How to Overcome Social Anxiety Without Medication: A Guide to Self Care, Exposure Therapy and Alternative Remedies
What is social anxiety?
Social anxiety disorder, also known as social phobia, is one of the most common psychiatric disorders in Western society. It is characterised by intense fear in social situations, causing considerable distress and impaired ability to function in at least some parts of daily life. The diagnosis of social anxiety disorder can be of a specific disorder (when only specific social situations are feared) or a generalised disorder. Generalised social anxiety disorder typically involves a persistent, intense, chronic fear of being judged by others and of being embarrassed or humiliated by one's own actions. These fears can be triggered by perceived or actual scrutiny from others.
How do you know how I feel?
For many years I suffered from severe social anxiety. I stopped socialising and I got very close to leaving school and teaching myself at home. I blushed whenever I was the centre of attention, and I was also affected by symptoms that ranged from sweaty palms to full-blown panic attacks. Life was very difficult back then, although it did not last.
Now I'm in my second year of university, I'm going to work in Barcelona for eight months from September, and my social anxiety rarely affects me. However, I do have to be careful not to fall back into old habits. In this Hub I'll explain how I overcame social anxiety, but also how I stop it from reoccurring.
If you're suffering from social anxiety, understand that it isn't a permanent part of your character in any way. It's more likely the result of thought patterns that have been repeated for many years, which are now embedded in your way of thinking. You can change this.
I must emphasise now that medication is required for some anxiety sufferers, and shouldn't be stopped mid-treatment. I tried Citalopram, Propranolol and Diazepam, but they all affected me in a severe way. Therefore, I hope the alternatives in this Hub prove useful, but remember not to go against professional advice.
What steps should I take to overcome social anxiety?
I'll explain a few options in this Hub. I'll mention viable alternatives to medication, and choose ideas that aren't unobtainable or excessively ambitious. I'll focus in particular on:
- Self care
- Exposure therapy
- Changing the voice in your head
- Alternative remedies
I cannot underestimate the importance of self care when dealing with anxiety. Being anxious gives you a really hard time mentally, but many of us don't realise the physical effects. Anxiety wears you out: you ache more, you become more susceptible to coughs and colds, and you generally don't have the appearance of a carefree, healthy person.
When I was struggling with anxiety, I'd always be the first to catch a cold. My skin wasn't great either, and my hair felt dry and weak. My body wanted me to slow down and stop stressing over the small stuff, and so it's not surprising that I suffered physically.
Although the root causes of social anxiety need to be addressed (more on this later), self care is also an important factor to consider. Make sure you're paying enough attention to the following:
- Nutrition - Especially your intake of leafy greens, omega-3s, and B vitamins. Nutrition should come from the diet, but a multivitamin can complement this.
- Sleep - This one's simple. How can you feel calm and confident when you haven't treated your body to sleep?
- Exercise - The fight-or-flight response is something most are aware of. Our ancestors required anxiety as it stopped them being eaten by bears, although nowadays few face such predicaments. Don't sit around all day. Get moving, and your body will become more accustomed to the rush of adrenaline and increased pulse rate. Next time something induces anxiety in you, you'll be less taken aback by the physical symptoms.
- Water intake - We need a hydrated brain and body to react to situations in a healthy way. When hydrated, we think better, and are therefore more equipped to rationalise our anxiety.
- Treat yourself - This is a big one. As mentioned earlier, anxiety really beats you up. Make sure you're looking after yourself, be it by watching a favourite film, spending time with friends, or having a long bath. Think about how you'd look after a struggling or sick friend, and treat yourself in the same way. Put aside an hour a day, but not too much time or you'll simply become lazy and lethargic.
Exposure therapy for social anxiety
Social anxiety can lead to agoraphobia, which in many cases can make you unwilling, or seemingly unable, to leave your house. Exposure therapy can gradually build up your confidence to leave your comfort zone and experience the situations that are often anxiety-inducing for you, but you must start with small steps.
