Social anxiety disorder – a seasonal epidemic

It is that time of the year when therapists and client alike can encounter SAD. Those initials usually refer to Seasonal Affected Disorder with that feeling of despondency or depression which comes with the dark nights.

There is, however, another very common form of SAD which is around at this time of year. This is the condition known as social anxiety disorder. An alternative name is social phobia. This SAD can become particularly prevalent from early December onward. The clinical definitions include ‘a marked and persistent fear of social situations’ and also that ‘social situations are avoided or else endured with intense anxiety or distress’.

The condition can occur at any time but for most sufferers, the festive season is particularly difficult with those social occasions which can at best come with a mild anxiety and at worst strike overwhelming terror into the minds of those affected. 

The Christmas work function, the New Year party and the family festive event can all loom large, evoking feelings of dread. And yet those who celebrate social events just do not understand the feelings of those who have social anxiety disorder. One of the most challenging aspects of social anxiety disorder is that it creates for the sufferer worry and torment about those situations that others seem to just enjoy and celebrate.

So what is to be done? Well if this condition affects you perhaps a good starting point is to recognise that you are not alone. Statistics suggest that this form of that SAD is increasingly commonplace. There is a continuum of experiences which go from a mild discomfort at the prospect of eating in public to a sense of unremitting horror at the prospect of attending a Christmas party with strangers.

The reasons underpinning SAD will be individual but will often have origins back in earlier life.  Childhood embarrassment, early family patterns of shunning social activity or years spent living with parents who were reclusive are all types of early life phenomena which may cause some individuals to develop social phobia. 

An understanding of just why one reacts in this way can be helpful for some sufferers. Rather than being continually self-critical with frustrating thoughts around perceived flaws in ones’ personality, the development of an understanding as to ‘why me’ can help to reduce that self-criticism. This can, in turn, encourage sufferers to think about how to move forward and to find remedies.

One positive suggestion is that social competence can be seen as a skill to be learnt just like any other. For example, if in childhood one was never taught to swim, an unease about being in water may persist into adulthood. That fear can, however, be tackled in later life through activity such as swimming lessons for adults. And those lessons can be undertaken whether one is eight, eighteen or eighty. Of course the eight year old may have slightly greater confidence than the eighty year old but so what!

The same can be true of the social world. Some people learn social competencies at an early age through the family practice of having an open front door where the welcome stream of visitors and relatives was unending. The ability to converse with all groups and ages develops organically and becomes as natural as breathing. Yet there will be many others who have not had that early socialisation and consequently have a more difficult path to tread. But change is still possible.

That may require some reflective work to think through firmly held views and thoughts on interactions with others. It may also be helpful to look to some practical experiences such as starting to undertake some of those social situations which would usually be avoided. It can be here that work with a therapist may provide much needed support and encouragement.

Combating SAD can be challenging particularly for those who are impatient for change. There are rarely immediate short cuts and any instant remedies which are substance based be it booze or drugs, carry an obvious warning. Alcohol can certain loosen inhibitions but reliance on this form of help can quite quickly create challenges of dependency as well as that embarrassment of the next morning when the memories come flooding back – or perhaps not dependent upon the amount imbibed!

Reducing social phobia like most changes to the emotional self takes time but it can be done.  Counselling approaches may include some behavioural and cognitive work. Remedies will often involve a degree of gradual exposure perhaps together with some work on thinking models. Solution focused work can also be helpful involving a degree of idealising and a looking at changes that are necessary to achieve a desired solution.

These practical responses are probably present in most remedial programmes. The optimum approach should always be tailored to the needs of each individual. An agreed way forward should reflect the extent and the degree of concern held by the individual SAD sufferer. 

The key point is that progress can be made. This type of therapeutic work is not intended to propel the reluctant socialiser into the social mix without any concerns. It is more an approach that looks to gently ease back those worries. The intention is to gradually allow fears to become concerns and those concerns to then reduce to a slight apprehension. 

It is important to acknowledge the reality that before any social event most people will have some emotional reaction about what is to come. There is a normality even for the most emotionally robust about feeling apprehensive when walking into a large crowd, of having butterflies before meeting his or her partner’s family for the first time (or sometimes the hundred and first time) or about feeling uneasy at a social function where most people will be unknown.

Perhaps the key challenge is to be able to acknowledge that concern but to walk through the door and engage anyway. As a generalisation the more we do something the more competent and confident we become. The novice swimmer will stand with some trepidation at the water side whether she or he is eight or eighty. Once in the water that trepidation can quite often literally be washed away.

For many people socialising is not easy. And even those in a social function who seem to effortlessly drift from group to group will have their own misgivings albeit well concealed. Nevertheless, if the plunge can be taken in the coming weeks to attend the least daunting of the events on offer, that may mean that next year things may be a little easier.  

And a final thought. Another phrase often heard around this time of the year is “I did not want to go but now I am glad I made the effort. I really enjoyed it”. Perhaps the constant use of that phrase suggests that there really can be an antidote to SAD which will also work for you!