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they assume they’ll bungle their lines, spill their drinks, shake hands with clammy palms, or commit any number of social faux pas and thus embarrass themselves. Ironically, because they are so anxious, they actually do what they fear. Shaky, sweaty hands spill drinks. Lack of eye contact turns people away. They worry about what others are thinking about them — so much that they don’t listen well enough to keep a conversation going.

      

Everyone feels uncomfortable or nervous from time to time, especially in new situations. For example, if you’ve been experiencing social fears about a challenging new situation, that may be normal. A short-term fear of socializing may be a temporary reaction to a new stress such as moving to a new neighborhood or getting a new job. However, you may have a problem with social anxiety if you experience the following symptoms for a prolonged period:

       You fear situations with unfamiliar people or ones where you may be observed or evaluated in some way.

       When forced into an uncomfortable social situation, your anxiety increases powerfully. For example, if you fear public speaking, your voice shakes, and your knees tremble the moment that you start your speech.

       You realize that your fear is greater than the situation really warrants. For example, if you fear meeting new people, logically you know nothing horrible will happen, but tidal waves of adrenaline and fearful anticipation course through your veins.

       You avoid fearful situations as much as you can or endure them only with great distress. Because of your fears, you may miss a variety of events you’d otherwise like to go to (for example, family gatherings, work opportunities, or parties).

      Check out the following prime example of a social anxiety and see whether any of it seems familiar.

       Maurice, a 35-year-old bachelor, wants a serious relationship. Women consider him attractive, and he has a well-paying job. Maurice’s friends invite him to parties and other social events in an effort to set him up with women. Unfortunately, he detests the idea of going. Maurice conjures up a number of good excuses for backing out. However, his desire to meet potential dates eventually wins. Whenever he imagines scenes of meeting women, he feels intense, anxious anticipation.

       When Maurice arrives at the party, he heads to the bar to quell his mounting anxiety. His hands shake as he picks up his first drink. Quickly downing the drink, he orders another in hopes of numbing his emotions. After an hour of nonstop drinking, he feels much braver. He interrupts a cluster of attractive women and spews out a string of jokes that he has memorized for the occasion. Then he approaches various women throughout the night, sometimes making flirtatious, suggestive comments. His silly, drunken behavior doesn’t get him any dates. The following day, he’s embarrassed and ashamed.

      THE DIAGNOSTIC AND STATISTICAL MANUAL-5 (DSM-5)

      Every so many years, groups of mental health professionals provide research and clinical experience in order to develop a list of emotional disorders. They publish their findings in a manual referred to as the DSM. Currently, the field is using the fifth edition. The diagnoses allow professionals to communicate with a common language. However, the formal role of diagnoses has its detractors. Many professionals believe it’s more useful to focus on symptoms as opposed to specific disorders. For your information, the DSM-5 currently lists the following major categories of anxiety disorders:

       Generalized anxiety disorder (GAD)

       Social phobia

       Panic disorder

       Agoraphobia

       Specific phobias

       Separation anxiety disorder

       Selective mutism

       Anxiety disorder due to another medical condition

      The previous few editions of DSM categorized obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) as anxiety disorders. No longer. Today, OCD has its own section, Obsessive Compulsive Related Disorders, and PTSD is categorized as a Trauma-and Stressor-Related Disorder. The controversies surrounding these changes are complex. And in most people with emotional problems, there are almost always overlapping symptoms. In other words, someone with anxiety is likely to have at least a few symptoms in one diagnostic category and a few others in a different category.

Maurice has social anxiety. Drug and alcohol abuse often accompany social phobia because people with social phobia feel desperate to quell their anxious feelings. And drugs and alcohol offer a quick fix. Unfortunately, that fix often causes additional embarrassment and may lead to an addiction.

      Beyond everyday anxiety

      Of course, everyone feels a little panicked from time to time. People often say they feel panicked about an upcoming deadline, an impending presentation, or planning for a party. You’re likely to hear the term used to describe concerns about rather mundane events such as these.

      But people who suffer with panic are talking about entirely different phenomena. They have periods of stunningly intense fear and anxiety. If you’ve never had a panic attack, trust us, you don’t want one. The attacks usually last about ten minutes, and many people who have them fully believe that they will die during the attack. Not exactly the best ten minutes of their lives. Panic attacks normally include a range of robust, attention-grabbing symptoms, such as

       An irregular, rapid, or pounding heartbeat

       Perspiring

       A sense of choking, suffocation, or shortness of breath

       Vertigo or lightheadedness

       Pain or other discomfort in the chest

       A feeling that events are unreal or a sense of detachment

       Numbness or tingling

       Hot or cold flashes

       A fear of impending death, though without basis in fact

       Stomach nausea or upset

       Thoughts of going insane or completely losing control

      Panic attacks begin with an event that triggers some kind of sensation, such as physical exertion or normal variations in physiological reactions. This triggering event induces physiological responses, such as increased levels of adrenaline. No problem so far.

But the otherwise normal process goes awry at the next step — when the person who suffers from panic attacks misinterprets the meaning of the physical symptoms. Rather than viewing the physical symptoms as normal, the person with panic disorder sees them as a signal that something dangerous is happening, such as a heart attack or stroke. That interpretation causes escalating fear and thus more physical arousal. Fortunately, the body can sustain such heightened physical responses only for a while, so it eventually calms down.

      

Professionals say that in order to have a formal diagnosis of panic disorder, panic attacks must occur more than once. People with panic disorder worry about when the next panic attack will come and whether they’ll lose control. They often start changing their lives by avoiding certain places or activities.

      The good news: Many people have a single panic attack and never have another one. So, don’t panic if you have a panic attack. Maria’s story is a good example of a one-time panic attack.

       Maria resolves to lose 20 pounds by exercising and watching what she eats. On her third visit to the gym, she sets the treadmill to a level six with a steep incline. Almost immediately, her heart rate accelerates. Alarmed, she decreases the level to three. She starts taking rapid, shallow breaths but feels she can’t get enough

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