Are you just afraid of being ugly or are you afraid of society? There is a cure for "social anxiety disorder"! 4 ways to see it at once

As children, we might have been afraid of taking minibuses alone, often worrying about having to loudly say “stop” when getting off. This could trigger many internal “what-if” scenarios: “What if the driver doesn’t hear me call to get off? What if I sing the words wrong and people laugh? What if the driver scolds me for calling too late—it would be so embarrassing.” Are these anxieties just common shyness, or could it be social anxiety disorder? Social anxiety disorder, also called social phobia, is a type of anxiety disorder. People with this condition experience noticeable and persistent anxiety or fear in one or more social situations, often accompanied by negative thoughts about themselves, others, and social interactions.

Feeling nervous or anxious isn’t necessarily bad？

Many young people experience these feelings due to fear of embarrassment or discomfort in expressing themselves publicly. Shyness is a common and mild form of fear. Feeling slightly worried or hesitant around strangers, or preferring not to communicate with them, without physical symptoms or significant interference with daily life, does not qualify as social anxiety disorder. In fact, feeling nervous or anxious to a moderate degree isn’t necessarily negative—appropriate levels of anxiety can even enhance performance at work or school.

Actor Tony Leung: A case of social anxiety

(Image Source: [email protected])

However, when feelings of nervousness and anxiety are continuously amplified and begin to affect decision-making and daily functioning, they can develop into a mental health issue. Social anxiety is one of the common forms of anxiety. Even Hong Kong movie star Tony Leung has been affected by social anxiety. He once shared in a video that he occasionally hides himself; despite being a top actor, he still feels nervous when meeting new people and can become flustered in large crowds.

If the level of anxiety intensifies, you may experience increased nervousness, restlessness, a faster heartbeat, or trembling. For example, when taking a minibus, you might prefer to miss your stop rather than call out “stop,” waiting for others to alert the driver first, or even avoid taking the minibus altogether. When this fear prevents you from enjoying life or doing everyday activities comfortably, it may indicate the presence of social anxiety disorder.

Do you exhibit signs of social anxiety?

• Social situations almost always trigger fear or anxiety, leading you to actively avoid social activities or endure them with intense fear or nervousness.
• Interacting with others—such as having conversations, meeting strangers, giving presentations, or expressing opinions in front of others—causes fear.
• You frequently worry about being judged in social situations, generating strong fear or anxiety.
• You fear that your words, actions, or anxiety symptoms will draw negative evaluation or ridicule from others.
• The fear or anxiety affects your social life, work, or other areas of daily living.
• These symptoms have persisted for six months or longer.

*Based on the *Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), USA

Are women more prone to social anxiety disorder?

A 2015 survey found that about 3.2% of Hong Kong’s population—over 240,000 people—experience social anxiety issues. Reports indicate that medical experts note this condition often begins during teenage years, and if left untreated, can eventually develop into depression. According to Western statistics, 5 out of every 100 people experience some degree of social anxiety, with women being two to three times more likely to be affected.

What are the main symptoms of social anxiety disorder?

Psychological

⃞    Worry - Concerned about embarrassing oneself in front of others.

⃞    Fear - Afraid of being the center of attention; aware the fear is irrational but cannot overcome it.

⃞    Apprehension - Worried that others will notice your nervous reactions.

⃞    Dread - Feeling threatened or under scrutiny.

⃞    Unease - Overly sensitive and negative about others’ evaluations, misinterpreting them as criticism or rejection.

⃞    Self-blame - Holding negative self-evaluations and repeatedly reviewing your performance after social situations.

⃞    Embarrassment - Constantly imagining scenarios that could cause personal embarrassment or shame.

Physical

⃞    Stammering, dry mouth, blushing, sweating

⃞    Palpitations, rapid heartbeat, rapid breathing

⃞    Gastrointestinal discomfort, muscle tension

⃞    Trembling hands, shaking, voice trembling

Behavioral

⃞    Difficulty attending social gatherings; may deliberately arrive late or leave early

⃞    Hesitant to express opinions even when necessary

⃞    Avoids eating in public, hesitant to enter stores or restaurants

⃞    Reluctant to speak; voice is very soft 

⃞    Worry about being observed or scrutinized  

⃞    Avoids social activities, avoids eye contact

⃞    Wears high-neck clothing even in hot weather to hide blushing

⃞    May rely on alcohol to cope

What are the causes of social anxiety disorder?

So far, there is no definitive answer. However, studies have found that some patients with social anxiety disorder experience chemical imbalances in the brain, combined with environmental and psychological factors, which often lead to severe anxiety, withdrawal, and mood swings. Experts also suggest that social anxiety may result from individuals remaining in the normal shyness stage of childhood development (ages 3–7). Those particularly affected include:

1/ People who are especially strict about their behavior in public.

