Social Anxiety & Substance Abuse

Tranquil Shores
December 8, 2017

When you suffer from social anxiety, you have a real and extreme fear of being judged and scrutinized by others in social situations. This fear can cause you extreme distress and can result in you avoiding getting into situations that most people take for granted. When you’re self-medicating with alcohol or drugs, it just compounds your challenges.

Far more extreme than just plain shyness, your social anxiety symptoms can severely disrupt your life, as your social phobia and substance abuse can make you feel very alone. This persistent and irrational fear makes you avoid all manner of social contact and is often something you keep to yourself or become depressed and even immobilized about over time. You might find you are unable to hold down a job, a relationship or even talk on the telephone.

Around 15 million people in America today suffer from social anxiety disorder (SAD), with the typical age of onset being 13 years old, according to the Anxiety and Depression Association of America. This condition is also something many people suffer from in silence as 36 percent of individuals with the disorder experience symptoms for ten or more years before getting help.

Women have a higher rate of anxiety disorders on a whole than men, including social anxiety disorders, which appear to be equally prevalent across both genders, according to a study published in the Journal of Psychiatric Research.

If you suffer from social anxiety, you’re at a high risk of becoming dependent on drugs or alcohol as a tool to boost your confidence and help you relax in social situations. You may believe self-medicating is helping you. However, in time, you might become reliant on your drug of choice — which leads to more challenges.

Understand the Definition of Social Anxiety Disorder
Recognize the Types of Substances Used to Overcome Social Anxiety
Understanding the Relationship Between Social Anxiety and Alcohol Abuse
The Connection Between Social Anxiety and Drug Use
Know That There Are Therapies to Treat Social Anxiety Disorder
Gain an Understanding of Cognitive Behavioral Therapy
Practical Tips to Conquer Social Anxiety Without Using Drugs or Alcohol
Get Long-Lasting Help for Social Anxiety and Substance Abuse
Know the Treatment Outlook for Social Anxiety and Substance Abuse

Understand the Definition of Social Anxiety Disorder

Social anxiety, also referred to as social phobia, is the intense fear of interacting with other people that makes you feel self-conscious and that you’re being negatively evaluated and judged. These fears are both unreasonable and excessive, and they result in you experiencing physical symptoms and changes in behavior.

The Common Fears of Social Anxiety

There are certain common fears that individuals confronting social anxiety experience. You might feel inadequate, embarrassed, humiliated, inferior, or depressed, or experience a combination of these emotions and fears. If your irrational anxiety rears its head in social situations but gets better when you’re at home alone, then social anxiety could be the reason.

There are currently millions of people from all over the world and all walks of life who suffer from this traumatic condition, so if you’re confronting this, know you’re not alone.

Common Physical Symptoms of Social Anxiety

When you’re placed in a social situation, such as a party, you might experience a number of physical symptoms of social anxiety, including:

A strong feeling of anxiety
Trembling
Panic attacks
A raised heart rate
Sweating
Feeling flushed
Feeling lightheaded

You may also experience constipation, diarrhea, headaches, muscle tension, faintness, and severe blushing.

The Difference Between Generalized and Specific Social Anxieties

There are two main types of social anxieties: general anxiety and specific social anxieties.

If you’re suffering from generalized social anxiety, you’re uncomfortable, nervous, and anxious in virtually all social situations regardless of what they are. On the other hand, if you have specific social anxiety, you might find that it relates to speaking in front of groups only, for instance.

It’s most common to suffer from a generalized type of social anxiety, and this can be identified by feeling anxious, embarrassed, inferior, worried, and experiencing feelings of self-blame in many life situations.

Be Aware of the Triggers of Social Anxiety Disorder

There are many, many triggers of social anxiety disorder, which include:

Meeting or being introduced to new people
Performing
Speaking publicly
Speaking with figures of authority such as your employer or teacher
Making small talk
Going on a date
Making a phone call, especially within earshot of other people
Being asked your opinion on something
Being asked to read aloud in front of others
Being invited out to dinner
Using a public restroom, a fear called paruresis
Being teased or criticized
Looking other people in the eye
Being the center of attention

There are rationales you may apply to some of these triggers. For example, when you’re speaking publicly, you may feel you’re not performing up to your ability. You may also feel frightened of eating in front of other people in case you spill your drink or others see your hands shaking.

