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New research targets sufferers of social anxiety disorder

New research targets sufferers of social anxiety disorder

  • Sufferers of social anxiety have markedly different personality traits than others.
  • By understanding these traits, researchers at Uppsala believe targeted therapies could evolve.
  • Social anxiety affects 15 million American adults every year.

In his essay, “The problem of anxiety,” Sigmund Freud wrote that anxiety is the “fundamental phenomenon and the central problem of neurosis.” You will not find a final word on the subject in Freud’s writing, however. His theories on anxiety evolved throughout his life. By the end of his illustrious and contentious career, he admitted that he would likely never completely define what anxiety entails.

That doesn’t mean his contributions were for naught. No one contributed as much to our understanding of the unconscious drives that fuel our reality. Freud’s ideas about sexuality are regularly debated—even he moved away from his earlier work—yet he knew what others, such as Kierkegaard and Rank, recognized: Anxiety is our natural state. To be conscious is to have anxiety. It’s the cost of being able to foresee the future. How you deal with that anxiety in large part defines your personality.

Freud terms objective anxiety “anxious readiness.” This function arms an individual so that they will not be surprised by sudden threats. Being overly prepared, however, leads to problems: your actions are paralyzed. This is the “freeze” function of our nervous system. This is also the basis of social anxiety: an inability to be in public, or, when you must go out, the sheer terror of being among others.

Social anxiety: How to rewire your confidence and be a better communicator | Andrew Horn

New research from Uppsala University, published in the journal PLOS ONE, investigates the ramifications of social anxiety. The conclusion that lead author Tomas Furmark comes to: sufferers of social anxiety disorders exhibit different personality traits than others.

Personality is defined by the Big Five traits: openness to experience, conscientiousness, extroversion, agreeableness, and neuroticism. Each of these traits operate along a spectrum. Are you curious or cautious? Are you compassionate toward your partner or are you emotionally detached? Do you step into the center of a party or are you the perpetual wallflower that leaves out the back door?

Context matters. You might be extroverted in an environment in which you’re comfortable, exuding a ton of confidence. Walk next door and suddenly you’re reserved and nervous. Anxiety is tethered to environment and your personality isn’t fixed. You can change your place on any of the spectrums, which is the goal of therapy.

For sufferers of social anxiety—15 million American adults every year—lateral movement is difficult. Just as depressed people often cannot envision the future, the socially anxious find it challenging to be in public. There’s context here as well. The supermarket might be easy but that cocktail party is never going to happen. At the extreme end, social anxiety means only leaving your home for specific, targeted purposes, and even those trips make you anxious.

Photo by Ahmed Nishaath on Unsplash

The team at Uppsala asked 265 volunteers with social anxiety to fill out comprehensive personality surveys. They identified three groups based on cluster analysis: prototypical social anxiety disorder (33 percent), whose members appear highly anxious and introverted; introvert-conscientious social anxiety disorder (29 percent), whose members are introverted but also have high levels of conscientiousness; and unstable-open social anxiety disorder (38 percent), with individuals scoring high on openness.

While the causes of each disorder differ, Fumark and his team identified specific personality traits that appear to be universal: high neuroticism and introversion, emotional instability, and a tendency to turn inward.

The researchers believe that defining these traits helps to expand our understanding of social anxiety disorders, which helps therapists target each subtype. As the team concludes,

“SAD personality subtypes may have different etiologies and it seems plausible that individuals exhibiting vastly different personality characteristics require different treatment strategies.”

For example, cognitive behavioral therapy could be utilized with social approach focus to treat SAD sufferers with depression or low energy. Targeted approaches might work better for patients with certain types of traits as compared to others with different traits. As always, the team recommends further research, but this seems to be an important step in understanding the many shades of social anxiety.

Stay in touch with Derek on Twitter and Facebook. His next book is “Hero’s Dose: The Case For Psychedelics in Ritual and Therapy.”

Dealing with loneliness during the pandemic

Dealing with loneliness during the pandemic

Tremaine Fredericks rides on an empty Staten Island Ferry to Manhattan on March 24, 2020 in New York City.

  • Mental health disorders are on the rise during the COVID-19 pandemic.
  • Lack of social contact is anti-instinctual behavior for humans, yet it is needed during this particular crisis.
  • How we cope with social distancing and sheltering at home will in large part dictate how long this crisis lasts.

