Being comfortable in a social setting is not something that many are good at. At least 7.1% of the American population will do everything in their power to avoid it, as documented by the National Institute of Mental Health (NIMH). This figure translates into 15 million adult Americans who suffer from social anxiety, and the sad reality is that many of these also suffer from a co-occurring alcohol use disorder.
This massive number is a sobering fact in the face of the issue of social anxiety and alcohol abuse, and on top of that, most people who have these conditions admit that they have had it for quite some time already, making early intervention and treatment in a residential addiction treatment center in Ohio crucial.
What is Social Anxiety?
Also known as social phobia, this anxiety disorder is characterized by overwhelming and excessive self-consciousness when exposed to the idea or actual presence of everyday social situations. Depending on the person, social anxiety could be associated with only one type of social situation, such as speaking in a public setting, or with every instance of being in a social setting, such as eating or drinking with a crowd of people or being approached by strangers.
Some people who have a severe form of social anxiety may have an anxiety attack anytime they are around any number of people in any setting. These attacks could range in intensity from having difficulty breathing to having an actual breakdown wherever they may be. Social anxiety is different from instances when people get performance anxiety in front of a large crowd or experience intense nervousness when doing a presentation before a panel. People who experience intense nervousness in this manner claim they feel like they were “dying” of fright just before the exposure, but once the scenario is over, they experience relief and lose all the fear and anxiety they felt. A person with social anxiety could suffer from an anxiety attack so severe they could feel like they are having a heart attack, or even lose all self-control.
Much like the experience of other people with disorders that involve intense psychological or emotional components, people with social anxiety feel that their reaction to social situations is simply beyond their control. These intense reactions are more than enough to get in the way of normal functioning at work, performing at school, or doing everyday activities. Granted that some are still able to muster enough will to function as close to normal despite their anxiety, they do so with great fear and effort.
What are the Symptoms of Social Anxiety?
Many people admit to varying degrees of discomfort at the thought of being in a situation where social exposure, such as public speaking or presentations. This discomfort is quite normal, as most people will always have the fear of not saying the right thing, doing something wrong when everyone is looking, or simply becoming the object of ridicule should things not go right.
Having a social anxiety disorder, however, is far more than the intense feelings of shame that many feel when faced with a social situation. Symptoms include:
- Extreme fear in situations believing you may be judged negatively
- Intense worry about embarrassing or humiliating yourself
- The overwhelming fear of interacting or talking with strangers
- Fear that others will notice your anxiety
- Fear of physical symptoms that accompany social anxiety, such as blushing, sweating, trembling, or having a shaky voice
- Avoidance of doing things or speaking in social situations
- Avoidance of situations where you might be the center of attention
- Anxiety-filled anticipation of social activity or event
- Paralyzing fear or anxiety while in social situations
- Constant analysis of performance and actions in a social situation
- Persistent need to identify personal flaws in a social situation
- The expectation of the worst possible outcome during a social situation
- Intense urge to cry or throw a temper tantrum if a social situation is unavoidable
- Sudden inability to speak in social situations
- Sudden blushing
- Racing heartbeat
- Uncontrollable trembling
- Profuse sweating
- Upset stomach
- Seeming manifestation of irritable bowel syndrome (IBS) due to anxiety
- Difficulty breathing or catching your breath
- Inability to think straight or logically
- Feeling that your mind has gone blank
- Sudden muscle tension
- Social inhibition
- Feelings of inadequacy
- Sensitivity to criticism or rejection
- Avoidance of any situation that might involve interpersonal contact
- Unwillingness to interact with others unless certain they will receive a positive response
- Hesitancy or complete avoidance of intimate relationships
- The constant expectation of criticism or ridicule in social situations
- Feeling inadequate and being inhibited in new social situations
- Perception of self as inept, unappealing, and inferior
- Reluctance to take risks for fear of failure
- Refusal to engage in activities that might result in embarrassment
What are the Diagnostic Criteria for Determining Social Anxiety?
An article published in the American Psychiatric Association detailed several points of reference to determine if a person is suffering from social anxiety. These include:
- A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.
- Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed panic attack.
- The person recognizes that the fear is excessive or unreasonable.
- The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
- The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
- In individuals under the age of 18, the duration is at least 6 months.
