What is Social Anxiety Disorder (SAD)

What is Social Anxiety Disorder (SAD)  –  by Marie Elmqvist


“Why am I so damn nervous? Now I am blushing, my heart is pounding, they must think I am a total idiot! I’m so weird. Oh no, my hands are shaking. I have to hide them so noone can see how nervous I am! Why can’t I just be normal, like everyone else? Oh no, I can’t find anything to say, I’m so boring. This person will never want to talk to me again. Who can blame her?”.

Welcome. You were just now invited into the mind of a social phobic in a social situation. Perhaps when talking to you.

Imagine that every social situation, every encounter with another person (and mind you, it doesn’t have to be physical. A phone call, or writing a letter, can be just as devastating), is a matter of life or death. Not literal physical death of course, but the next thing – your very “self”, your being, is put at the ultimate risk. Your whole self-worth depends on how this situation/encounter ends. And you know beforehand that you will fail. Because you know you are not loveable. You are weird, strange, quiet, awkward, stupid, ugly or whatever negative self-describing adjective you can come up with. Or even worse, you feel you are invisible. A “nothing”. Of course you will fail! And after the fact, you proved yourself right. “Yes, see, Marie, you are hopeless.”

That’s social anxiety disorder (SAD), or with an alternative less appropriate name, social phobia.

Some so-called experts describe social anxiety as being afraid of making a fool of oneself. That description gets to me because it simplifies the whole thing horribly and gives the idea that social phobics lack a sense of humour or that they can’t laugh at themselves. It’s almost offensive! I think a more accurate description of social anxiety is a very deep basic human fear – the fear of not belonging, of being left-out, of not being part of the group – gone to an extreme. The disorder is not the fear itself but acquired misconceptions of thoughts, self image, reality and other people’s view of you that turn the fear into this crippling self-fulfilling anxiety.

There are of course different degrees of social anxiety too. For some, it’s mild, or isolated to certain specific social situations. They can function pretty much normally, but they don’t like being in the centre of attention or they blush easily or they avoid speaking their mind in a group or won’t speak in front of an audience (the most common SAD symptom). They might make up excuses to get out of the most anxiety-provoking social situations but make it through others. For other people, the anxiety can be so severe it affects every aspect of their life. Just the thought of taking out the trash or going to the store can be combined with such high anxiety that they just can’t do it. Remember what I said in the beginning – every social encounter can be a life-death situation. Even the mere risk of running into someone can be enough for these people. Perhaps they are not able to work, with all the social situations and social stress that requires. It also affects a person’s ability to make new friends, find a partner and start a family or maintain the friendships and family relationships they once had. Depression and self-medicating substance abuse (people use alcohol or drugs to be able to socialise at all) are common “side effects” of this disorder.

For me my social anxiety has kept me from fulfilling my dreams and from believing in myself as a social person. It has led to a deeply rooted self hate, low self esteem and bad self image. The older I get, the more I realise how much impact the disorder has had and has over my life and how I see and feel about myself. So far the disorder has given me an isolated life without many friends (I have fortunately been blessed with few but very good ones instead, and for that I am forever grateful!) and no family of my own, and the lack of a professional career. I can work, but I can’t give myself the career I want, so I am stuck with low income jobs way below my skills and education. I have lived a life ruled by this fear as far back as I can remember, even though the actual social anxiety started to “blossom” in my teens, which is very common.

The turning point came when I was 32 years old (now six years ago) and felt that I had reached the bottom. Life had to be more than the vacuum of fear I was living in. I felt like I was living my life watching it from inside a glass bottle, without being able to take part. I saw all the things I wanted, right there in front of me like a tease, so close, but still out of reach. This could not be “it”. My life could not be meant to be this hell I was living. The anxiety just kept getting worse, never better. Right at that time, by coincidence of fate, I saw an ad in a newspaper where they announced a science project to which they needed people with social anxiety to take part. It was a scientific study trying cognitive behavioural therapy (CBT) to treat anxiety disorders over internet. I took this chance that fate handed to me. I filled out the form, got called for an interview, and was accepted to the project. For the first time my eyes were opened to the real truth.

One that was totally different to the one I had previously had in my head.

I found out that my thoughts and the feelings they caused had in my mind become distorted truths of reality. My “truths” contained life conceptions and life rules that I thought I had to live by to be “accepted”, to be loveable and likeable. It also contained very devious deceiving self-degrading thoughts about myself that had led to a truth of enormous self hate – “I am weird, ugly, not worthy, stupid, a failure, totally worthless” etc. I learned how the vicious circle of these “truths” of thoughts and feelings kept the social anxiety in an endless increasing spin. The CBT helped me challenge my negative thought patterns, my life conceptions and self image – I could finally see a different more realistic reality. The spin slowed down. I haven’t been able to completely stop it, but I have come a long way.

However one thing is true about social anxiety, and that is that it’s not something you can ever stop fighting against. The moment you relax from the fight and social exposure, or if you are put through other emotional stress,  the thoughts have a tendency to sneak up on you again, so slowly that you at first don’t notice them. It’s not until they make you feel you notice them, and by then, the harm is already done. You have a setback. But once you have started the fight, the setbacks are learning experiences. Every setback you get will make you more prepared for setbacks and their warning signs in the future. Fighting social anxiety is two steps forward and one step back. But even with the setbacks, you are always one step further than you were before. Every step is an uphill climb, and sometimes you are so tired from the high hill that you slip back. But every step and every slip are totally worth the effort. You choose the fight, because you don’t want the alternative.

It’s a matter of life and death!

My name is Marie Elmqvist. I am 38 years old and live on my own in a mid-sized town, Lidingö, right outside Stockholm in Sweden. I work as a receptionist but dream of a whole other existence of creativity and independence. I am educated in a variety of areas like language, journalism, media and communication science and graphic design. I love to write, so that would be a dream come true if I one day could support myself using the written word in some way.
Other than writing my hobbies include reading, blogging, (amateur) singing, languages and photography. I don’t excel in any of them but I enjoy them very much and would like to be able to spend more time on each and everyone one of them.
I am also an animal lover. I love all animals (well – with exception of snakes and spiders and other slimy creatures and insects. But they have their right to exist too of course, just not anywhere near me!) but I especially love cats. I swear I must have been a cat in a previous life, if such a thing exists, because I definitely feel connected to these beautiful cute little creatures.
I also want to spread knowledge of social anxiety to the general public, so if anyone wants to learn more about it, feel free to contact me.
Marie Elmqvist
  • E-mail: marie.elmqvist@gmail.com

Image: Andy Newson / FreeDigitalPhotos.net



  1. Hey there. I enjoyed reading this post. I, too, suffer from social anxiety disorder. I’ve been suffering from it for over ten years and have been trying to “fight” it for the last year or so. I don’t like the word “fight”, though, because I think fighting it just makes it worse. I’m trying to accept who I am, anxiety and all. I’m currently in graduate school for library and information science. It’s an online program, which hasn’t really helped with my anxiety. I have few friends, and, at the moment, the future seems pretty bleak. I’m using a combination of talk therapy, cbt, yoga, meditation, and hypnotherapy as interventions. Anyway, I just wanted to say HI!

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