Extreme Shyness: Social Anxiety the Malady of our Times

The High Frequency of Extreme Shyness: Social Anxiety the Malady of our Times

Extreme shyness–or social anxiety–is the most common mental disorder in the United States. It is also the most common of all the anxiety disorders.

About 1 in 8 people (12 %) in the US have suffered from Social Anxiety Disorder (SAD) at some time in their life.
Out of a population of 330 million people in the US, some 40 million report having suffered from this condition in their lifetimes!
These are staggering numbers as we see that one of eight people you meet suffers from this condition.
Always keep this fact in mind before judging someone else as a “snob.”

This number is called the “lifetime prevalence” of social anxiety as a disorder. In a given year, about 7 out of every 100 (or approximately 15 million people) suffer from Social Anxiety Disorder (this is called the “12-month prevalence of the disorder” or how many people suffer from social anxiety in a given month).

According to the National Institute of Mental Health, Social Anxiety–or excessive shyness–is defined as:

“Social anxiety disorder (formerly social phobia) is characterized by persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.”

Social Anxiety Disorder Among Adults

Based on diagnostic interview data from National Comorbidity Survey Replication (NCS-R), the past year prevalence of social anxiety disorder among U.S. adults aged 18 or older is:

1-An estimated 7.1% of U.S. adults had social anxiety disorder in the past year.

2-Past year prevalence of social anxiety disorder among adults was higher for females (8.0%) than for males (6.1%).

3-An estimated 12.1% of U.S. adults experience social anxiety disorder at some time in their lives.

Putting social anxiety into perspective

Statistically, the number one fear among Americans is public speaking (which is a manifestation of social anxiety).
The second most common fear reported in surveys is Death.
This means that in a funeral most Americans would rather be the person in the coffin rather than the one giving the eulogy.
This is just a funny way of putting it, but this is really a sad state of affairs for those who suffer from this crippling psychological condition.

Why are we so socially anxious?

Despite its frequency and its impact on people and society, Social Anxiety Disorder—not only is an all-too-common problem in America–but it is undiagnosed and neglected in clinical and research settings. The main reason for this neglect is that no new medications have been FDA approved for this condition in about a quarter century now, so there is no money to be made from this diagnosis.

Why don’t we hear more about this problem

In the last three decades, pharmaceuticals have focused on other more profitable conditions, such as ADHD, Bipolar Disorder, Major Depression, and Schizophrenia. The reason for the focus on those other disorders is that these companies invest money on promoting the diagnoses for which their new drugs are FDA approved. Another reason for its neglect is the educational deficiencies in mental health professionals and psychiatric residency trainings that do not pay enough attention to this problem.

And finally, the fact that most people with social anxiety hide their fear pretty well contribute to the lack of its detection. These individuals are introverts and do not see their extreme shyness as a psychological problem that needs help. They just lead an avoidant lifestyle and live around their fear of people. An avoidant person rationalizes their excessive shyness as permanent character traits. For this reason, you will often hear the socially anxious say: “I don’t care much for socializing, I am ok as I am, I am ‘a homebody,’ I have always been like this.”

Social Anxiety is a growing mental health problem in America

Statistics today are better than they were in the past; and they seem to show an increase in the incidence of this condition across the board. Clinically, my experience is that extreme shyness is becoming a much bigger problem in larger numbers of people in the US, particularly in the younger generations.

Why are we getting more socially anxious in this country now

I think that there are multiple factors in our post-modern lifestyle that promote social isolation and social anxiety. Too many to mention them all here. But I will advance a few that are relevant to being implicated in its increase in frequency and in severity of SAD:

People today are more isolated than ever before in history.
The COVID19 pandemic has exacerbated the problem of social isolation.
As a result of automatization, the internet, and cybernetics, we are now more and more in contact with machines (AI, computers, and robots) than with people.
Today most people feel more comfortable text messaging than picking up their phones and talking to someone personally.
This tendency to communicate in written form takes away the anxiety from the interaction and the social skills of maintaining a real phone conversation with another person.
Fear and distrust have grown immensely in American society in the last four decades–and with justified reasons.
Given the high frequency of betrayal in relationships and emotional, physical, and sexual abuse people are less inclined to trust others.
The advent of social media has transformed the way people communicate.
People’s reputations can now be easily ruined by any ill-intentioned individual by going public online without the implicated person being able to defend himself/herself.
Cyberbullying has become commonplace and is wreaking havoc with pre-teens and teenagers’ self-esteems.
As a result of social media, we are all much more exposed to ridicule and the potential for image-bashing by large numbers of people.
We are all much more influenced by the need for approval from others–as shown by the number of “Like its” or “little hearts” we get on our social media applications.
People–but particularly young people in the last three generations–have not developed good social skills.
This loss in social skills training in the US has been a growing problem with every generation since the baby boomers.
This lack of exposure to social interaction that help develop social skills is aggravated now by almost a year of social distancing and stay-at-home orders caused by the COVID19 pandemic.

What to take home out of this first post on this subject

This post is the beginning on a series of posts about this subject. The most important points to keep in mind here today are these:

A little bit of shyness is normal, particularly in childhood and early adolescence in most people.
An excessive amount of shyness can be the harbinger of a social anxiety disorder, social phobia, or avoidant personality disorder.
Too much shyness is a symptom of low self-esteem and predisposes people to depression.
If you have children, observe them to see whether they can be suffering from social anxiety.
If they do, have them checked by a child psychologist or therapist.
To avoid this problem from becoming even more frequent, it is important to realize whether you suffer from social anxiety disorder. In this regard self-observation and other people’s opinions about your behavior matter.

If you feel your people anxiety gets in the way of you being able to do what you want to do, whether this is asking someone out on a date, talking to a stranger, speaking in class or in public, making friends–asking for favors or applying for a job–then consider consulting a psychiatrist or a psychologist/counsellor to help you overcome your social anxiety problem.

The worst thing you can do with your social anxiety is to tell yourself that “this is the way I am, I have always been this way, and there is nothing I can do to change it.” These statements are simply not true. These are signs that you are transforming your social anxiety disorder into an Avoidant personality disorder.

You should go by this rule of thumb, if you want to do something and your anxiety prevents you from trying it or doing it–or if you keep postponing it forever–then you probably suffer from social anxiety that requires treatment.

There are effective medications, and psychotherapeutic and behavioral interventions that can help you overcome your shyness. Do not hesitate to avail yourself to these means for improvement. The option, as always, is yours and is in your hands. Do not let your life pass you by.

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I hope to see you in my next post. Till then, stay safe and sound,

And have a peaceful holiday season and a great 2021

Dr T