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Can social anxiety look like ADHD?

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What Is Social Anxiety?

Social anxiety is associated with a distinct fear of potential, devastating scrutiny and judgment from others in one or more social situations. For people with social anxiety, worries about humiliation and rejection are persistent, often lasting six months or more. Crippling worry about negative judgment from others may restrict participation in activities, interests, and relationships; it may prevent a person from building a satisfying life. Approximately 12% of all adults experience social anxiety disorder (SAD) at some time in their lives and it’s one of the most common of all of the anxiety disorders. Social anxiety is even more prevalent among adults with attention deficit hyperactivity disorder (ADHD or ADD), who experience SAD as a common comorbid condition. Some individuals with social anxiety can’t eat in front of other people, avoid public places where they may be forced into conversations with strangers, and loathe public speaking, Many teens and young adults with ADHD are susceptible to social anxiety due to executive functioning challenges that impair emotional control, working memory, and self-awareness (metacognition). They may avoid specific triggering situations such as in-person classes or feel intensely nervous and uncomfortable in any social environment.

What Are the Symptoms of Social Anxiety?

The symptoms of social anxiety commonly overlap with the characteristics of ADHD, which makes diagnosis and treatment particularly complicated. Sometimes they vary. What’s more, people with ADHD who already struggle to understand or interpret social cues and manage big emotions are particularly vulnerable to social anxiety. If any of the following characteristics describe you, talk to your prescriber, therapist, or primary care provider. Untreated anxiety combined with isolation and low self-esteem can quickly lead to extreme sadness.

Common symptoms of social anxiety include the following:

Feeling uncomfortable talking to people outside of your immediate family and/or keeping conversations very short

Having trouble making or keeping friends

Worrying for days or even weeks before an event

Being intensely afraid other people will negatively judge you

Avoiding experiences or places where social interaction will occur (parties, classes, stores, restaurants, gyms, grocery stores, etc.)

Feeling very self-conscious around other people and in front of them

Feeling embarrassed to eat in front of others

Experiencing panic attacks including nausea, shaking, or perspiration in social environments.

One telltale sign of social anxiety is a response to a trigger or a situation that is above and beyond the actual threat of that situation. For example, an individual may be so convinced that everyone is looking at them standing in line for a muffin and a coffee that they don’t even try to stay and order. In reality, no one is paying any attention. Many people with social anxiety know that their actions make no sense, but they feel unable to change them. They then feel badly about themselves and wish they were different. But the fact is that you can manage social anxiety effectively with the right support — if you truly want to change. Being honest and naming what’s really going on improves your willingness to participate in solutions for change. Tackling anxiety requires courage and patience; it’s a tough competitor who wants to keep you disarmed. To address social anxiety effectively, you must set a goal that’s reasonable and within reach — and be willing to experience some discomfort along the way. That’s how you’ll grow and develop the skills you need to build the social confidence and connections you really want.

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How to Improve Social Anxiety

You can’t dismiss all of your social anxiety at once. It serves a purpose, albeit misguided: to protect you from discomfort. Despite your best efforts to erase it, you’ll fall flat because anxiety is a natural part of being human. Our goal is to reduce its influence on your life, which is more realistic. Pick ONE thing: Begin by looking for easy wins to build your sense of security and your self-esteem. What is the one thing you would like to do differently that’s a big struggle right now? Focus on this goal over and over again to summon the courage to expose yourself to what scares you. Find someone to support you in this process. You’ll need an accountability partner — a sibling, a parent, a therapist or coach. You don’t have to do this alone and you shouldn’t. [Take This Test If You Think You Might Have Generalized Anxiety Disorder] Start small: To avoid initial discouragement, start small. Master a change that’s within reach before taking on a bigger challenge. For example, if you are uncomfortable talking to new acquaintances but want to make some friends, expecting yourself to message a classmate and ask them to get a latte is WAY TOO MUCH. Instead, think about the first, very small step you could make to ask someone you don’t know a question or make a request? Perhaps you could contact a fellow student or co-worker with a question or ask them how they are doing? Do this several times until it’s easier. Then you’re ready for the next step, which may be sharing a coffee. Be kind to yourself: People with ADHD and social anxiety tend to be intensely self-critical. You have heard negative comments about how they’ve missed the mark and what they could do better for years. Overtime, you begin to unintentionally adopt this dialog. This negative self-talk is your worst enemy when tackling social anxiety. Start by coming up with a phrase that you could say to yourself that’s encouraging — something like “You are stronger than you think.” Write this down on your phone and on Post-Its that hang in your room or your car. This sounds corny, but you’ll need to know what to say to counteract that negative voice when it tells you that you can’t take a chance and do something different. Consider keeping a written journal that documents one daily success related to your challenge. Practice basic mindfulness: When you are in a panic attack or lost in a shame spiral related to social anxiety, work to become aware of your physical body and your breathing. This is your ticket out of the spiral. When people are feeling anxious, their breathing often becomes very shallow as their adrenaline runs the show. This is our fight or flight response kicking in. In these instances, you’ve got to get grounded and slow down your energy. Try placing one hand on your chest and one on your belly. Breathe into both hands, noticing their feel and imagine that, with each breath, you are breathing in a soothing color. Do this for several minutes. Or use alternate-nostril breathing from yoga for five rounds. As you take steps to address your anxiety, you may well experience discomfort and insecurity. Those are signals that you are moving the right direction. Talk to someone everyday: As much as you’d rather not, you’ve got to practice your social skills. Combat your natural tendency for isolation by having a 3- to 5-minute conversation with someone outside of your household at least three times a week. It can be over Zoom or FaceTime, on the telephone or in person, but you need to make real-time contact with someone that isn’t over text messages, Snapchat, or Instagram.

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Make a list of people with whom you could talk — distant or local friends, cousins, siblings who’ve moved away, grandparents, etc. You can’t improve how you connect with someone or read their emotional state via text, and this is exactly the skill you need to develop. If you aren’t sure what to say, think of some questions in advance, or ask your accountability partner for help and practice those prompts. Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

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