Author: Katie Borrman
My work friends and I were all freshly vaccinated and looked forward to having another dinner party together after a year of isolation. Most of us had kept to our “pods” (a limited group of friends/family to socialize with during the pandemic), and hadn’t risked socializing outside of that. It was the first time in a year I expanded my social circle to an indoor party with friends in different pods. I was excited. What I didn’t expect was to feel an inescapable level of anxiety. I remember feeling like I was watching myself in the group, asking myself, “Why aren’t you talking more? Why are you so tired? Do they think you’re not having fun? Do they think you have changed during this year of isolation? Have I changed for the worse? Do you have anything to contribute? Why are you being so boring? Does anyone else feel like the volume is too high?” This anxiety-induced questioning led me to a full bodily shutdown, and I felt paralyzed. The last thing I expected during this reunion was for me to excuse myself at 9:00 pm to read a book and fall asleep before anyone else. After this event, I tried my hardest not to judge myself, and instead, evaluate psychologically what was going on.
The DSM-V describes social anxiety disorder with 10 main criteria, but for my situation, the first 3 criteria pertain the most directly:
These symptoms checked out with how I was feeling at the reunion. Social anxiety had never been a controlling element in my life, and I knew that the Covid-19 lockdown was a major contributor to this psychological state. As a society, we are going through something difficult, unpredictable, and traumatic. According to the Center for Disease Control and Prevention (CDC), “Elevated levels of adverse mental health conditions, substance use, and suicidal ideation were reported by adults in the United States in June 2020. The prevalence of symptoms of anxiety disorder was approximately three times those reported in the second quarter of 2019 (25.5% versus 8.1%).” Whether or not you have had experiences with social anxiety before, or are recently feeling its crippling effects, there are many reasons why an increase in this type of unhelpful habit of thinking may have developed over the past year:
Expectations for personal growth during lockdown
Lockdown brought about many opportunities for people to explore new interests, pick up old hobbies, or “reset” their bodies in a way that was not afforded to them while working full-time. It’s hard not to compare your own personal growth to those who share their experiences freely on social media. But not all experiences during lockdown are seemingly “self-enhancing.” According to the American Psychological Association’s Stress in America Report, since the pandemic started: 61% of adults reported experiencing undesired weight changes, nearly 1 in 4 adults reported drinking more alcohol to cope with their stress, nearly half of Americans said they delayed or canceled health care services, essential workers were more than twice as likely as nonessential workers to have been diagnosed with a mental health disorder, and Gen Z adults were the most likely generation to say that their mental health has worsened.
Those dealing with social anxiety might fall victim to an illusion of unworthiness, or a cycle of thinking that minimizes their own experience. If this thinking has dominated your thoughts during the lockdown, then assimilating back into social circles face-to-face might bring about the same negative cycles of thinking - that your own experience is inadequate, disappointing, or depressing compared to those around you.
Conflicting media information
There are endless amounts of information one can digest through media outlets pertaining to Covid-19, and after a year of deciphering which information feels the most accurate, we are bound to come into conflicting points of view on the safety, regulation, and validity of the information we are taking as truth. The CDC has methods for tracking the deaths, outbreaks, and hospitalizations of Covid-19, as well as which public health measures seem to be working. However, according to the CDC, “...counting exact numbers of COVID-19 cases is not possible because COVID-19 can cause mild illness, symptoms might not appear immediately, there are delays in reporting and testing, not everyone who is infected gets tested or seeks medical care, and there are differences in how completely states and territories report their cases.” This ambiguity can cause tension within our community and social circles due to a lack of consensus and trust. These disagreements can turn into confrontation or avoidance, and in turn, exacerbate anxiety levels while socializing with new or familiar groups.
Grief, loss, and survivor’s guilt
For anyone grieving the loss of loved ones close to them, or feeling loss and grief on a “global community” scale, reemerging from lockdown can feel emotionally overwhelming. According to the CDC, “...the prevalence of depressive disorder was approximately four times that reported in the second quarter of 2019 (24.3% versus 6.5%)”. Depression almost always contributes to anxiety levels, and after a year of isolation and social distancing, the question of how to reintegrate can feel nearly impossible to answer. The pressure to “reopen” may feel like too much too soon, and it’s important to let the phases of grief happen naturally and at whatever timeline feels right.
Unwillingness to return to “normal”
The “reopening” of our community structures is a relief for some, while for others creates a sense of dread. For some, this time in lockdown has given a much-needed dose of self-reflection and an opportunity to change personal circumstances and values. For others, reopening might feel simply unsafe. According to the APA Stress in America Report, when asked about feelings concerning the future, “...more than half said they feel uneasy about adjusting to in-person interaction once the pandemic ends (57% Black, 51% Asian, 50% Hispanic and 47% white).” The pressure to return to whatever “normal” was for us pre-pandemic might feel unaligned. I think the pressure becomes particularly more intense when our usual socializing habits have changed over the course of lockdown. Whether that be switching your social scene completely or having new boundaries around the time you spend socially, a new way of being can cause a lot of anxiety when confronting your peers.
