Social Anxiety: A Spectrum From Shy to Avoidant
It can be confusing and frustrating. All around you, you see others attending meetings, luncheons, study groups, parties, and activities. "Everyone" seems able and willing to do so. But for you, the mere thought is horrifying. So what's up? Are you "simply" shy? Is it something more than that? The answer is actually quite personal.
Anxiety in general has defining characteristics. That said, how, why, where, and how intensely someone experiences anxiety is quite individualized.
From Shyness to Social Anxiety Disorder to Avoidant Personality Disorder
Experts use labels and categories for anxiety. This is useful because it provides a common language for understanding and communicating. However, in reality, the types of anxiety, including social anxieties, aren't entirely separate packages stored in distinct boxes. Think of social distress as a spectrum or a continuum.
On the left of the spectrum is shyness. People who describe themselves as shy often say they feel hesitant, uncomfortable, and nervous around others. They may be reluctant to join a group or contribute to a conversation, but they often feel more comfortable and are able to join in once they have time to get used to a situation.
Social Anxiety Disorder (Social Phobia)
As one moves along the spectrum and approaches the middle region, one will encounter social anxiety disorder (SAD, social phobia). At this level, things go beyond discomfort. There is often an accompanying dread associated with having to deal with people. SAD is also about fear: the fear of being judged, criticized, ridiculed (openly or behind one's back), and rejected. There's also a prevailing fear of being embarrassed and humiliated. Sometimes, but not always, these intense fears induce panic attacks.
Avoidant Personality Disorder
Continuing along the spectrum, at the very right, is avoidant personality disorder. This is so extreme that it's actually classified as a personality disorder rather than an anxiety disorder; however, it is based on anxiety and fear. It's quite similar to SAD, but it's extremely magnified. With avoidant personality disorder, the fear even extends to intimate relationships and familiar situations and is so intense that the person avoids almost all social settings.
Social Anxiety is a Matter of Degree
When you're feeling frustrated because of uneasiness in social situations and you're worried about it, don't try to fit yourself into a little box. Instead, think of how this distress impacts you. Remember, it's personal. It's not a matter of black-and-white; it's a matter of degrees and where you fall. How do these apply?
- level of fear
- level of avoidance of people and situations
- severity and frequency of your anxiety symptoms
- duration of the symptoms
- impairment of functioning/how much this impacts your life, your satisfaction, your ability to work and engage in activities
Your personal answers to these questions will help you decide where on the spectrum you fall. Both the answers and the placement on the spectrum will help you determine what this all means for you and in what ways you might want to make changes.
NCC, T. (2014, March 5). Social Anxiety: A Spectrum From Shy to Avoidant, HealthyPlace. Retrieved on 2019, September 22 from https://www.healthyplace.com/blogs/anxiety-schmanxiety/2014/03/social-anxiety-a-spectrum-from-shy-to-avoidant
Author: Tanya J. Peterson, MS, NCC
Your message is amazing. You have a lot of insight into yourself and your world (school, peers, home). Your ability to reflect on what's causing you difficulty and think about it on this level indicates intelligence, thoughtfulness, and maturity. This is a big part of what makes someone resilient and able to thrive despite problems, even things like social anxiety in high school. While I do think your doctor's suggestion about counseling is a good one, I also think that the time might not be right for you right now. So don't feel that you "should" be going to a counselor. Because of your level of insight and intelligence in communicating, you might consider bibliotherapy, which is the process of healing and growing through reading. Your library will likely have books about social anxiety, and hopefully the library will have books specifically for teens. Books about communication are great, too, because they can help you develop one-on-one conversation skills. A few books to look into: The Shyness and Social Anxiety Workbook for Teens: CBT and ACT Skills to Help You Build Social Confidence by Jennifer Shannon LMFT and Doug Shannon (note: I love ACT -- acceptance and commitment therapy -- and paring it with cognitive behavioral therapy (CBT) is great for social anxiety), Smile and Succeed for Teens by Kirt Manecke, and Beyond Texting: The Fine Art of Face-to-Face Communication for Teenagers by Debra Fine. (A note about this one. Personally, I find the title and description a bit off-putting, as if the book is written to "straighten kids these days out." :) Looking beyond that, the content of the book seems good.) These are just a few examples. If you like the idea of finding books to help you discover how to rise above social anxiety, you'll discover that there are many different choices available. Social anxiety can be terrible (as if adolescence and high school weren't challenging enough!), but you can grow past it.
