under a microscope put her on emotional and sensory overload. Feeling defeated, she began to cry. She knew it would be the same as last year: extreme social fears, no fun, no friends, and no boyfriend.

It's normal to feel some anxiety in new situations whether it is the first day of school, the first day of a job, or giving a public speech, but extreme fear and self-consciousness is not normal.

Kayla is not aware of it yet, but she suffers from an anxiety disorder. According to the National Institute of Mental Health, dreading social interactions, sweating profusely, trembling, chronic, extreme fear, and excessive self-consciousness are all symptoms of severe social anxiety that affects about 15 million people a year.

Social Anxiety Disorder is characterized by a constant state of worry and fear that others are watching, judging, and simply looking for ways to humiliate. Those who struggle with this disorder realize that it is an irrational fear, but that doesn't help lessen their irrational thoughts and behaviors. They still feel the way they feel and act accordingly.

Kayla, wiping the tears from her eyes, grabbed her remote and turned the TV on. As she stared at the screen, her mind began wandering. She remembered how many times she'd sit in the cafeteria at school and watch her peers laugh and engage in conversation and wish with all her heart that she could be more like them. She thought about the neighborhood kids playing at the park and how sad she'd feel because she could only watch from her window, too nervous to join them.

According to the National Institute of Mental Health, those who suffer from severe social anxiety disorder wrestle with irrational social fears that are out of proportion to any real danger and will go to great lengths to avoid social situations. The difference between normal anxiety or shyness and those with social anxiety disorder is the severity and frequency of symptoms. Daily life and functioning becomes difficult due to extreme anxiety and missing school, work, or any social gathering is common.

Kayla's mind was racing. "Maybe Mr. Lewis is right," she mumbled. "Maybe Dr. Allison really can help me."

Mr. Lewis was Kayla's guidance counselor at school. Though Kayla never mentioned her struggles to him, he took note that she was quite introverted, always by herself, would not look him in the eyes, and spoke with such a thin, subtle voice. Last year when it was time for scheduling, he asked her if she struggled with social anxiety and she told him no. She just couldn't bring herself to talk to him about it. Mr. Lewis, not really believing her, mentioned to Kayla that some social anxiety is normal for teenagers, but severe fear and worry is not. He told her that if she ever felt that her anxiety was too much, it would benefit her to see a counselor that specialized in treating anxiety. He recommended Dr. Allison and assured her that she was an outstanding counselor. He also gave her Dr. Allison's business card. Kayla, embarrassed beyond belief, threw it in her purse, thinking that there was not a chance she would ever see a shrink!

Severe social anxiety is torturous and can cause a lot of emotional pain but there is hope. One does not need to continue to struggle with such fear and isolation as it is treatable with various kinds of psychotherapy, cognitive behavioral therapy, medication, and positive coping skills. Because social anxiety disorder is primarily caused by irrational thoughts and fears, therapy is necessary and beneficial to break the cycle of negative thoughts and patterns. Individuals must confront false beliefs that underlie anxiety and replace them with affirming and positive thoughts. Various medications and therapies have been successful in minimizing symptoms. Cognitive-behavioral therapy, in which faulty thinking and behavior patterns are identified, understood, and modified, is a common treatment and has had great success. Relaxation techniques and positive visualization are assets to the treatment plan as well.

Kayla made one of the most important decisions of her life that day. She bravely told her mother why she was so upset about wearing colored shirts. She explained that she would get so nervous at school that her underarms would sweat profusely and drip all day. Her underarms would be drenched with sweat and she just knew that her peers would see this and make fun of her. Furthermore, she discovered that white and black shirts did not show the sweat and that is why she preferred wearing such colors. Kayla told her mother that day that she wanted to try to overcome her extreme anxiety and see if Dr. Allison could help her. As nervous as she was to talk to Dr. Allison, she was more nervous about starting high school and thought just maybe there was a chance she could get a handle on her anxiety level.

"So tell me how your homework assignment went, Kayla." said Dr. Allison. "It went alright I guess. I'm finding out that changing my negative thought patterns is harder than I thought. I am doing what you're telling me to do, but I still find myself getting all tense and nervous sometimes at school." Kayla responded.

Kayla had been to four sessions with Dr. Allison. She felt relieved that she finally found someone she felt comfortable talking to and was learning a lot about anxiety and how she had allowed it to negatively affect her life. She and Dr. Allison created a treatment plan to combat social anxiety disorder and Kayla committed to being proactive in her treatment. They agreed on holding off on taking any medications and trying Cognitive-Behavioral Therapy (CBT) as Kayla had acquired many irrational thoughts over the years and CBT aims to break the cycle of negative thoughts and patterns and replace with more realistic ones.

"I want to tell you, Kayla, that I'm proud of you. You are making progress. I see you're writing more in your journal as well. I hope you are filling it up with positive affirmations." said Dr. Allison.

Kayla laughed, "Well, I am realizing that the more I read and say positive things about myself, the better I feel and the more confident I am at school. When I feel myself beginning to tense up at school because I think that people are staring, I take a deep breath and begin repeating my positive affirmations under my breath over and over. For the most part, it is working, but I have a ways to go. But I did make one friend last week! Well, I've known her for years but never really talked to her. She is my lab partner for Biology and we have been getting to know each other. She said she wants me to meet her at the mall sometime to hang out."

Dr. Allison smiled. She was delighted to watch Kayla make progress in overcoming her social anxiety. She listened as Kayla spoke about how she was utilizing deep breathing techniques and positive affirmations to decrease her anxiety level. She was proud of Kayla for her bravery in confronting negative thoughts and beliefs and replacing them with positive ones. As she listened to Kayla talk, she noticed that she was wearing a pretty blue shirt. As her eyes drifted toward the underarms, she noticed they were dry, and it warmed her heart as she felt confident that Kayla was going to not only overcome social anxiety, but have a great freshman year as well.

Sources: National Institute of Mental Health, retrieved from http://www.nimh.nih.gov/health/publications/anxiety-disorders/social-phobia-social-anxiety-disorder.shtml.

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