These are only a few of the endless reasons why we may be facing social anxiety at this point in a major world transition. It might be hard to end cycles of negative thinking that are based on realistic responses to a global pandemic; so the question of how to manage this type of anxiety can be tricky to relieve. Acceptance Commitment Therapy (ACT) has the goal of adjusting the language we use in talking to ourselves about our anxiety. This method is not trying to eliminate the symptoms themselves - which oftentimes creates more of a problem as the more you try to get rid of it, the worse it can become - but rather manage the anxiety through acceptance, mindfulness, and committed action based on our personal values. This means going towards one’s values, despite the anxiety, rather than waiting to overcome the anxiety to move in the direction of your values.
Acceptance Commitment Therapy
The first step in this therapeutic process is Cognitive Defusion. The goal of this technique is to separate yourself from the personal sensations, (such as thoughts, feelings, images, and memories), that send anxiety down a self-deprecating spiral; to create space between our private experiences and the reactionary impulse of having judgments and trying to control them. A huge component of this technique is accepting that thoughts of pain and suffering inevitably happen. Trying to eliminate them is like swimming upstream - the harder you try to control them the more the anxiety will build. Ways to practice cognitive defusion are by the use of labeling thoughts as they pop up into your mind. For example, the thought I had at the reunion, “I am being boring”, could have instead been phrased as, “I am having the thought that I am being boring.” In this way, we are becoming mindful of the “judgment” aspect of the thought, without trying to eliminate the thought from happening. Instead, we are acknowledging that it is a thought, as opposed to an objective truth.
The second step is Acceptance. Letting unpleasant emotions come and go without resistance is a key factor in this therapeutic process. When we notice the anxiety emerge, we have a choice. We can let ourselves feel it - meaning we can let the anxiety be noticed, remaining in a state of curiosity. The other, more automatic, choice is having an anxious response to the experience of anxiety (i.e. having anxiety about having anxiety). This can be seen as the panic that follows social anxiety, focusing on your future actions, perceptions of others, and shaming oneself into a deeper level of discomfort (also known as “secondary emotions”). Meditative imagery is a useful tool in the acceptance process - imagining the anxious feelings being invited to sit down to tea with you; it can be there, without having to engage or push it away.
The third step is Mindfulness. Being in contact with the present moment is at the heart of Acceptance Commitment Therapy. It is necessary to be in a state of mindfulness to achieve acceptance and cognitive defusion. Remaining present will help you not become lost in your thoughts, and will help heighten your level of awareness around the secondary emotions that emerge during episodes of social anxiety. The most simple and effective tool for mindfulness is breathwork. Paying attention to your breath keeps your body regulated and fixated on the present moment.
The fourth step is establishing your Values. Affirming oneself in their values builds a strong emotional foundation. From this foundation, one can feel confident and assured in situations that might shake their emotional stability. By reverting to our values we can feel assured that our actions align with our emotional goals and commitments. In my situation, my value was to be connected with my friends and our community. Rather than going to the other room and going to bed early, I chose to stay with them, despite the anxiety and the anxious thoughts, and chose to instead be present with them and my experience.
And finally, Taking Action is the last step. Once one’s values are established, it becomes easier to take steps toward fulfilling goals. For people with symptoms of social anxiety disorder, those goals might be something like, “I want to reach out to someone I haven’t spent much time with”, or “I want to call a friend who lives in a different city”, or “I want to make sure I’m giving myself enough alone time, so I won’t feel drained in social situations.” Whatever the “action plan” is, the important thing is to keep the plan aligned with one’s values.
I tried to recall the feeling I had during the beginning of lockdown and remembered the “mourning” phase I went through in saying goodbye to the normal routine I had and prepared for the social, economic, and personal changes that were about to happen. This process changed my social routine, the way I interact with others, and the relationship I have with myself in ways that I didn't come to realize until being put back into a situation without the restrictions I had grown comfortable with. Having the psychological tools to ground yourself during moments of instability can make this journey all the more manageable. Unfortunately, we still have a long way to go. The next psychological phases have yet to present themselves, but they are surely going to change the way we live in a post-pandemic world. Looking at this time as an opportunity for growth and exploration is a comforting truth. We can all look to therapeutic techniques to support ourselves and each other.
American Psychological Association (2021, March 11). Stress in America 2021 One Year Later, a New Wave of Pandemic Health Concerns. American Psychological Association. https://www.apa.org/news/press/releases/stress/2021/one-year-pandemic-stress
Arlin, C. (2021, March 23). The Use of Acceptance and Commitment Therapy in Treating SAD. VerywellMind. https://www.verywellmind.com/acceptance-and-commitment-therapy-for-social-anxiety-3024910
Centers for Disease Control and Prevention. (2021, March 23). About CDC Covid-19 Data. Center for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fcases-updates%2Fabout-us-cases-deaths.html
Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1external icon.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.
8/1/2022 09:52:49 pm
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