Anyway, I was wondering if you could help me to determine this social problem of mine.
Ever since I was a kid, I've always been quiet and shy; however in the past year or so, it's been getting sort of worse. I socialise less with my family, my lack of socialness is increasing.
In public, especially in school, when I walk the hallways or am sitting in lessons, I usually think that everyone is judging me and I feel quite insecure, nervous and uncomfortable. I always care what people think of me and sometimes/usually this can stop me from doing the things I want. Sometimes I worry about the way I'm walking, or even my eye movements. I worry if I might humiliate myself and I'm afraid of looking stupid.
I don't have any friends but I do have acquaintances. I feel like nobody likes me because I'm so boring and quiet. I often sit alone when I can. Plus, it's always been impossible for me to be myself when around people - the only people I am truly myself with are two of my cousins.
Also I have a throat problem that can affect my speech (I can temporarily lose my voice) and since I am so shy and often nervous this affects me greatly. This throat issue has been going on for a year and it's been hell. Everyday I worry whether I might lose my voice while someone is speaking to me.
I'm very self-conscious and I don't speak much; I am quite submissive. I fear I may offend someone if they ask for my opinion so I'll probably lie/sugarcoat the truth so I don't hurt them. Speaking of opinions, I'm afraid to express them because someone might disagree.
I can't put my hand up in class, I don't eat in public, I can't wear the clothes that I want in fear that people may judge me. I don't like going out to places where there are people because they'll judge me on what I wear and look. After whenever I have interacted with someone, I always criticise myself and find flaws in what I said, did or looked.
Most sites about social anxiety that I've been on usually state that people with social anxiety have intense fears and they have panic attacks. However my fears are not very extreme - although they do cause problems for me, and I worry about a lot of things - and I've never had a panic attack. I can talk to people I know without feeling that nervous and I can be calm when in school (but often I'm not comfortable).
I'm not sure if it's as far as social anxiety disorder because it seems so serious, and I've heard about other people's experience with social anxiety and theirs seem to be so much worse than mine - this leads me to think I don't have social anxiety at all. I know that I am definitely shy, but I think it might be a little more serious. I don't believe it's severe social anxiety or avoidant personality disorder. I'd like to talk to a counsellor but I dislike talking about my feelings face to face. It's really uncomfortable for me and I feel like they don't care at all. Could you please tell me what your thoughts on my symptoms are?
Also please remember again that all these numerous feelings of mine are not extreme - they most likely won't send me into a panic attack (yet) - they are just high in number and a little less than severe. Perhaps moderate.
By the way, I apologise to whoever is reading this as it's so long. Thank you for taking your time to read this :)
I'm very glad you commented. By reading articles, questioning, and commenting, you're being proactive in achieving your own wellbeing and happiness. I'm happy to reply, but please know that this won't be diagnostic. I would never try to do that based on the little snapshot you shared. There's so much more to you than the problem you're dealing with!