When I was fifteen, I went to Santander for a language exchange. I spent two weeks there on my own, and must have spoken about ten words of Spanish overall. The girl I stayed with enjoyed saying how lazy English people were and that she hated the language, which was charming of her. Needless to say, it wasn't a fantastic experience, and I don't think I was ready for it. I think I'd have the confidence to enjoy travelling alone now though, as I've gradually built up experience of smaller exposure tasks.
The quote below is appropriate here, as it suggests that you need a record of smaller success before facing your larger fears:
"The way to develop self-confidence is to do the thing you fear and get a record of successful experiences behind you." - William Jennings Bryan
Try making a list of the situations that cause you anxiety. Number them from 1-10, with 1 indicating the lowest level of anxiety, and 10 the highest. Start exposing yourself to the least stressful situations, and you'll gradually acclimatise to being out of your comfort zone. By going at your own pace, and gradually increasing the intensity of the exposure, you can drastically decrease your social anxiety, or even overcome it entirely.
Here are some exposure therapy ideas that I've put to good use:
- Smile at a cashier
- Ask a waitress/waiter a question about a meal on the menu
- Go to a shop I've never been into before
- Go to a bar with a friend
- Compliment someone (even if the person is a friend)
Changing the voice in your head
Social anxiety is often caused by the way you talk to yourself internally, particularly in regard to what others think of you and how you perceive certain situations. After telling yourself that nobody likes you after several years, it becomes a habit, and a very unhealthy one at that. However, it can be reversed with positive thinking.
Consider the following if you're guilty of doubting yourself, criticising yourself, or believing that others think badly of you:
- Think or list compliments that others have given you. Pay attention to the happy, pleasant feelings that fill your body when you think of them.
- Think of situations in which you've felt happy, anxiety-free and confident. Let the good feelings fill your body, and pay attention to how it feels.
- Consider Stoic philosophy. The Stoic philosophers had a vital role in the development of modern CBT (Cognitive Behavioural Therapy). You can read my Hub about how Stoicism has helped my anxiety here.
You can also try something called a "butterfly hug", which is often used in trauma therapy. I use the technique regularly, and find it so useful for difficult moments.
- Cross your arms in front of you, with your right hand on your left shoulder and your left hand on your right. Close your eyes.
- Bring up an image of a safe or calm place along with a positive word that you associate with it. Let it fill your mind.
- Wait until you feel a state of safety or calm. Do not try to force this, but see if it comes naturally when you think about the safe or calm place and the associated word.
- When you feel safe and/or calm, tap your hands alternately on each shoulder slowly four to six times. Make sure you only do this when you feel calm and safe.
- Take a breath and see how it feels.
- Try it for one more set.
- Open your eyes.
- If the positive state increases, once again just close your eyes, allow yourself to feel the feelings, and bring up the word. As you feel the positive sense arise, again alternately tap each side four to six times.
You can use this technique to handle momentary disturbance, but it's good to reinforce the good feelings every so often when you're in a calm and safe place. This keeps the technique strong for when you need it most.
Alternative remedies to anxiety medication
Medication should be the last resort. After my experience of using anxiety medication, I'd never like to return to it. Unless your doctor has advised otherwise, perhaps try some of these ideas below. But remember, never stop a course of medication without discussing it with your doctor, or go against professional advice.
- . This is a natural supplement, available in health stores, which works to increase tryptophan levels and therefore reduce anxiety and depression. It does work well, but I will warn that it can produce vivid dreams if taken at bedtime. 5-HTP
- Aromatherapy. Lavender oil is useful for me, but I also like the roll-on oils that have recently become more popular. . Try this Tisserand de-stress roller ball, for instance
- Rescue Remedy. Even if the relaxing effect is a placebo (many would disagree), or simply from the act of using the product, it works for me.
- Water therapy
- Herbal teas, such as chamomile or Ayurveda influsions
- Massage therapy