Have you ever had a drink to “loosen up” and feel more comfortable in a social situation? If so, you are close to understanding the connection between social anxiety and substance use. Research suggests that living with any type of anxiety disorder increases a person’s risk of developing a substance use disorder.
Misusing substances may provide temporary relief from anxiety symptoms, but it causes more problems in the long run. Some substances raise anxiety levels, and frequent use may lead to dependence and addiction.
What Is Social Anxiety Disorder?
It’s natural to feel some nervousness at social gatherings. Attending a holiday party where most of the people are strangers or even going to a family gathering can cause some people to feel anxious and uncomfortable. Having a social anxiety disorder is more than feeling a little nervous in a crowd.
Social anxiety is a type of anxiety disorder and a serious mental health condition. It can make everyday interactions difficult. People with social anxiety may feel they are being scrutinized and judged by others even when they are not.
The condition may affect relationships, lead to social isolation, and even make going to work or school impossible.
Everyone has a different comfort level when it comes to social situations. Some people are naturally outgoing, while others are more introverted. However, social anxiety disorder is more than just being introverted. It can significantly affect a person’s quality of life.
Symptoms of Social Anxiety Disorder
The symptoms of social anxiety disorder typically begin in the early teens. Older teens and young adults can also start experiencing symptoms for the first time. The disorder can be difficult to diagnose in teenagers because symptoms mimic many of the “normal” changes adolescents go through at this stage.
Symptoms include emotional, behavioral, and physical changes such as:
- Avoiding going to work, school, or social gatherings
- Not making eye contact
- Fear of being judged
- Fear that others will notice you look nervous
- Avoiding any situation that puts attention on you
- Intense feelings of anxiety during social interactions
- Expecting the worst from social interactions
- An inability to perform simple tasks such are returning items to a store or eating in front of other people
- Blushing
- Sweating, trembling, feeling nauseated in public
- Your mind goes blank when approached by others for casual conversion
The symptoms of social anxiety disorder can be mild to debilitating. They may change over time and flare up when you’re under stress. Avoiding social interactions may make you feel safe, but avoidance isn’t a solution. Fortunately, anxiety treatment is effective and can help you live a more balanced, happier life.
How Do Substances Affect Social Anxiety Disorder?
Some people turn to alcohol and other depressant substances to ease symptoms of anxiety. Self-medicating can relieve symptoms temporarily, but misusing substances creates a new set of problems.
To start, the long-term effects of alcohol and other drugs can make an anxiety disorder worse. Alcohol and other substances cause chemical changes in the brain that can worsen anxiety symptoms and create new ones.
Misusing substances activates the brain’s reward system and triggers dopamine release. Dopamine is responsible for producing positive emotions.
The immediate effect of a dopamine drop is pleasantly stimulating. However, substance misuse also interferes with the brain’s ability to regulate mood. It does this by blocking the release of neurotransmitters such as serotonin and norepinephrine.
Consistent changes in brain chemistry caused by substance misuse can lead to depression and anxiety. In addition, the reward of dopamine reinforces the brain’s desire for more alcohol or drugs. This creates a dangerous cycle that may require an addiction treatment program.
Substance misuse can intensify the fear and negative emotions related to social anxiety disorder. By lowering inhibitions, substances may allow all those uncomfortable feelings you are trying to control to come flooding out all at once. You may accidentally create the very “over-emotional” public scene that anxiety makes you fearful of.
Lastly, drinking or misusing drugs to cope with anxiety may prevent you from getting real help. Treatment that addresses the underlying causes of social anxiety is needed to find permanent solutions.
Does Anxiety Disorder Cause Substance Use Disorder?
The Anxiety and Depression Association of America estimates that around 20% of people who have been diagnosed with social anxiety disorder are also either misusing alcohol or have developed alcohol dependence.
While 20% is significant, there is no evidence that anxiety causes alcohol use disorder, only that it increases the risk. Other factors, such as genetics and past trauma, can also increase the risk of alcohol or substance use disorder.
If you’re concerned about substance misuse, stay alert for these symptoms:
- Continuing misuse despite negative consequences
- Risk-taking behavior while under the influence
- Loss of interest in other activities
- Wanting to stop or reduce the amount of substances/alcohol you consume but feeling unable to control it
- Changes in mood, sleep, or appetite
- Loved ones becoming concerned
- Legal or financial problems related to substances/alcohol
- Experiencing withdrawal symptoms
- Ignoring relationships and responsibilities in preference to substances
Self-medicating is the main connection between social anxiety and substance use. Relying on substances to relieve anxiety symptoms instead of seeking evidence-based mental health treatment is a major red flag that you are developing a substance use disorder.
Treating Social Anxiety Disorder
Diagnosis for social anxiety disorder typically includes a physical examination and a discussion of symptoms. The criteria for the disorder are listed in the Diagnosis and Statistical Manual of Mental Health Disorders.
Once diagnosed, your provider may recommend a combination of therapies, including medications, psychotherapy, and lifestyle changes.