There are indeed different degrees of social anxiety. Also, while there are common symptoms of social anxiety, it is a very individualized disorder. What it's like for one person is different than what it's like for someone else. So while some people also have panic/anxiety attacks with social anxiety, others do not. Panic attacks are not required for social anxiety. Many things you describe do match social anxiety, but again, it's impossible (and unwise) to diagnose online. Some things that are considered when counselors/psychologists/psychiatrists make a diagnosis for any mental health issue are the length of time something has lasted. In your case, it's meaningful that it's been worse over the past year. You've perhaps been shy since you were a kid, but if that didn't disrupt your life or occur with other things, it could very well be temperament -- which never has the labels "good" or "bad" attached to it.) Since it's now worse, it's possible that you might be experiencing social anxiety disorder of some degree. Another thing that is considered when deciding if symptoms are part of a disorder is how much they disrupt and limit someone's life. The more disruptive or disabling the symptoms are, the more they point to a disorder. One other thing that should be considered (not all professionals take this into consideration, but many do) is development/stage of life. How old someone is and where they are developmentally does have an impact on mental health. Adolescence is a time of great change and discovery. Friends and peers become increasingly important, but because nearly every teenager is self-conscious (many don't admit it, but don't let that fool you), it can make social interaction difficult. If the awkwardness and discomfort continues, though, and even gets worse, and if it severely limits what someone does, then it could be social anxiety. Social anxiety can cause physical symptoms such as the one you're experiencing with your throat. However, it's important to see a medical doctor to rule out a physical illness. The Catch-22 about social anxiety is that seeing a professional can be extremely helpful in overcoming it (and it can be overcome), but the nature of social anxiety makes it hard to see a professional. Some people find it helpful to write a list of what they're experiencing to give to the therapist to start things off. If your school has counselors, you could start there. While it could be hard to start, it could also be incredibly helpful to see a professional therapist. It's very important to know that no matter what degree of social anxiety you may be experiencing, this anxiety isn't who you are. It's something you're dealing with, and it's something you can overcome in a way that works for you. You don't have to become something you're not in order to get rid of an annoyance.
Keep doing what you're doing -- seeking answers and help. It's not easy, but it's very worth it. You've already shown strength by reaching out. It's possible that nothing has been done with the school counselor because he/she can't do anything without you coming in yourself (I've been a school counselor, and that was usually the policy because of confidentiality and because it's best for the person seeking support.) Perhaps the person that spoke on your behalf could go along with you to see the counselor, at least at first. It might feel less intimidating that way. Keep moving forward!
Thank you so much for sharing your thoughts! I love what you had to say. The message I took from this is that being shy isn't "bad." Yes, there are challenges that result, but strenghts come from it too -- we are who we are, and who we are affects what we learn in life. I think general well-being would increase if people would accept themselves and accept others for all of our similarities and differences. I like your comment about techniques, too. No matter what it is we live with or what our inborn temperament is like, we can find ways to grow and overcome difficulties. We can embrace who we are while striving to beat obstacles. I'm glad you have visited our website, and I hope you return. (And happy birthday next week.)
Thank you for commenting. I will keep my comments to a minimum because you are addressing this to other readers for their thoughts. HealthyPlace is designed to be a place for people to interact with each other and exchange experiences, so it's great that there's a discussion here! I'll simply say that you aren't alone at all. There's no specifier attached to the criteria for social anxiety that indicates that the anxiety must happen around X number of people. You feel comfortable one-on-one, but anything more than that is very difficult. That's not at all strange, and that is definitely social anxiety. I'm wondering if you've ever tried gradually increasing the number of people you feel comfortable with by practicing with people you hang out with individually. For example, you could be with your finacee and then have a good friend or family member join you for a short time. I'm sure others can share their experiences as well as some tips. Oh, one last thing. Congratulations on your sobriety. Be proud of yourself for that. It takes a strong person to recognize a problem and take action to fix it.
It is extremely important for you to know that your daughter's anxiety is not your fault. Other than in extreme circumstances such as abuse, anxiety in children/adolescents is not caused by parents (studies show it). I'm a parent, too, and I know that it's natural for us to question ourselves when our children go through something like this. Truly, though, her anxiety is not caused by you. Your message indicates a mom who is extremely caring and wants to help her daughter. That is an asset, and your daughter is lucky to have such a supportive parent. Don't think of her anxiety in terms of what you are doing wrong. Think instead from her perspective. The best way to do that is to talk and listen to your daughter (you most likely are doing this, so keep at it!). Sometimes it's helpful to not focus so much on the anxiety. Talk to her about other things in her life: interests, classes, TV shows, anything other than the anxiety. Play games together or find other hobbies. These will show her that there's more to her than anxiety. Regarding her anxiety, don't ignore it. Ask her what would make things better for her, then slowly work to make those things happen. What strategies a therapist or school counselor should use will depend on her age and developmental stage. True improvement is a gradual process, but it can happen. (And one final thought: let her define what "improvement" means to her. If, for example, social anxiety is the main issue, she might not want to turn into a social butterfly. The goal doesn't have to be extreme popularity. It's perfectly okay if her goal is to simply be more comfortable in a classroom and have one or two friends to eat lunch with.) You seem very caring, and that is going to help your daughter.