Remember, this list is not exhaustive, and there are many situations that can trigger feelings of social anxiety. If your fear of these types of situations interferes with your daily functioning, it’s important to seek help from a medical professional, especially if your social anxiety has led to substance abuse.

Recognize the Types of Substances Used to Overcome Social Anxiety

For many people, drinking alcohol and taking drugs go hand-in-hand with social settings. You may have a few drinks when going out for the night with friends. However, if you suffer from social anxiety and are feeling very stressed, alcohol and drugs can rapidly become a necessity to help you get through a whole host of social situations.

Understanding the Relationship Between Social Anxiety and Alcohol Abuse

Around 20 percent of sufferers of social anxiety disorder also suffer from either alcohol dependence or abuse, according to the Anxiety and Depression Association of America. Advances in Psychiatric Treatment states that 22 percent of people with a social anxiety disorder will misuse or become dependent on alcohol at some point in their lives.

Although it’s true alcohol has the ability to reduce social anxiety symptoms on a temporary basis, it can also exacerbate your feelings of depression, irritability, and anxiety hours later, or on into the following day. This is true even when you drink moderately.

Signs you may be dependent on alcohol include:

Having five or more alcoholic drinks in one day.
Needing to drink alcohol in the morning before starting your day.
Drinking alcohol four or more times a week.
Being unable to stop drinking once you’ve started.
Feeling guilty after drinking alcohol.
Hearing someone close to you expressing their concern about your drinking.

Drinking to excess can lead you to become addicted to alcohol. If you’re worried about your alcohol consumption or that of someone close to you, it’s time to seek help.

The Connection Between Social Anxiety and Drug Use

Self-medicating to alleviate your emotional pain and anxiety is commonplace when you’re suffering from SAD. In 2012, Drug and Alcohol Dependence published a study that discovered a significant number of people with cannabis use disorder also have a social anxiety disorder, and that in individuals with comorbid social anxiety disorder, their challenges with cannabis are more severe.

Drugs work by targeting the reward centers in the brain, causing a sensation of pleasure. When you have an anxiety disorder, this is often a very attractive prospect, as it’s the polar opposite of the dread, stress, and fear you’re used to feeling.

Using drugs to alleviate your anxiety symptoms can easily lead to addiction. If you’re a younger person, you may find you use drugs to overcome social anxiety when you’re out with friends. With this in mind, although you can find temporary relief by using drugs such as ecstasy or marijuana to help you cope socially, when the influence of the drug wears off, you’ll still feel isolated and lonely.

Taking drugs to relieve your symptoms of social anxiety, such as methamphetamine, cocaine, and heroin, makes you run the risk of developing both high levels of tolerance and chronic dependence. This is the same for drugs such as Ativan (lorazepam) and Xanax (alprazolam), which you may have been prescribed to use on an as-needed or short-term basis for panic attacks or to sleep better. These, too, have the potential for abuse and addiction.

In terms of gender differences, women were more likely to receive pharmaceutical prescriptions than men, according to a study published in the Journal of Anxiety Disorders, which means they are at a higher risk of becoming addicted to these prescription medications. Regardless of gender, though, drug abuse and social anxiety can trap you in a vicious cycle.

Know That There Are Therapies to Treat Social Anxiety Disorder

There are various approaches used to treat social anxiety disorder. If you’re suffering from social anxiety and substance abuse problems, you may need to enter a treatment program to detox from the substance before the root cause of your social anxiety can be dealt with.

After your supervised detox, your dual diagnosis recovery includes treating your co-occurring disorders of substance addiction and social anxiety.

Therapies to treat social anxiety disorder include:

Cognitive-behavioral therapy
Psychotherapy
Social skills coaching
Systematic desensitization or exposure therapy
Antianxiety or antidepressant medications

These are in addition to practical tips you can use to conquer social anxiety without using drugs or alcohol.

