Whenever I have to talk to someone face to face, especially someone I’m not friends with, I get really anxious. My palms get sweaty, my hands start shaking, and my throat feels like sandpaper when I talk. And this happens every single time. Even when I’m talking to someone alone. You might think my symptoms are just because I’m an introvert, and I’d rather spend my time reading at home (true), but that’s not entirely right. My symptoms are actually part of a condition called social anxiety disorder, or SAD for short.
SAD is an emotional hyper-reactivity to social stimuli that can lead to lowered self-esteem and increased judgement of others. It basically makes you judge every book by its cover and overthink every spoken interaction. It’s caused by a failure to regulate the emotional response in the prefrontal cortex by signaling from the limbic-cortical pathway. When this pathway is not functioning effectively, an emotional signal is produced, but can’t go anywhere on the limbic-cortical network. This heightened and lengthened response can be caused by a number of social situations: harsh facial expressions, giving a presentation, delivering a speech, or even talking in a group setting.
A group of researchers conducted an experiment in which they used fMRI data to analyze the emotional response of healthy control participants and participants with SAD to various stimuli. In the experiment, participants were exposed to a series of physical threat, social threat, and neutral stimuli across a nine-minute period. Participants with SAD had heightened responses to social threat stimuli as observed in the anterior cingulate cortex and other emotion processing regions in the occipital lobe. Furthermore, mixed facial expressions, such as anger and contempt, produced even worse responses in the participants with SAD, meaning that their emotional reactivity was heightened, and their regulation time was longer. The participants with SAD took much longer to regulate their emotions because their initial reactivity was extremely high, so while their fear levels were decreasing over time, it still took them longer than the healthy control participants.
You’re probably wondering why these results even matter. They matter because it helps psychologists and doctors understand that SAD isn’t the exact same as other anxiety disorders. Sure, there are some similarities in symptoms and responses, but SAD is ultimately specific to social threat. Psychologists, therapists, and doctors can use these results to develop and train their patients in new emotional regulation strategies like deep breathing and encouraging self-talk. Patients can also be trained in how to prepare effectively before any social situation to help calm their nerves and get ready for the experience.
Anxiety is the most common psychiatric condition out there, with SAD being the most common subtype. If you have SAD, like me, you’re not alone. You may get anxious talking to big crowds, or even sitting with different people than normal at lunch, but maybe they’re nervous about it, too. Experiencing SAD sucks. I won’t lie about that. But it is possible to learn healthy coping mechanisms and create support systems for when you feel that panic attack coming on right before a speech.
Image from Simply Psychology
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