Damaging Effects of Social Anxiety
Last week, back-to-back, I saw two male patients discussing the same concerns: how damaging the social anxiety can be in the dating arena. Of course, this makes sense; someone with social anxiety may have difficulty in his dating life. However, the issue appeared so much more complex when I actually heard the pain and struggle through personal stories.
Social anxiety, or social phobia, is defined in DSM V(The diagnostic manual mental health professionals use to make diagnoses) as a marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. The individual fears that he or she will act in a negative way or show anxiety symptoms that will be negatively interpreted. Typically the fear is out of proportion to the actual threat, and triggers avoidance of the social situations or interactions.
These male patients had a lot in common. Both were good looking, young professionals, one in his late twenties the other one in his early thirties. They both were looking for a committed relationship (eventually), but they both felt extremely inadequate approaching women in social situations. They had no problems at work, and they were both successful in negotiating the stress of working in the corporate world. They were able to interact with women in the work environment; however the situation was completely different at social gatherings, during happy hours, or company parties.
*Carlos, at 28 years old, described the reaction he had when facing women as an overwhelming wave of heat, associated with increased heart rate, which would make his mind go blank. He would find himself unable to speak, becoming painfully aware of the entire room scrutinizing his moves, appearance, posture, and demeanor. The only relief would be to find an excuse to leave the room. Once the event passed he was able to have a rational understanding of what went on and to try to prepare for the next encounter when, without failing, the chain of reaction would happen again. That left him feeling completely inadequate and hopeless about the whole dating scene.
*David, at 35 years old, described his experience with women differently. He would spot an interesting woman in the room, but also potential other men contenders. All of a sudden, his mind would run a series of reasons for which he would not be a good candidate for the woman in question. He began to doubt his appearance, his intellect, his ability to offer anything of value, and would eventually talk himself out of approaching her.
Both patients have tried therapy, and despite learning and practicing the necessary ‘social skills’ in the therapy sessions, when they were faced with the real situations, the same physiological response was triggered. They were referred for evaluation for possible medication treatments, and they looked to that as the last resort. Both hoped that having at least one positive experience would help them undo or reduce the anticipatory anxiety. They hoped to lessen the dread of something that other people would find entertaining, enjoyable and natural: dating.
Anxiety to social situations is common in both men and women, and as a psychiatrist I work with my patients to explore their options for treatment for their anxiety. Should my patients choose to use medication, my goal, usually shared with my patients, is to find a medication that works well for that individual without causing side effects.
In the case of Carlos and David, both individuals tried medication to relieve their anxiety and both are finding the medications helpful. It is not uncommon to try several medications and dosages to try and balance effectiveness and avoid or eliminate side effects. Typically, the duration of treatment can be up to 6 months, during which time my patients are encouraged to continue individual therapy and the exposure to the social situations that were anticipated as anxiety provoking. Luckily, with both Carlos and David- the medication worked well once we found the right ones that addressed the symptoms without causing side effects. Now both individuals will work on, and practice, learning the skills needed for developing and maintaining healthy and satisfying relationships.
*Please note that some of this client information such as age, sex, client details, and exact diagnosis was modified to protect the identity of my client(s), however, the impact, treatment, or effect of the treatment is the actual experience of the client.
Social anxiety and dating is common and anxiety can be managed with medication so that individuals can learn to manage the anxiety, learn new skills and the build confidence necessary for success.
If you like this article on social anxiety and dating, or have questions, schedule your first session by calling us at 713.426.3100.