Gain an Understanding of Cognitive Behavioral Therapy

Cognitive-behavioral therapy, or CBT, can treat social anxiety so you can live a full and calm life. This therapy changes the way you think, behave and feel. It’s also focused on changing your negative beliefs about yourself to positive ones.

The cognitive aspect of the therapy is about learning or thinking, and it’s the part of the therapy a counselor teaches you. Then, you need to take the information you’ve been given and put it into practice in your everyday life.

By repeating what you’ve been taught over and over again, your brain learns new ways of dealing with social anxiety — and positive responses will become automatic. This therapy takes patience and time, but it can have some amazing effects in a number of applications, include social anxiety disorder and substance abuse.

The behavioral component of cognitive-behavioral therapy usually involves participating in a structured therapy group where you’ll voluntarily engage in mildly anxiety-causing activities. This helps you to build confidence and to achieve control over your anxiety.

According to the Social Anxiety Institute, many large-scale studies over the past ten years have been consistent in showing that CBT is the only therapy that can be depended on entirely to help people overcome anxiety disorders.

Grasp the Concept of Psychotherapy

Psychotherapy is often a very effective way to treat social anxiety. When you feel at ease with an accepting, warm and non-judgmental therapist, you can speak freely about your condition and tackle it at your own pace.

In a psychotherapy session, you discuss the negative thoughts you have about your own worth and how you feel others perceive you. Your psychotherapist aids you in challenging these negative thoughts and supports your confidence as it grows.

Find out About Systematic Desensitization, or Exposure Therapy

It may seem like an intimidating concept initially. However, exposure therapy for social anxiety helps you overcome your specific fears. A therapist will usually conduct exposure therapy as part of a CBT treatment program, but this program can also be incorporated into your everyday life.

You may have gotten into the habit of avoiding your own specific social anxiety triggers. Although this may work in the short term, it’s not a practical way to live your life. Avoidance will only sustain your anxiety in the long term, so you need to teach yourself how to effectively handle your triggers.

As part of systematic desensitization, or exposure therapy, gradually introducing yourself to increasingly difficult situations helps you get to past your social anxiety. You’ll need to practice staying in these situations until your fear subsides. A very positive aspect of this type of exposure training is you can practice the exercises in your imagination, as well as in real life.

Learn About Social Skills Coaching

SAD has a negative impact on your social skills in a variety of ways. For example, the disorder makes you less likely to go out and meet people, preventing you from building on your social skills and gaining confidence.

Social skills coaching improves your self-esteem and confidence while teaching you how to better manage your social interactions. This, in turn, reduces your social anxiety, and it is a particularly effective treatment when used alongside medication or CBT.

Be Aware of Anti-Anxiety or Antidepressant Medications and Supplements

Medication is useful for some people with social anxiety, and it is usually used alongside cognitive behavioral therapy, as on its own medication won’t make any changes to your actual thinking and behavior.

Though there are others, examples of anti-anxiety and antidepressant medications are:

Selective serotonin reuptake inhibitors (SSRIs), such as Lexapro, Paxil, Prozac, and Zoloft
Selective serotonin and norepinephrine inhibitors (SNRIs), such as Cymbalta, Effexor, and Pristiq

In addition, some people find symptom improvements with herbal supplements such as St. John’s Wort, Kava Kava, Passion Flower, and Valerian Root. Though primarily for helping to improve sleep, melatonin is also used by some people for anxiety.

With all of this in mind, it’s important to remember everyone is different, and what works for one specific individual may not work for you. Social anxiety disorder does not have to be a life sentence, though — with the right help, you can make a full recovery.

