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Stress and anxiety
Social anxiety disorder: Panicked about meeting new people, speaking up in class, and so much more!
Originally Published: January 11, 2002 ~ Last Updated / Reviewed on: September 11, 2007
 
Dear Alice,

I have social anxiety disorder and was wondering how it would be possible to see someone for help without my parents knowing about it. I know that they'd be anything but supportive. They would think I'm absolutely insane. The truth is, I've put off dealing with it, acting as if it'll just go away or that I'll outgrow it. But in reality, the older I'm getting, the worse I'm getting. I avoid as many social situations as I can. I completely panic when meeting new people. I only stay in classes that don't require any talking on my part. I've dropped so many of my classes already that I don't know what to do. It seems the only place I'm actually happy is at home or with people that I've known all my life. I want to see someone, hoping they can prescribe something for me. I'd also like to talk to someone and figure out where all this anxiety is coming from. Is there anyway that I can do to achieve this? I'm a student, currently unemployed, under my parent's insurance... hope u can help!

 

Dear Reader,

About 5 million Americans have some form of social anxiety disorder, also known as social phobia. While everyone experiences nervousness or fear in social situations to a certain extent, those with social anxiety disorder are debilitated by their fear. They may have a constant, intense, and chronic fear of being watched and judged by others, or be terribly afraid of being embarrassed or humiliated by ways in which they behave. As you have described, this fear can prevent people with social anxiety disorder from doing everyday activities, such as going to school or work, and can become so much of a focus that they severely limit their socializing.

It's understandable that you are worried about how your parents might react to knowing what's been going on for you. Many people think that their families will blame them for how they're feeling or belittle their concerns. Being honest with your parents, however, might help you to feel more at ease; it's possible that they've noticed your behavior and wondered about it, or even struggled with similar feelings themselves. There's even some evidence that anxiety disorders may be genetic or run in families — perhaps due to environmental factors and patterns expressed through interpersonal interactions. Once you seek help, one of the things you can work on is deciding if you might want to discuss your social anxiety with your family, and if so, strategies for doing this that will be comfortable for you. Perhaps showing them this answer will help you describe your situation to them, and get any doubters to take you more seriously.

In the meantime, it might make sense for you to start by seeking assistance from people and places that will allow you to do so without your parents knowing. Depending on your age and school situation, you can explore some of the following:

  • speaking with a school nurse or guidance counselor
  • reaching out to a dean or another school administrator who knows you or works closely with students
  • consulting with your pediatrician or another health care provider or clinic staff member who has known you for a while
  • talking with a religious leader you know or a friend or mentor — even someone close to your age — to find out if s/he knows of free or low-cost services in your area
It may not feel like it, but you are by no means the only person who struggles with these issues. While it may feel embarrassing to ask for help, health care and school personnel are trained to help you find the support and resources you need, so that you can figure out what's going on and start feeling better.

If you're a Columbia student, visiting Counseling and Psychological Services (CPS) would be a great start. CPS offers psychological counseling to all undergraduate and graduate students who have paid the Health Service fee. Psychopharmacological consultations are available as needed. Indeed, many prescription medications are available to help alleviate many of the symptoms you describe. And, you can rest assured that CPS adheres to strict standards of confidentiality. No one has access to information about your situation or your use of CPS without your permission. You can call x4-2878 to make an appointment. This would be an ideal time to share how you've currently been feeling with a counselor who can give you more details about what CPS can do for you, and offer options for next steps in getting treatment. If you're not at Columbia, most colleges and universities have similar counseling programs that offer confidential services.

You mentioned that you are currently on your parents' health insurance plan. Contacting your parents' health insurance company can help you to get answers to these basic questions:
  • Is mental health counseling and treatment covered by the plan they have?
If so:
  • In order to use this benefit, do you need to see your primary care provider in order to get a referral for counseling?
  • Are there ways for you to use their insurance plan, but maintain confidentiality, by having the billing information sent directly to you instead of to your parents?
You can also find out if staff members (receptionists or billing personnel) could contact you in a way that further ensures your confidentiality — if you still live with your parents.

You've also indicated that you are currently unemployed. The following may be able to provide you with services for free or for a small fee:
  • Most major teaching hospitals have mental health clinics where they see people at low cost.
  • There may be training institutes in your area for postgrads in psychology and social work that offer counseling at low cost, too.
  • Not-for-profit organizations can assist you in finding a therapist who sees people on a sliding scale, which means that the fees will be adjusted based on what you can afford.
Looking into these options can also help you to learn as much as you can about social anxiety disorder, and the many forms of effective treatment. For example, numerous medications are now available through a prescription that can help alleviate symptoms and allow you to focus on figuring out what triggers anxiety for you. Many counselors also use cognitive and behavioral therapies to help manage anxiety when it crops up. Cognitive therapy is designed to help people understand how their thinking contributes to symptoms of anxiety and how to change those thought patterns and adjust their coping strategies. In behavioral therapy, a person learns techniques to decrease or overcome the behaviors associated with his or her anxiety, particularly those that cause discomfort or impair his or her ability to enjoy daily activities. When you find a counselor who's right for you, the two of you will develop a plan that meets your needs and helps you to find ways of managing your fears on a day-to-day basis.

To get additional information about social anxiety disorder, treatment, and payment options, check out: Acknowledging that your anxiety is getting in your way and seeking the help you need takes courage. You deserve to get assistance in a way that feels safe and comfortable to you, and that allows you to get back to living a full life. Best to you,
Alice

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