- The fear or avoidance is not the result of the direct physiological effects of a substance or a general medical condition and is not better accounted for by another mental disorder.
- If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it.
What is the Connection between Social Anxiety and Alcoholism?
A recent study commissioned by the National Institutes of Health (NIH) revealed that people who suffer from social anxiety typically admit that alcohol use helps them feel more comfortable when in social situations. This largely points to why individuals with clinically diagnosed social anxiety disorder have a higher tendency to develop alcohol-related problems as well.
The article goes on to say that clinical studies indicate that people use alcohol as a means of coping with social fears as well as much as they do with stress. This admission on the part of the patients participating in the clinical study seems to affirm the theory that alcohol acts as a negative reinforcer to reduce stress and anxiety.
A negative reinforcer is something that eliminates an unpleasant experience, and in this instance, anxiety or stress is the unpleasant experience and alcohol consumption serves to reduce these intense feelings. It also follows the logic that if a person experiences stress or anxiety relief after consuming alcohol, the person is highly likely to continue to use alcohol for this seeming beneficial property.
The accuracy of the claim that alcohol reduces stress is still quite debatable, as some researchers argue that based on its pharmacological properties, alcohol only serves to increase the stress levels of the person, and based on this reasoning, negative reinforcement using alcohol is ineffective. Regardless of the correctness of this reasoning, it is a known fact that people who experience anything that they feel is beyond their ability to manage, such as stress, fear, frustration, and the like, will inevitably turn to alcohol for relief.
How is Social Anxiety and Alcohol Addiction Treated?
Co-occurring conditions such as social anxiety coupled with alcohol addiction are typically treated together, as there are many instances where treating one condition before the other only proved to make the entire more difficult as the condition that was treated later became worse. There is also the matter that one condition may be feeding the other, in which case, addressing both at the same time could prove to be far more effective than just treating one first before the other.
Depending on the severity of the situation and the assessment of the specialist providing addiction therapy services in Ohio, several approaches could work in addressing these issues, including:
Talk therapy or psychological counseling typically involves a patient engaging in dialogue with a therapist to bring out what might be causing them distress, and thus triggering their anxiety. Psychotherapy has been clinically proven to help patients by giving them the benefit of “unloading” or talking about the issues that bother them, as one of the foremost beliefs in psychology is that unaddressed issues often “fester” and worsen other underlying conditions.
Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy (CBT) is an approach in psychotherapy that many therapists use when dealing with anxiety disorders, including social anxiety. CBT for substance abuse focuses on teaching the patient the specific skills to recognize thought patterns and behaviors that lead them to harmful actions and feelings.
This is important to note because many people unconsciously induce an anxiety attack because of the way they think, “working themselves up”, so to speak. One example of this relevant to social anxiety is the way they seem to always think ahead of how many people could be at a given event, or how many mistakes they could commit in the presence of others.
By being able to recognize specific thought patterns that induce a person to get worked up into an anxiety attack, they can avoid these thought patterns, and therefore, prevent the onset of an anxiety attack. Even if they are not completely able to prevent the onset of anxiety, they are at the very least able to mitigate the overall effect of the anxiety attack as they already know it is coming. By knowing that an anxiety attack is coming, they are at least given the option to manage their reaction to the best of their ability.
There are several medications used to help relieve symptoms that people experience when they have an anxiety attack. People need to understand, however, that medications will not treat the actual anxiety. The medication is given so that the effects of the anxiety are better handled or kept at a manageable level. These medications need to be able to directly affect the central nervous system, as the nature of anxiety is associated with mental health. This is another reason why a person with social anxiety and alcohol addiction needs to address their alcohol use with alcohol detox in Ohio, as alcohol is known to not only affect any medication taken but could also interact with the medication in a hazardous manner.
Legends Recovery Can Help You with Co-occurring Anxiety and Alcohol Addiction
Having to deal with one persistent issue like social anxiety could be difficult enough without having to deal with the additional burden of having an alcohol addiction that comes with it. This might prove to be far more than any person could recover from if they don’t receive the necessary care and attention they need to facilitate their recovery.
This is why we here at Legends Recovery, a rehab center in Ohio put every effort into helping people with their issues because this could be the only chance the person might have at getting better. Talk to us now.