You’re at a social event where you don’t know anyone. Your hands tremble and your voice shakes. You begin to sweat, and you feel a little queasy. If this scenario sounds familiar, you may be dealing with social anxiety.
What Causes Social Anxiety?
So, what is social anxiety? Social anxiety disorder is a mental health disorder that causes a person to feel high anxiety in social situations, especially public events. Physical symptoms of social anxiety include nausea, excessive sweating, tremors, and trouble speaking.
Social anxiety can also cause psychological symptoms, including:
- Excessive worry about being in a social setting or event
- Avoiding social interactions with others
- Worrying about public embarrassment
- Frequently missing school or work
Who it affects: Research shows that social anxiety is especially prevalent among millennials, defined as those who were born between 1981 and 1996. There is no social anxiety test or anxiety disorder test. A mental health professional will make a diagnosis of social anxiety based on a description of symptoms and where and when they occur.
What causes it: While the cause of the disorder is unknown, it may be attributed to mental stressors. Researchers have also identified a connection between the prevalence of social media in modern society and social anxiety. In general, Millennials tend to be tech-savvy, and these days it’s often common to spend more time on virtual interactions than in-person relationships.
Other contributors: Social media stressors – cyberbullying, scams, and cheating – in particular, have also been associated with some mental health disorders. These include anxiety disorder, depression, self-harm, and suicidal thoughts.
Early childhood experiences can also contribute to social anxiety. For example, shy children and those with overbearing parents may be more likely to become socially anxious as adults. In addition, challenging early experiences, such as bullying and abuse, may also contribute to social anxiety. Another possible cause is poor social skills.
What It’s Like To Live with Social Anxiety Disorder
To better understand how to cope with social anxiety disorder, here are three first-hand accounts of individuals with the disorder and some tips on how to manage social anxiety symptoms.
“My family has given up on inviting me to events that are based in a public setting.” – Kate, 38
Kate, a 38-year-old nurse, began struggling with social anxiety about five years ago, in addition to ADHD and general anxiety. She began finding herself feeling extremely anxious at concerts and other public events. She changed her grocery shopping routine to go to stores that weren’t as busy. Often, she will reschedule doctor’s appointments several times before finally going. Her social anxiety has also impacted her personal relationships. Kate says she often makes excuses to miss weddings, funerals, and weekend trips.
Large crowds and being in public for extended periods of time can trigger Kate’s social anxiety symptoms. Noisy crowds can feel overwhelming. In these situations, Kate says she often feels irritable and distracted. She becomes hyper-vigilant and fearful that something horrible might happen.
Kate copes with social anxiety by taking anxiety medication and attending remote therapy sessions. She also wants to explore natural remedies like breathing exercises to help her manage her symptoms.
“I feel out of place, even when the environment is supposed to feel warm.” – Melissa, 37
Participating in conversations can be difficult for Melissa, an IT project manager. She says her brain races to keep up with the conversation while she frantically tries to think of ways to contribute to the discussion. Meanwhile, her lips and mouth feel dry and “gummy.”
Although being in social situations where she doesn’t know people well often triggers her social anxiety symptoms, Melissa also struggles when she is with people she does know well. In fact, she says she has canceled professional and personal events because of social anxiety.
Melissa says she takes social anxiety medication to manage her symptoms. Besides taking medication, Melissa is also curious about exploring other ways to relieve anxiety symptoms.
One natural strategy Melissa could try is making sure that she’s getting enough rest. Getting a good night’s sleep can help control social anxiety effectively.
Aromatherapy also can help with relaxation and sleep. Using an essential oil diffuser to pair different scents, including lavender and bergamot, can promote calmness and quality sleep. Aside from burning incense or aromatherapy candles, drinking a cup of jasmine tea can soothe the mind with its sweet aroma.
“Social anxiety is definitely something I would like to get past. It would change my life for the better, both personally and professionally.” – Toby, 40
Toby works with horses in his current occupation. However, he wants to be self-employed. He feels frustrated because it is difficult for him to grow as an entrepreneur due to his social anxiety symptoms.
Whenever he’s around people he doesn’t know well, Toby says he feels extremely nervous. He begins to feel hot and shaky. These symptoms have caused him to avoid people completely at times. Sometimes he will rely on someone else to manage social or business interactions for him.
Toby relies on physical exercises like lifting weights and bicycling to help manage his anxiety symptoms. He knows that finding healthy ways to manage his social anxiety is critical for him to expand his business.