Practical Tips to Conquer Social Anxiety Without Using Drugs or Alcohol

In addition to therapy, there are a number of other strategies you can use to reduce your social anxiety. These include:

Calm your breathing. When you’re anxious, you’ll breathe more rapidly, making you feel lightheaded and dizzy. This, in turn, makes you even more anxious. By learning to take regular and slow breaths through your nose that fills and activates your diaphragm, you can cope more easily.
Relax your muscles. Try tensing and then relaxing the various muscle groups around your body. This lowers stress and tension, and it gives you something to focus on so your anxiety doesn’t overwhelm you.
Think realistically. If you feel a social situation is threatening, you’ll likely feel anxious. Recognize that the negative thoughts you’re having aren’t actually facts. Therefore, it’s important to identify negative thought patterns and do your best to change them to positives.

Ask yourself questions like:

Am I completely sure something bad will happen?
How many times has something bad actually happened?
Is there any evidence to support my thoughts?
What can I do to handle this situation?
What advice would I give to a good friend who was thinking this way?

By actively evaluating your negative thinking, you’ll find some of your worries are never likely to actually happen, and if something less than perfect does occur, it won’t be as bad as you might imagine.

Face your fears. If you feel ready to do so by yourself, get out there and repeatedly face your fears. Start small, for example, taking a trip to the grocery store and having a small chat with the cashier. Once you’ve completed this exercise, you’ll feel more confident to move onto bigger tasks. Don’t pressure yourself — be sure to take all the time you need.
Ask questions. When you’re in a social situation, you’re no doubt preoccupied about how others see you. Instead of worrying about this, focus on the other people around you. Ask them questions about themselves that require more than a single yes or no answer. Remember those answers and refer back to them.
Meet new people. Once you’ve gained more confidence, start chatting more to co-workers, people at the gym, and so on. Great ways of meeting new people include:
- - Joining a club or organization
  - Taking a class
  - Volunteering
  - Taking group lessons
  - Trying online dating
If you make an attempt to make new friends, and it doesn’t work out, keep trying. Developing friendships takes time.
Stop your imagination from running wild. Don’t try to imagine what others are thinking of you as this will undoubtedly just cause you upset and worry. While you may or may not be able to influence what people think of you, it’s impossible to control it.

Get Long-Lasting Help for Social Anxiety and Substance Abuse

If you have a dual diagnosis of coexisting social anxiety disorder and substance abuse addiction, it’s imperative you seek professional assistance. First, you need to fully detox from alcohol or drugs. Then treatment for your social anxiety and substance addiction can begin.

It’s crucial to seek out a recognized leader among treatment programs, like Tranquil Shores, that specializes in a multi-disciplinary and holistic method of treating your body, mind, and spirit simultaneously.

When you’re suffering from co-occurring disorders, the importance of finding a treatment program that addresses all of your challenges cannot be stressed enough. If a treatment center attempts to address only your addiction or anxiety, or address them separately, this is counterproductive. Recovery requires a full understanding of both disorders and the complex interactions between them.

Thankfully, there is lasting recovery for both your addiction and social anxiety, and it’s important to seek it out now. We’re here at Tranquil Shores to help.

Know the Treatment Outlook for Social Anxiety and Substance Abuse

Recovery from a dual diagnosis of social anxiety disorder and substance abuse is entirely achievable, and it helps to have a good network of trusted people to support you throughout your journey. Ensure you choose a treatment program that offers family counseling, aftercare coaching, and support so you never need to feel alone.

Once you eliminate substance abuse from your life, your anxiety treatment will begin — which includes trusting the process and believing that happier results can sustain recovery. As you are learning to identify and change your negative thoughts, you’ll carry these new positive ones with you for the rest of your life.

The feeling of freedom when you overcome a dual diagnosis of substance abuse and social anxiety is second to none. Now you can begin to live your life to the fullest, participating in activities you only dreamed of trying in the past. You can meet new friends and travel anywhere in the world without having to worry. If you do find any anxiety creeping up on you, you have all the tools to effectively handle it and continue living your life.

The practical techniques you learn to overcome social anxiety in day-to-day situations will also stay with you for many years to come. By participating in the treatment you need for both disorders, you can get healthy and stay healthy. You’ll find you are soon feeling healthier and happier than you have in a very long time and are able to embrace life to its fullest.