I'm still a social butterfly, who loves interaction with people... I'd just rather interact with people I won't ever see again. (Like when I used to waitress, or cater for weddings). I'm great with strangers... better then even "normal" people, but when I have to go back to those I know, I'm so weary of what I do and say...and how it will effect the relationship in the future. To the point now that I don't even know how I could hold a job (with consistent co-workers) in order to fulfill my need for stranger interaction... or even figure out a way to dial the phobia back or at least keep it from progressing.
I'm so glad that you found this helpful. It's so common to think that we're the only ones experiencing something like this, and that makes us think there's something wrong with us personally. But there's nothing wrong with you. You're definitely not wrong as a person just because you are experiencing anxiety. Be patient with yourself as you try new suggestions and ideas (things take time), and adjust things if you need to so they fit you personally. You can do this!
I imagine that it might have been frustrating to be told that you'd grow out of your shell! Even if people were very well meaning, it kind of sends a message that there was something wrong with your shell. There is nothing wrong with being shy or having social anxiety disorder or avoidant personality disorder. The only thing that might be "wrong" about it is not a flaw in the person experiencing such social anxiety but a sense of "wrongness" if you think it's getting in the way of living the life you want. Living life around your nerves might not be limiting at all for you. Many people are very comfortable living quiet lives that aren't very social. And that's perfectly okay! Where it becomes problematic is if someone wants to come out of their shell but can't. There are ways to gradually do just that if you want to. But if you don't perceive a problem, then you should embrace who you are and how you want to live!
I just stumbled upon your answer here and it totally blew me away. It was exactly what I needed to read after years of feeling that there is something wrong with having social anxiety. I was taught to believe that and I have never viewed it in any other way until now. Your words are so unbelievably freeing. I actually think a lot of my social anxiety has been exaggerated by the belief that there is something wrong with it.
Thank you so, so much.
All the best
It's fairly common for social anxiety (phobia) to be with a person from a very early age. You're very correct that it could be caused by a variety of things. Sometimes exploring the cause is helpful, and other times it can prevent someone from moving forward. It's good that you are working with a therapist, as knowing when to explore the past and when to let go is a decision best made with help from a therapist, and one that you are comfortable with. You have another astute observation: that the more you avoid the fear, the bigger it becomes (that's true for all of us). Have you considered gradual exposure therapy and in vivo therapy? With these, you are slowly exposed to the phobia to let your mind and your body gradually become accustomed to social settings. In vivo means in life or in the world. The therapist accompanies you to various social settings and works with you through the fear until it becomes tolerable. Perhaps you might want to discuss these techniques with your therapist and he/she can help you decide if they are right for you. It's not easy, but there are ways to reduce that mountain to a hill. It might never be flat, but it will not be so big as to get in your way.
My therapist has told me that I should gradually be involved and get to know people, that the world is like a market where you can choose what to "buy" and what to avoid. I feel that it would be easier if i had someone to support me, but i am not very social and not an easy-going person.
I wish I could put everything behind me, because as i tried to understand the past I found myself in a breach with my mother which was painful especially for her. I wish i could erase the past and all these thoughts and move on.
Thank you once more.
I like your therapist's analogy of the world as a market. That's a very healthy perspective. We don't have to internalize the opinions of those whom we don't respect. That attitude takes practice, though! It is definitely easier with support. That's the catch-22 of social anxiety disorder: support is vital, and we do want support, but it can be very difficult to reach out and gain that support. Start small. Is there just one person that you would like to form a friendship with? If there isn't someone in your life yet, think of places that you feel at least a little bit comfortable and begin frequenting one or two. Over time, you'll feel more comfortable and notice others that are usually around. You can work with your therapist to practice ways of reaching out in an environment where you feel comfortable.
You're definitely not alone in wishing you could erase the past! That's a very common thought/feeling. It's too bad that that's impossible, isn't it? You can take it's power away, though, by focusing on the way you want your life to be from this moment forward and then by taking small steps to get there. It's not easy, and the past won't change, but you can reclaim your life. Having a supportive therapist is very helpful in this.