By Dr. Gbonjubola Abiri

Hannah, was a 26 year old, admin executive who was described as dependable and overly quiet. She was known for delivering excellent work but never wanted attention drawn to her. As she lay on the couch, her voice trembled as she volunteered: “I avoid speaking in meetings. Even when I know the answer”.
“I usually feel like everyone is watching me, like they are judging and and that they are planning to embarrass me”.
“I get very anxious during interactions, I avoid social gatherings and I notice that I start sweating and trembling.

She stated that she recently turned down a promotion, not because she wasn’t competent; in fact she was a top performer on the team. The role however had expectations she wasn’t comfortable with: regular presentations, leading meetings and more visible interactions with senior management. She just couldn’t imagine it.

In frustration, she expressed: “Doc, this is causing me significant distress and is impairing my daily functioning”.
She was experiencing a condition known as Social Anxiety Disorder; which is more than shyness and describes a persistent and intense fear of being watched, judged negatively or embarrassed in social or performance situations. In many individuals, it causes lost opportunities, affects relationships and quality of life.

A pattern appeared when she revealed that the symptoms started subtly in secondary school. She was mocked when she responded in class with an inaccurate answer. In university, she actively avoided presentations and noticed that in social and networking events, she would avoid interactions and choose roles that kept her behind the scenes. Even with simple interactions with friends or colleagues, making small talk was distressing.

The body then responds with the fight and flight response, typical of anxiety. She would notice a racing heart, sweaty palms, weakness in the knees, a knotty feeling in the throat and an urge to escape the situation. The mind would then fuel her heart with thoughts such as “ I will end up embarrassing myself’, “They will see I am so stupid”.

The response is often to avoid these social situations. While this brings temporary relief, it reinforces fear over time and limits growth in many spheres.

In my work with her, progress was not immediate. We started small with gradual exposure as she started to practice speaking in front of the mirror and speaking in low-stakes setting. Grounding exercises helped to manage her physical symptoms as well as challenge the negative self talk and harsh self-judgments that had become almost second nature.

Months later, she said something that stayed with me: “I still feel nervous, but it no longer controls me.”
Social Anxiety Disorders often goes unnoticed as they who struggle with it learn to hide in plain sight. They are often seen as reserved, quiet and even aloof. Beneath that exterior is often a battle with fear and self-doubt.
Help is available as with the right support, therapy, practical coping strategies and sometimes medication, people can learn to navigate social situations with greater confidence.

Remember there is no health without mental health.