Approaching treatment with patience and a positive attitude will help. Learning how to manage social anxiety takes time. Keep your appointments and be honest with your healthcare team for the best results.
Medications
Selective serotonin reuptake inhibitors are commonly prescribed for social anxiety. Familiar brand names are Zoloft and Paxil. Other medications may be prescribed depending on your symptoms. Beta-blockers to reduce the stimulating effect of epinephrine and other anti-anxiety and antidepressants are frequently prescribed.
Keep in mind that medication alone is typically not enough to treat anxiety disorders. Medication can take weeks or even months to be effective, and it can take some experimentation to find the right combination and dosage of pharmaceuticals to address each individual’s specific symptoms.
Psychotherapy
Cognitive behavioral therapy (CBT) is one of the most common forms of psychotherapy used to help people with anxiety disorders. CBT is widely studied and highly effective in helping people change unwanted behaviors. It teaches how to stop negative patterns of thinking and behaving and develop new, more productive patterns.
In exposure-based CBT, clients gradually work up to facing the types of social situations they most fear. Being exposed to anxiety-producing experiences provides the opportunity to deal with symptoms in real situations with support on hand.
Other forms of therapy, such as trauma therapy techniques, may be recommended when anxiety is related to traumatic events.
Lifestyle
Lifestyle treatments focus on issues like diet, sleep, and physical exercise. Maintaining a healthy lifestyle helps support other treatments and may help you avoid anxiety triggers. Avoiding alcohol, limiting caffeine, and learning how to manage stress are key.
A therapist may encourage you to spend time in social situations with people that make you feel safe and comfortable.
Tips for Coping With Social Anxiety Disorder
The best way to conquer social anxiety is to seek treatment from medical professionals. Self-medicating or ignoring your symptoms could lead to worse problems and severely diminish your quality of life. There are skills you can practice along with doctor-recommended treatments.
Try Relaxation Exercises
Learning to relax your mind and slow your breathing without the pressure of social interaction can help you stay calm when it is time to mingle with others. Try meditation, yoga, or other mind-body practices to develop relaxation skills you can rely on anytime.
Evaluate Negative Thinking
Instead of telling yourself not to think about the things that frighten you, ask yourself reasonable questions about your fears. Questions such as these may help dispel anxiety and stop negative thought patterns:
- How many times have my concerns about a social gathering come true?
- What would I say to a good friend who was in this situation?
- Is there any evidence to support my concerns?
- Am I absolutely certain something bad will happen?
Evaluating negative thinking allows you to see your thoughts from a new perspective and may help stop your imagination from taking over.
Take Yourself on a Date
Going to public places where there is no pressure to interact with others may help build your confidence for social interaction.
The movie theater is a great example of a place where you are with others but are not expected to carry on a conversation. Coffee shops are also ideal places to be in public while still being “alone,” especially if you have a laptop or other device with you.
Volunteer
Being of service is a great way to stop focusing on what you imagine others are thinking about you. You may choose to volunteer at an animal shelter, a food bank, or another location where interaction with other people is limited.
Join a Club
Joining a club may seem like the last thing anyone with social anxiety disorder would want to do. However, joining a club means you automatically have something in common with every other person present. You won’t have to struggle to find topics for small talk or worry if someone thinks your interest is strange.
Breaking the Connection Between Social Anxiety and Substance Use
Social anxiety disorder makes it difficult to interact with other people. The symptoms typically emerge during adolescence and may include avoiding social events and being fearful that others are judging you.
Some people turn to substance use as a way to self-medicate their social anxiety symptoms, but misusing drugs or alcohol only makes anxiety symptoms worse and can create other problems.
The types of substances that relieve anxiety affect brain chemistry and can end up causing depression. One of the greatest concerns is developing a substance use disorder.
Depending on alcohol or drugs to relieve symptoms of anxiety only masks the problem and delays more effective treatment. The best option is to seek treatment from a mental health professional.
Treatment for Social Anxiety at All Points North Lodge
Treatment options such as medication and psychotherapy are evidence-based and can eliminate or reduce symptoms. However, it can take several weeks or even months for treatment to be effective. Lifestyle changes and taking steps to cope with social anxiety will support treatment efforts and may help you find relief sooner.
If you or someone you care about is struggling with social anxiety disorder, All Points North Lodge can help. Complete our confidential contact form or call us at 855.934.1178 to learn more about our anxiety and dual-diagnosis treatment programs.
References
- Mayo Clinic . “Social Anxiety Disorder (Social Phobia) – Symptoms and Causes.” Mayo Clinic, 19 June 2021, www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561.
- “Social Anxiety Disorder and Alcohol Abuse | Anxiety and Depression Association of America, ADAA.” Adaa.org, 2019, adaa.org/understanding-anxiety/social-anxiety-disorder/social-anxiety-and-alcohol-abuse.
- “Social Anxiety Disorder (Social Phobia) – Diagnosis and Treatment – Mayo Clinic.” Mayoclinic.org, 2021, www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/diagnosis-treatment/drc-20353567.