In fact, studies have found that regular physical activity and mindful meditation can be effective in alleviating anxiety symptoms. Physical activity, specifically, can help by reducing hypothalamic-pituitary-adrenal reactivity and increasing endorphins output.
For example, Tai Chi and Qi Gong are ancient, traditional forms of “moving meditation” that directly impact endocrine circulation and the nervous system to balance and strengthen qi, or vital life force.
TCM and Social Anxiety
From a Traditional Chinese Medicine (TCM) perspective, certain organs are also associated with emotional and psychological functions as well as physical functions. TCM views social anxiety as an imbalance of the heart and stagnation of liver qi, or life force. But it also can affect other organ systems.
It is important to understand that TCM views the body and its functions holistically. This means that no “entity” is separate from its relationship to other entities. From this perspective, physical and mental problems correlate and can be a product of disharmony between what TCM calls the “5 Spirits/Energies” and 5 internal (Zhang) organs.
These “5 Spirits” include Shen (mind, connecting Spirit, resides in the heart), Hun (ethereal soul, resides in the liver), Po (corporeal Spirit, resides in the lung), Yi (intellect, thought, resides in the spleen), and Zhi (will, resides in the kidney). Shen is associated with joy, whereas Hun relates to anger. Po relates to grief, sadness or worry, while Yi and Zhi are linked to pensiveness and fear, respectively. Typically, TCM practitioners perceive emotional dysregulation as a disturbance of a person’s Shen (Heart energy). Anxiety can also cause a disturbance of Po (Lung energy).
These natural remedies can help to relieve anxiety symptoms when a person is feeling stressed or anxious.
Acupuncture and acupressure
Acupuncture is one of several types of treatments TCM practitioners recommend. In fact, scientific evidence indicates that acupuncture can improve symptoms in people with anxiety who weren’t responsive to other treatments.
Eu Yan Sang’s TCM physician, Kong Teck Chuan, explains how acupuncture can help to relieve stress and symptoms of anxiety in the body, “Stress and anxiety can cause qi flow to be stagnated and muscle tension to build up. Acupressure, which refers to the application of pressure on acupoints or meridians, can promote blood flow and qi circulation while helping to calm us down and reduce tension in our body, thus helping us relax.”
Physician Kong suggests acupuncture for promoting qi (energy) circulation, which, in turn, will help to treat problems associated with qi stagnation. Acupuncture can also complement the consumption of herbal formulations made with rosebuds, mimosa tree bark (He Huan Pi), or chaiyote (Fo Shou).
Applying pressure to common acupoints like EX-HN3 (Yintang), HT7 (Shenmen), GB 21 (Jianjing), LI-4 (Hegu), LR 3 (Taichong), and PC6 (Neiguan) can help relieve social anxiety symptoms when a person is feeling stressed or anxious.
You can also try consuming 8 Treasures soup (Ba Zhen Tang), Spleen Restoration formula (Gui Pi Tang), or Chinese Angelica (Danggui) to nourish blood and qi.
Additionally, he also suggests that people who are consuming blood-thinning medicine should seek professional advice before deciding to consume herbs that promote circulation, like Danggui.
Consuming dried hawthorn berry slices is another natural option to help with anxiety. It can help alleviate anxiety and tension and stabilize your blood pressure level. Eat it raw, as this is a great on-the-go snack, or make a cup of tea.
However, physician Kong cautions, “The only absolute contraindication for the use of hawthorn is known hypersensitivity to Crataegus products. We don’t recommend using this herb during pregnancy because of potential uterine stimulation. One publication recommends against use in pregnancy based on results of animal studies and human case reports.”
Consuming foods like brown rice, barley, quinoa, and oats also can help to promote relaxation. Nuts and chickpeas, meanwhile, can provide your body with tryptophan, which can promote feelings of happiness by boosting serotonin.
Drinking a TCM health beverage can help you manage social anxiety. Choose one with ingredients like red dates, ginger, longan, and goji berries that are specially formulated to nourish your blood and calm your mind.
Social anxiety can be challenging, and it can affect everyone differently. While there is no one-size-fits-all method for coping, these first-hand accounts and TCM tips provide a few ways to manage anxiety symptoms. If you’re struggling with social anxiety, you also may want to reach out to a mental health professional for more help.
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- Cureus. 2020. Social Media and Its Connection to Mental Health. [Accessed 29 October 2021]
- Alexander Bystritsky, M.D., Ph.D. Anxiety.org. 2021. Western Medicine and Traditional Chinese Medicine Can Complement Each Other. [Accessed 29 October 2021]
- HelpGuide. Social Media and Mental Health. [Accessed 29 October 2021]