Fear, noun: an unpleasant emotion caused by the threat of danger, pain, or harm. 

Does that sound familiar to you and your experiences? Perhaps it may. Anxiety is often coined to be a particular type of persisting fear, wherein we worry about potential future outcomes associated with specific events. In fact, the way we feel when either frightened or anxious are extraordinarily similar, because the basic emotion for both remains the same. So, despite not being in any immediate danger, anxiousness can result in similar symptoms to that of fear: increased heart rate, feelings of sickness and/or dizziness, and a loss of appetite. For many, new social situations can be a common trigger of these symptoms, often termed as social anxiety. 

Social anxiety: what is it?

Also labelled as social phobia, social anxiety presents itself as a long-lasting fear of being humiliated or scrutinised by others. It is sometimes (and incorrectly) compared to general shyness. However, whilst shyness often manifests for many prior to an unfamiliar situation, this usually dissipates following exposure to the new social situation. This is not the case for social anxiety. The latter often manifests during adolescence, when the opinions of friends and peers become increasingly important. This impairment can continue into adulthood, wreaking havoc on a wide variety of important life events. Separating social anxiety symptoms from those of general shyness is thus essential before discussing management and treatment options. 

The symptoms

Symptoms of social anxiety (as with any form of anxious behaviour) can be wide ranging, and it is unlikely that any one individual would experience them all. All anxiety disorders can be associated with the symptoms mentioned previously. However, common identifiers for social anxiety usually include the feeling of dreading everyday activities, such as starting up conversations with strangers, speaking on the phone to unfamiliar people, or even going into work. As a consequence, social anxiety can result in the avoidance of many social activities such as eating out or going to parties.

Can social anxiety effect my health? 

Because of the primal need for social interaction between humans, the consequences of social isolation on both physical and emotional health can be catastrophic. A recent meta-analysis – a statistical approach which combines data from multiple studies – identified that a lack of social connections can heighten health risks as much as smoking fifteen cigarettes a day or having an alcohol consumption disorder. The analysis suggested that social isolation can significantly increase the risk of premature mortality, with the magnitude of risk exceeding that of other common leading health threats. A recent study in 2019 analysed the data from more than 580,000 adults, finding that social isolation increases premature death risk for every race.

The negative impact on both mental and cognitive health is also apparent. Evidence supports a link between social isolation and adverse health effects including poor sleep quality, depression and accelerated cognitive decline, the latter of which is associated with problems in memory, language and judgement. A 2018 study also discovered a clear association between loneliness and dementia, increasing a person’s risk of developing the latter by up to forty percent. Examining data from more than 12,000 U.S. adults aged fifty or older, participants rated their loneliness and social isolation alongside completing a battery of cognitive tests every two years for up to ten years. 

Do you think this applies to you?

As reported by a 2018 survey, loneliness levels have reached an all-time high. Of the 20,000 U.S. adults approached, nearly half reported feeling alone, with the youngest generation being the loneliest of all. However, isolation is also well characterised in the elderly. According to Age UK, over two million people in England over the age of 75 live alone, with over one million stating that they go for over a month without conversing with a friend, neighbour or family member¹⁰. 

It is essential to determine whether social anxiety and/or loneliness applies to either yourself or a loved one, and then take appropriate action. It is important to try and communicate with friends and family where possible. However if this is hindered, it is imperative to seek out advice from a qualified medical professional.