Social anxiety disorder is crippling – and common. Graded exposure is the first step out | Gill Straker and Jacqui Winship

Effective treatment usually requires a holistic approach, yet those suffering often avoid seeking help

Many of us are familiar with the uncomfortable feeling of entering a cocktail party at which none of our friends are present. We sidle in awkwardly, imagine others might be wondering what we are doing there and find ourselves not sure where to stand or who to look at. We gaze intently at our prosecco and hope the floor will swallow us up. In most instances we can push through and engage with someone at the party, often ending up having a great time. However, our initial discomfort allows us a window into what it’s like to live with social anxiety disorder (Sad), a ubiquitous and crippling mental health condition.

In a study involving thousands of participants aged 16-29 across different socioeconomic strata and from seven different countries, including Brazil, Russia, the United States and China, it was found that a staggering 36% met the threshold for Sad. While akin to shyness, Sad involves anxiety that is way more intense. It leads to the avoidance of social situations including work, family gatherings and even events the person believes they would enjoy if they did not feel so anxious. Research indicates Sad particularly afflicts young people. Explanations for this include neurocognitive changes in this age group as well as a developmental shift towards a focus on peer evaluation. One hypothesis for the apparent rise of Sad in the 21st century is the proliferation of social media and digital alternatives to face-to-face contact.

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