Imagine a room full of people. You don’t know anyone. Your hands are sweaty. You want to talk to someone but don’t know what to say. Your heart starts beating faster. You feel an overwhelming sense of panic.
Now imagine feeling like that in every social encounter you have – that’s what social anxiety is like.
The NHS defines social anxiety disorder as a “persistent fear about social situations and being around people”. This disorder manifests itself not only in situations of stress, but also during mundane activities like talking on the phone, shopping or going to work.
While people who suffer from social anxiety develop ways to deal with their condition, unfortunately these frequently involve alcohol.
Alcohol, a deceptive coping strategy
A study conducted in the US found that around 20% of people suffering from social anxiety also developed an alcohol use disorder. There was also a reverse relationship, with 15% of alcohol abuse cases being associated with symptoms of social anxiety.
At Castle Craig, around one quarter of patients being treated for alcoholism show forms of social anxiety: from milder manifestations to the more acute form known as social phobia.
In most cases, alcohol was used as a way to combat feelings of embarrassment in social situations, while many also drank as a means of dealing with stress.
Alcohol creates a false sense of security, and what starts off as a temporary solution becomes a long-term problem. Indeed, according to Dr Jim Craig, a Consultant Psychiatrist at Castle Craig, alcohol augments anxiety, rather than relieving it: “It may relieve anxiety and it may enhance self-confidence and self-esteem for a few hours”, he says. “But as it comes out of a person’s system, they are often left feeling more anxious, more agitated, so there is a vicious circle of taking more alcohol to cope with the resultant anxiety and agitation.”
High expectations and other contributing factors
Drinking as a coping strategy for social anxiety can also be about expectations. “In certain industries heavy drinking, especially amongst men, is the norm,” explains Dr Craig. “Drinking is expected of certain high-flyers, who have to hold a lot of meetings and do a lot of entertaining.”
However, social anxiety and alcoholism do not exist in a vacuum free of other factors. Self-esteem, high stress levels and personal trauma all play their part in fuelling anxiety and alcoholism.
One major concern besides the associated alcohol misuse has been the common practice among doctors of prescribing painkillers to treat anxiety. Dr Craig says: “Sometimes, even nowadays, the easiest thing for the doctor is to prescribe tablets like Valium or Librium. [It] looks like about one third of people who get Valium and Librium become hooked.”
With anxiety and alcoholism frequently going hand in hand, it makes sense that both are treated together as if they were part of the same problem. And a key component of any treatment is interaction with peers, sharing experiences and making the most of the feedback from other members of fellowships.
“Whenever I see patients I ask them if they’ve given the others their life story. Then I ask how was it giving your story, how was it received, what did your group say?” Dr Craig says. “I’ll ask what came out of it, what strengths and weaknesses the group found. These are all part of making the person not only deal with social anxiety, but also with other problems they have with themselves.”
What is your experience with social anxiety?
Photo source: Wikipedia