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We offer both in person services based in Mission Valley as well as telehealth services via video-conferencing platforms to patients located in California.

We do not accept walk-ins. You must contact our Clinic Coordinator at 858-354-4077 or info@csamsandiego.com before visiting us on site.

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IF YOU WOULD LIKE TO INQUIRE ABOUT TREATMENT AT CSAM, PLEASE FILL OUT THE FORM AND A THERAPIST WILL CONTACT YOU TO MAKE AN APPOINTMENT.

You may also contact us via phone or email:

Phone: 858-354-4077

Email: info@csamsandiego.com

7860 Mission Center Ct, Suite 209
San Diego, CA, 92108

858.354.4077

At The Center for Stress and Anxiety Management, our psychologists have years of experience. Unlike many other providers, our clinicians truly specialize in the diagnosis and treatment of anxiety and related problems. Our mission is to apply only the most effective short-term psychological treatments supported by extensive scientific research. We are located in Rancho Bernardo, Carlsbad, and Mission Valley.

More than Butterflies: Overcoming Social Anxiety

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Read our award-winning blogs for useful information and tips about anxiety, stress, and related disorders.

 

More than Butterflies: Overcoming Social Anxiety

Jill Stoddard

a guest blog post by Barbara Markway

The Signs, Symptoms, and Learning How to Cope

Most of us can relate to feeling anxious before a big speech, a job interview, or a first date. But for some, the experience is much more than butterflies in the stomach.

If you worry a great deal about what others think of you, you have social anxiety. You might be uncomfortable returning items to a store or ordering pizza over the phone. You might avoid social gatherings. You may have few or no close friends. Perhaps you’ve turned down job promotions because you feared needing to make presentations. Maybe you even use alcohol or drugs to feel more comfortable in social situations.

When social anxiety ramps up to this point – where you’re living your life based on fear – it’s morphed into what’s termed social anxiety disorder.

According to the Anxiety and Depression Association of America, social anxiety disorder is characterized by an extreme fear of judgment and scrutiny in social and performance situations. It’s a serious, real, and treatable disorder. According to the ADAA, about 15 million American adults struggle with social anxiety disorder, making it one of the most common psychiatric disorders, second only to depression.

Signs and Symptoms

The symptoms of social anxiety disorder fall into three categories: mental, physical, and behavioral. People with social anxiety are plagued by negative thoughts and beliefs about themselves. With the fear of possible rejection or disapproval being foremost in their minds, they scan their surroundings for any signs that confirm their negative expectations.

Physical symptoms most commonly include blushing, sweating, and shaking. Full-blown panic attacks, in which a rush of physical sensations bombards them all at once, are not uncommon.

Finally, people with social anxiety may go to great lengths to avoid the situations they fear.

Do you have a problem?

Because we all have some degree of social anxiety, how do you know whether you have a problem? Start with these questions:

Do you feel extremely uncomfortable in social situations?

Do you consistently avoid social situations?

Are you self-conscious and believe everyone is watching you?

Do you constantly worry about what you do and say?

Do you worry a great deal about doing something embarrassing?

Do you worry for weeks before the dreaded situation?

Do you critically analyze your own performance after the situation?

The more of these questions you answer “yes” to, the more likely it is you have social anxiety disorder.

Positive Thinking Versus Realistic Thinking

When feeling anxious, you’re likely to give yourself a pep talk and say things like, “Don’t worry. It’s no big deal.” Similarly, other people may tell you to “think positive.” Although well meaning, this advice is not particularly useful. What’s needed is not positive thinking but realistic thinking.

Two types of unrealistic thinking contribute to social anxiety. First of all, you may overestimate how likely it is that something bad will occur. Second, you may exaggerate how bad it would be if the feared thing actually did happen.

Let’s look at an example in which Jennifer is worried about an upcoming business lunch she will be attending. She may have anxious thoughts running through her head such as: What if I don’t have anything in common with the other people there? What if there are awkward silences?

What could be a calming, realistic way for Jennifer to think about the lunch? Jennifer realizes that she may or may not have much in common with the other people there, but she at least does “OK” at these meetings. Even if she does not have much to offer, she can always ask people questions about themselves to show an interest in them. And even if there are some awkward silences, it’s not the end of the world. She can focus on trying to be helpful to the other attendees, to meet their needs. That’s what they are likely to remember.

What can you do?

But what if you feel out of control physically – rapid heartbeat, trembling and clammy hands, perhaps even some dizziness? These sensations can be so unnerving.

When you are anxious, you tend to breathe in a shallow and rapid manner. This can cause you to feel dizzy and short of breath. With practice, though, you can change this.

While sitting or lying down, place one hand on your chest and one on your belly. Take a deep breath and try to have your belly move more than your chest. Feel your belly rise as your lungs fill with air. Once you are able to do this, you have succeeded with the first step in learning belly breathing. Next practice breathing in slowly to a count of four and exhaling slowly to a count of four. Practice breathing with this steady rhythm, in and out. Notice how you feel more relaxed. Practice this several times a day for a few minutes at a time.

Belly breathing allows your body to calm down. With practice, belly breathing will help you be more relaxed, and no one will even know you are doing it.

When things make you anxious, you may find may find yourself developing a pattern of avoidance. For example, if you hate having to stand in front of a group to do any kind of presentation, you may not take a job that required this. Avoidance may temporarily help you feel better, but you never learn how to overcome the fear.

Most people find that gradually confronting their fears, one small step at a time, is what helps the most. For example, John hated any type of public speaking. When his therapist asked what first step he might be able to take, even though it still made him anxious, he thought he could ask one question in a meeting at work. There was a specific question he had regarding a new project a team was working on, and he planned what he would ask.

He was quite nervous ahead of time and practiced his belly breathing. He also used realistic thinking by reminding himself that he had a legitimate question and that others in the meeting likely would focus on the answer to the question rather than on him. He felt considerable relief when he was able to follow through. Over time, he gradually became more open to talking in front of the group.

Even if you do everything suggested here, you may still struggle. Sometimes it seems that the more we “fight” our anxiety, the more it fights back. Keep in mind though, you are not a “failure” if you feel anxious – you are human.