I think that I may have some sort of anxiety disorder. When I am around a large group of people, or even one or two people, I tend to clam-up and get really nervous and can’t think of anything to say. It makes me look really stupid. What do you think the problem is? What can I do about this? It’s really disrupting my social life.
You don’t say whether your nervousness around people happens in every situation, or only when you are with people you don’t know very well. If it is the latter, you might temperamentally be a shy person. Shy people often first manifest their timidity around new people when they are young children — strange, new situations and strange people make them feel hesitant and fearful. Shy children generally (but not always) grow into adults who are on the shy or introverted side. However, once they know someone and are comfortable, shy people are just as capable of warm and friendly interactions and attachments as anybody else.
If your situation is more extreme, you might be suffering from social phobia, or what is sometimes called “social anxiety disorder.” In social phobia, a person has a marked and persistent fear of social or performance situations in which embarrassment may occur. Exposure to the social or performance situation almost invariably provokes an immediate anxiety response, and is usually endured with dread (if not avoided altogether). In the feared social situations, persons with social phobia are afraid that they will embarrass themselves and are afraid that others will judge them as nervous, weak, or stupid.
Social phobia is more common than you might think — some studies estimate that 3 to 13 percent of people will experience social phobia at some point during their lives. Studies suggest that it might be slightly more common in women, though men probably seek treatment for it more often. It appears that some children who are temperamentally on the excessively shy side later go on to develop full-blown social phobia in their teens and twenties (usual onset is in the mid-teens).
How do you get help for this? The first step is to see a competent mental health professional, preferably a psychiatrist, for a full evaluation. You want to make sure that another condition — mental or physical — is not causing your symptoms. The next step involves treatment. Most people with social phobias can be greatly helped by using the SSRI (serotonin selective reuptake inhibitor) antidepressants. These medications alter the levels of serotonin in the brain, and serotonin-containing brain circuits appear to be involved in anxiety and in social information processing. Another step is to have several sessions of talking therapy to develop and practice some relaxation techniques to use when anxiety levels start to rise. Several sessions of talking therapy can also be used to build up self-understanding and self-confidence and to practice some basic conversational skills to use during social encounters.