There have been many comparisons between the COVID-19 pandemic and previous historical incidents. Obviously, the last great flu pandemic of 1918-19 has been receiving a lot of attention. There’s also quantitative comparisons. Pundits compare this pandemic death toll to wars and terrorist attacks. This week, America surpassed the death toll in Vietnam. In previous weeks, rates were compares to the War in Afghanistan and 9/11.

Comparing a virus to a war isn’t fair, though the headlines can be forgiven. We’re trying to wrap our heads around the enormity of tragedy. One feature of consciousness is qualia, instances of subjective experience. In order to understand something—say, a glass of wine—we relate to it by stating “this is like this.” This Bordeaux smells like peppercorn and chocolate. Comparison gives us a point of reference in an effort to understand concepts. We do it with everything.

While death tolls are one thing, conditions on the ground are entirely different. Consider 9/11. During the months following that day, New Yorkers were more likely to say hello to random passerby on the street. There was an uptick in kindness and charity. People were present for one another on an unprecedented scale. There was a real feeling of “we’re in this together.”

Feeling like you’re a part of something requires presence, which is exactly what’s lacking as we shelter at home. Even on 9/11, as I walked from downtown Manhattan to my girlfriend’s apartment in the Upper East Side—I lived in Jersey City and had no way of returning home—I would stop to talk to people on the street. We were able to look one another in the eyes. Life was briefly upended, sure, but we could still physically be there for one another. We could even touch each other.

Why loneliness is a danger to individuals and societies | Andrew Horn

Lack of contact is driving loneliness during this pandemic. Health care workers are experiencing an increase in mental health conditions. Being on the front lines is emotionally taxing. But those forced to shelter at home, especially when living alone, are also facing increased anxiety and depression.

An avoidance of social contact is an evolutionary mismatch, argue three researchers in a recent essay published in the journal, Current Biology. Evolutionary biology dictates that we come together during times of crisis. We’re social animals. The inability to make contact is frustrating and leads to trauma as self-isolation persists.

The authors (Guillaume Dezecache, Chris Frith, and Ophelia Deroy) write that the media is driving narratives counter to natural behavior. During tragedies, we tend to want to help others more than take care of ourselves. Empathy is our biological inheritance. The media, they write, has adopted a Hobbesian view of the world: every man for himself.

The focus on irrational hoarding of supplies is one example. While running from a fire is a natural reaction to danger, they note that our intuitive responses are cooperation, not selfishness. News outlets perpetuate problems by homing in on aberrant behavior. In fact, they drive the problem. We believe supplies are running short, creating this Hobbesian mentality: I must hoard as well.

This mindset seems worse in cities. As they write,

“In all likelihood, the mismatch between our misperception of the severity of the threat and its consequences is likely to become even more destructive in dense urban areas in which social isolation is a costly good.”

man on Staten Island Ferry

A man rests on an empty Staten Island Ferry on March 24, 2020 in New York City.

Photo by Spencer Platt/Getty Images

Then there’s the flip side: refusing to social distance or shelter at home. Because the threat is invisible we tend to downplay the risks. This is in stark contrast to 9/11, in which more fearful minds associated any Muslim with terrorism. Fortunately, this trend was relatively rare in New York City, though anti-Islam sentiments exploded across the nation, usually in regions with less diverse cultures.

Sine we cannot see this virus, and therefore don’t necessarily understand how it’s transmitted or concern ourselves much if we’re not in a high-risk group, we don’t take precautions. The short-term benefit of contact might, however, fuel the long-term detriment of increased hospitalization and death.

Nonchalance isn’t the only reason for such behavior. It might be something much more ingrained in us.

“It is because our infection-avoidance mechanisms are overwhelmed by a much stronger drive to affiliate and seek close contact.”

As the authors conclude, the more we can stave off loneliness for the greater good of society—at-risk populations, such as the elderly and immunodeficient; health care workers; supply chains providing hospitals with necessary resources; workers contracted to produce those supplies—dictates how we emerge on the other side of this pandemic.

Sadly, there is no easy response. Collectively we’re facing a range of terrible outcomes. The best we can do is strive for the least tragic result. We passed 60,000 deaths in America today. How high that number climbs is in large part in our hands, yet keeping it low requires anti-instinctual behavior. That conundrum is shaping what our society will look like in the future.

Stay in touch with Derek on Twitter and Facebook. His next book is “Hero’s Dose: The Case For Psychedelics in Ritual and Therapy.”