Social anxiety disorder — also known as “social phobia” — is more than just being terrified of speaking publicly or feeling painfully shy around others.
A person struggling with social anxiety becomes intensely anxious or fearful of certain (or all) social situations or interactions with other people.
In fact, the symptoms of this mental health condition seriously impact every aspect of life, from making friends to keeping a job. Sometimes, the tension, fear, and embarrassment can drive a person to self-medicate with alcohol in a desperate attempt to cope socially or relieve the underlying emotional pain.
Learn why social anxiety and alcohol can be a “dangerous cocktail.”
Social anxiety affects as many as 13% of Americans. The crippling disorder makes it hard for a person to do typical, everyday tasks, like talking to coworkers or eating in front of others. Those who suffer from social anxiety often feel highly self-conscious or embarrassed when interacting with others. Some experience physical symptoms in social situations, such as nausea or a racing heart. A few struggle with intense blushing or profuse sweating — symptoms that make them feel even more self-conscious and uncomfortable because they’re almost impossible to hide. The intense anxiety is constant and can seriously interfere with their ability to establish and develop relationships, stay in school, and get a job.
Social anxiety and alcohol abuse
It’s not uncommon for individuals to use alcohol in order to reduce the anxiety they’re feeling. One large study found that approximately 12% of substance-using Americans said they’d used alcohol to reduce their fear or anxiety about a situation. The study also revealed that 13% of those who did this developed an alcohol problem during the study’s three-year course, compared with just 5% of those who didn’t self-medicate their anxiety symptoms. Overall, it’s estimated that one out of five people specifically diagnosed with social anxiety disorder abuse alcohol.
There are two common reasons that individuals struggling with social anxiety end up abusing alcohol. The first is that alcohol is used to eliminate the negative feelings that social situations bring. For example, they may feel the desire to drink after giving a nerve-wracking presentation at work. The alcohol provides a temporary numbing that reduces or prevents the feelings of embarrassment or anxiety connected to the presentation.
The second reason that social anxiety often leads to alcohol abuse is because it helps sufferers better cope with the social situation itself. For instance, they may choose to consume alcohol before or during a crowded networking event. The relaxing impact of the alcohol helps them get through the event without paralyzing fear. The disinhibiting effect of alcohol also helps some individuals interact with others more easily, lessening the intense shyness they may be experiencing.
Because daily life so often involves social situations, it’s no surprise that those who suffer from social phobia feel the need to regularly reduce painful emotions or relax enough to interact with others. The problem is that alcohol is not a safe or healthy way to deal with anxiety.
Effects of alcohol on health, career and family
Alcohol is a very short-term solution for feeling anxious.
At first, drinking seems to lower inhibitions and reduce tension and fear. However, as a depressant, it actually has a negative effect on the central nervous system.
Research suggests that alcohol actually prolongs feelings of tension. In addition, chronic alcohol use raises adrenaline levels in the body. Both of these factors make a person more likely to feel afraid and tense, rather than relaxed and calm. Drinking also elevates heart rate and blood pressure, leading to a state of heightened anxiety.
Alcohol also makes social situations worse. The person who consumes a glass or two of wine before a presentation is more likely to make errors or fumble it entirely due to the impact of the alcohol. This, in turn, may increase anxiety over future social situations and lead to further alcohol abuse. In other words, it using alcohol to self-medicate can quickly create a vicious cycle. It’s interesting to note that some people with social anxiety disorder avoid drinking alcohol precisely because they fear that it will cause them to engage in embarrassing behavior.
In addition to perpetuating anxiety, alcohol abuse has a direct impact on you and those you love. For example, excessive drinking leads to an increased risk for accidents, like falling or car crashes. Alcohol abuse also interferes in your relationships with a partner, children, and friends. Work often suffers too, especially if you’re calling in sick or performing at levels below what’s expected.
Drinking’s long-term effects and short-term “relief”
Drinking to reduce anxiety symptoms carries the risk of long-term health problems as well. Regular alcohol use has been linked to inflammation of the stomach lining, high blood pressure, stroke, and liver disease. Alcohol abuse also raises the risk for some cancers, such as those of the mouth, throat, breast, and colon.
Finally, alcohol does nothing to provide lasting relief from anxiety symptoms. When the buzz it creates wears off, the fear, tension, and social inhibitions will return. Considering its short-term effect on anxiety relief and the numerous other downsides, it’s clear that self-medication with alcohol isn’t a safe or effective solution for managing social phobia.
Social anxiety and alcohol abuse are treatable
If you suffer from social anxiety, don’t make the erroneous assumption that it’s an aspect of your personality that you have to deal with for the rest of your life. It’s not — it’s a treatable psychiatric condition. Talk to a psychologist or other mental health professional about your social phobia symptoms. If you’ve already started self-medicating with alcohol, be up front about it.
Your therapist and other treatment providers can help you get better only if they’re aware of all the challenges you’re dealing with. Depending on the severity of the substance use, you may need outpatient alcohol counseling and education or residential alcohol rehab, in addition to your treatment for social anxiety. Many alcohol rehab facilities offer “dual-diagnosis” treatment for individuals who struggle with both mental health issues and substance abuse.
Social phobia treatment
The primary treatment for social phobia is talk therapy. Cognitive-behavioral therapy (CBT) is considered one of the most effective types of therapy for any type of anxiety disorder. During regular sessions with your therapist, you’ll learn how negative thought patterns and irrational beliefs create difficult emotions that influence your behaviors, especially those related to your interactions with others. Your therapist will also help you adjust the way you perceive social situations so you’re able to interact with others with less fear. Treatment may also include exposure therapy, which involves gradual exposure to anxiety-inducing situations. Your therapist will likely recommend relaxation techniques as well.
When anxiety symptoms are severe, medication may be a necessary part of treatment. These may involve beta blockers, SSRIs (selective serotonin reuptake inhibitors), or benzodiazepines. These prescription drugs don’t cure social anxiety disorder, and they should never be the used as the sole treatment for it. They can, however, relieve symptoms in order for you to participate in therapy and function more normally. They’re most effective when used in combination with talk therapy rather than in lieu of it. One of the downsides of benzodiazepines (e.g. Xanax and Ativan) is that they have a high potential for abuse and addiction. For that reason, they may not be the best choice for anyone already struggling with a substance abuse problem. They should be used with extreme caution if prescribed.
Social anxiety doesn’t need to ruin your life or drive you to abuse alcohol. Talk with a mental health professional today about treatment. You can learn how to reduce symptoms, manage your disorder, and avoid or overcome the temptation to cope by self-medicating with alcohol or other substances.