2/ Individuals who had stuttering issues during childhood.

Can social anxiety disorder lead to depression?

If you experience the social anxiety symptoms mentioned above and they affect your studies or career, these symptoms may worsen over time. Delaying diagnosis and treatment could lead to other complications such as depression, substance abuse, and alcoholism, eventually developing into more serious mood disorders.

• Depression — Social anxiety can lead to persistent low mood, and if severe and prolonged, it may develop into clinical depression.
• Agoraphobia — Continuous avoidance of social situations may result in fear of going out alone, leading to agoraphobia.
• Dependence on alcohol or drugs — Some may use alcohol, medication, or sedatives to cope with anxiety, increasing the risk of dependency or addiction. 
  

Can social anxiety be treated? Ways to improve it:

Self-help methods

• Refer to psychology books, music, or videos to learn relaxation techniques.
• Write down your self-perception or mental image to better face and change them.
• Try focusing on listening to what others say, reducing internal self-talk.
• When engaging in self-talk, avoid using “I” (first person); instead, use your own name (third person). Research in the U.S. shows that using third-person self-reflection can help maintain rationality, stay calm, build confidence, and reduce social anxiety.

Therapist-assisted methods — Psychological therapy

Social skills training can help you interact with others more easily and confidently. Additionally, Cognitive Behavioral Therapy (CBT) provided by psychologists or therapists can help patients manage emotional issues and change negative thoughts about themselves or others. For example, it can assist in reducing unhelpful rules, assumptions, or predictions about oneself, thereby improving physical discomfort and stress responses.

Doctor-assisted methods — Medication treatment 

Antidepressant medications prescribed by a doctor can help treat anxiety and depression. During the first few weeks of use, side effects such as headaches and dizziness may occur. Generally, effects start to appear within six weeks, but it may take up to twelve weeks for the full effect to be achieved.

Relying on Technology – Natural Therapy

A non-invasive medical innovation—Deep Transcranial Magnetic Stimulation (TMS)—targets patients whose prefrontal cortex shows slowed metabolism, impairing its normal regulation of the brain’s emotional centers, which can lead to symptoms such as depression and anxiety. The TMS technique uses magnetic pulses to stimulate neurons in the prefrontal cortex, increasing blood flow and metabolism, thereby restoring normal regulation of the brain’s emotional areas and effectively improving mood. Its principle is similar to that used in Magnetic Resonance Imaging (MRI).

Life Young Health – Hong Kong’s First Deep TMS® Treatment

Hong Kong’s first clinic to introduce®️ Deep TMSTM, a next-generation technology using a patented H-coil. It offers three treatment modes tailored to individual emotional conditions, effectively improving various emotional symptoms and enhancing brain health.

Targeted Symptoms

・Insomnia  ・Anxiety  ・Depression  ・Obsessive-Compulsive Disorder (OCD)  ・Low Mood  ・Nicotine Addiction

Clinical Evidence

• 40% of patients with anxiety or depression experienced long-lasting symptom reduction for at least 16 weeks¹
• 80% of patients with severe depression responded well¹—50% higher effectiveness than medication alone*
• Over 70% of OCD patients experienced symptom relief³

Treatment Features

Naturally activates brain function  Non-invasive  No medication required  No drug side effects  

Each session takes only 20 minutes       Professional medical consultation and healthcare team follow-up

Official Recognition

• Over 30 years of technology with extensive clinical research data
• Over 2.5 million treatment sessions conducted in the U.S., with more than 100,000 patients treated*
• FDA-approved in the U.S. for treating major depression and multiple psychiatric and neurological conditions
• Hong Kong Hospital Authority uses the first-generation TMS, while the new Deep TMS™ penetrates deeper with broader treatment coverage and improved outcomes

Want to learn more about the next-generation emotional therapy solutions?

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Reference Source:

自在社交- HKBU  https://easeonline.hkbu.edu.hk/aboutdepression 

香港健康情緒中心 https://www.hmdc.cuhk.edu.hk/emotional-illness-introduction/#illness_title 

香港醫管局 https://www3.ha.org.hk/cph/imh/doc/information/psychiatrists/L8.pdf 

1 Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial. World Psychiatry Vol.14. 2015｜2 Efficacy of Deep TMS with the H1 Coil for Anxious Depression. J. Clin. Med.2022,11,1015｜3 《精神病學研究雜誌》(Journal Of Psychiatric Research) 指出，72.6%平均進行18.5次深度TMS療程後開始達到首次緩解。｜*資料及數據由原廠提供