The shutdown over a year ago seemed to be a blessing for many with social anxiety. They were happy to stay home. It was an easy excuse to avoid all their anxious triggers.

Many have continued to work from home or learn from home, but what happens when it's time to get back to public activities?

As a pediatrician I'm very worried about some of my patients who think their anxiety is gone so have stopped therapy and/or their medication while they’ve been able to stay home.

If the only trigger for their anxiety is being around others, they’ve been able to avoid their trigger for a long time during the pandemic. The underlying anxiety may only be growing since they’re not being challenged to overcome it anymore. This can easily be unrecognized.

I'm not a therapist and I encourage people with anxiety to see a professionally trained therapist, but I know the reality is just like people self diagnose and treat medical issues at home, they do the same for mental health issues. I'd like to share some tips on how to learn about and manage your social anxiety, but this is just the tip of the iceberg of ways you can overcome anxiety. Seek professional help if you've struggled with anxiety - especially if tips like the ones below aren’t helping.

Anxiety can be helpful

First, be aware that anxiety can be a good thing. We often think of anxiety only in a negative way, but it's important that we all have anxiety to keep us safe.

If you're approaching a street, you must look both ways before crossing. The fear of getting hit by a car is real and appropriate. If you can use facts to reassure yourself that it's safe to cross, that's great!

The problem is if you stand at the curb looking back and forth, worrying about the “what if's” and can't cross even though it is safe.

That's when anxiety is out of proportion to the situation and holds us back.

Recognizing healthy vs unhealthy anxiety is important.

Social anxiety is normal... to a point

Most of us have a little anxiety about meeting new people, talking in front of a group, or going to unfamiliar places. It is normal and healthy as long as it doesn't keep us from meeting new people, talking in front of the group, or going to unfamiliar places.

If these worries keep us from these situations, it is no longer healthy and it's time to work on ways to allay the fears.

Tools

There are many ways people can assess their anxieties and put them to rest. These tools help us like any other tool can help when used appropriately.

Learn your triggers and response

You'll need to learn about your anxiety to help identify the triggers and know when to get out the toolbox and which tool to use.

Think about the situations that cause anxiety.

Write those down.

Add to the list as new triggers are identified.

Next to each situation, write your reactions to the situation. Some symptoms and reactions to consider (but yours may be different):

• Do you feel sweaty or dizzy?

• Is your heart pounding?

• Does your breathing rate increase?

• Is your mind racing?

• Does your gut tense?

• Do you start moving around or wiggling?

• Do you have chest pain or heartburn?

• Is your sleep affected?

• Does your appetite change?

• Do you become irritable or angry?

Use your list

Once you recognize your triggers and typical reactions, practice watching for these.

With practice you can learn to recognize your symptoms early. It's easier to gain control of a situation if it's addressed early, before it's out of control.

Think about what you can do that can help the situations that make you nervous.

Practice your response when you’re not actually anxious.

Face your fears

Once you know the triggering situations for your anxiety, rank them in order of least scary to most scary.

Put yourself in the least scary situation to practice.

For example, if you're scared of meeting new people, try a stepwise approach to getting to know people.

• Start with just saying "hi" to strangers as you pass on the street. If it's hard to actually say hi, start with a smile or nod with eye contact, then try actually speaking as your next step. This is low risk - they may or may not respond. You don't have to hold a conversation. Just say hi and keep going.

• When saying hi starts to feel more comfortable, move a step forward and ask someone for directions or about what they're doing - anything to start a conversation.

• Once quick and simple conversation starters gets easier, practice making follow up plans to talk again.

For more details, click here for a Facing Fears handout from Anxiety Canada.

Keep track of self-talk thoughts

Social anxiety is often rooted in feelings of inadequacy. Do you hear yourself saying that you're not good enough? That no one will like you? You'll embarrass yourself by saying the wrong thing or falling?

The truth is, most of these self doubts are not realistic.

Run through questions that help put your worries into perspective.

1. What are you really worried about?

2. How likely is it that your worry will come true? Use evidence to support your answer. Think of past similar experiences - what happened?

3. If your worry comes true, what is the worst thing that will happen?

4. If your worry does come true, what’s the most likely thing that will happen?

5. If your worry does come true, what are the chances that things will be okay

   1. In one week?

   2. In one month?

   3. In one year?

Try a Thought Record to help get your thoughts in order. Here’s a completed example and one you can use for yourself.

Consider testing your fears

Most of our worst fears with social anxiety can be shown to not be as bad as we think. You can even prove this to yourself.

Worried you'll embarrass yourself with saying something stupid?

Try saying something stupid on purpose and see how others react.

Unless they're real jerks, it won't be that bad. Even if they laugh, if you laugh at yourself too it won't seem so bad. Everyone will move on and the chances are you'll be the only person who remembers this.

Worried that you'll do something stupid?

Think of the times you've fallen or dropped something and people offered helped you - most of the time they don't laugh and make fun of you.

And if they do make fun of you, what does that say about them (not you)?

Can't remember a situation like this? Go somewhere and drop your book or spill your drink. See what happens. The chances are others will not even notice, or if they do, they'll offer help.

Join a group

Think about what interests you - are you into art, music, sports?

Consider joining a group within that interest. This gives you the opportunity to meet people who share your interest. You'll already have something in common, which makes it easier to start up conversations.

It's usually easier to do new things you enjoy or if you know your skills or knowledge on the subject is good.

Groups have specific meeting times, which helps you schedule and prepare mentally for that time.

Relax

There are many relaxation techniques that can be used.

The simplest and easiest to do in any situation is deep breathing.

Mindfulness is a way to train our brain to respond to stress with awareness of what is happening in the present moment, rather than simply acting instinctively, unaware of what emotions or motives may be driving that decision.

For those who say they've tried mindfulness and it doesn't work: it takes practice. The more you try it, the better it works.

For mindfulness resources, see my practice's Pinterest Mindfulness Board.

For more:

HeySigmund.com has resources about anxiety from internationally renowned psychologist and author Karen Young. There are articles and videos to teach parents as well as children and teens.

AT Parenting Survival has resources for parents of kids with anxiety and OCD. It is from Child Therapist, Natasha Daniels, and offers articles, podcast episodes and YouTube videos.

Self-help strategies for social anxiety (Anxiety Canada)

Anxiety Canada has many resources to learn about anxiety and to manage its symptoms.

10+ Things You Can Do to Stop the Panic (ADHDKCTeen)