One of the biggest mental health disorder that has come to the surface in a rapid uproar has been social anxiety. Feels like thanks to COVID when it basically smacked us in the face back in 2020, social anxiety came to the surface in all types of different individuals. A social anxiety is best “defined as a ‘marked fear or anxiety one or more social situations in which the individual is exposed to possible scrutiny by others” (sections 300.23).’ (Gruman, Schneider, & Coutts, 2016, pg. 102)” Seems to be that you come across someone daily who sufferers from this disorder and it is one that attacks you in ways that you never thought could. I personally known a girl 16-years of age, a high school student, technically a junior this year, who has such a social anxiety that she has gotten special approval for the past year and a half that she does not have to return to school, she has the availability to do it online. Which gives her the availability to join her classes via zoom, so she is not missing anything, she does not have to show her face and still gets the education that her fellow classmates do. This social anxiety has been apart of her life since she was a little younger but was never as bad as it is today. She always feared big crowds such as parties, social events, etc. Though once she was taken out of the social interactions when COVID hit, the anxiety multiplied by a thousand. She is basically afraid to leave her house now. Which has given her the opportunity to learn from home but yet causes more issues such as when she gets older, begins to work and have more of an adult life. Since there are two different approaches for treatment for the social anxiety she has been treated with both approaches.
The biomedical approach to social anxiety is known as a “brain diseases and emphasizes pharmacological treatment to target presumed biological abnormalities. A biologically-focused approach to science, policy, and practice has dominated the American healthcare system for more than three decades. (BJ;)” Which gives indication that the biomedical factors of the social anxiety disease are from the serotonin and dopamine levels getting disrupted, which cause the anxiety. Which in her case was treated pharmaceutically with medications that aided her anxiety. However, not all medications for anxiety work to their full potential. In her case, she was tried on multiple different medications to help aid, though not all worked successfully. With the trial and error of medications she’s finally come to the point where a medication subsided the anxiety to the point that with a combined aid of another approach, the biopsychosocial approach she is able to function without a constant attack of anxiety.
“A biopsychosocial model for anxiety disorders includes an individual’s genetics, brain structure, environment, and general thinking patterns to explain etiology, effects on thinking, behaviors, and development of an anxiety disorder. (Jokinen & Hartshorne, 2022)” Therefore, her social anxiety disorder is based off both biological and psychological makes ups that generate her attack in a social environments. Treatments in the form of psychosocial for the attacks are teaching an individual ways to cope with the anxiety so that it does not escalate to the attack level.
So a huge part of her life the last few years has been trying to be taught and to understand the psychological aspects of life which can be tailored to her, to help her cope with the social anxiety. Reducing her social anxiety has been tough, there are many approaches she took to help reduce her attacks. She worked on her own stress of school, work, assignments, etc. Her parents helped her with becoming for physically active such as walking the dogs, yoga and stretching daily. They also helped her with a consistent schedule to be sure that she had more of a routine with sleep, waking up, eating, school, homework, etc. Doing all of this has reduced the anxiety of stress and she is finally at the point where she has the courage to participate in small social activities. Seeing her develop the courage is wonderful, though you have to start somewhere she has finally taken the step of being a little uncomfortable to be comfortable in social situation. It’s not easy to do and social anxiety is a real thing, it is a disorder that overtakes the body and attacks an individual in many different environments, meaning a extremely social (multiple individuals / groups), or even a small gathering (two or more individuals). Social anxiety has been a major disorder that has come to the surface over the last few years and is such a disorder that disrupts an individual at any given time.
Reference:
BJ;, D. (n.d.). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Clinical psychology review. https://pubmed.ncbi.nlm.nih.gov/23664634/#:~:text=The%20biomedical%20model%20posits%20that,for%20more%20than%20three%20decadesLinks to an external site..
Gruman, J. A., Schneider, F. W., & Coutts, L. M. (2016). Applied Social Psychology : Understanding and Addressing Social and Practical Problems. (3rd ed.). SAGE Publications
Jokinen, R. R., & Hartshorne, T. S. (2022, May 18). Anxiety disorders: A biopsychosocial model and an adlerian approach for conceptualization and treatment. The Journal of Individual Psychology. https://muse.jhu.edu/article/855020/summary#:~:text=A%20biopsychosocial%20model%20for%20anxiety,development%20of%20an%20anxiety%20disorder.
Much like many mental health disorders, social anxiety is misunderstood. I remember a peer of mine in high school who was diagnosed with social anxiety describing an experience she had. Before hearing about her experience, I did not fully understand what it meant to struggle with social anxiety. Reading about the high school student you describe is saddening as it can truly remove an individual from the experiences of life.
As you mentioned, after COVID-19, the rise of mental health concerns has increased significantly. This past summer, I interned at an outpatient clinic and shadowed therapists. During my time there, I learned that the demand had risen so much they now had a waiting list for people looking for help. All that to say, many of these individuals were looking for biomedical help in addition to biopsychosocial. Biomedical is helpful because it helps relieve some of the symptoms related to social anxiety. However, it will not help solve others’ influences. Those who struggle with social anxiety experience self-presentation; people are driven to manage the impressions they make on others, seeking approval and favoritism (Gruman et al., 2017). Consequently, treatment helps them by teaching them social skills and raising their self-efficacy. Through the biopsychosocial model approach, an individual gets medication and therapeutic treatment.
Reference:
Gruman, J. A., Schneider, F. W., & Coutts, L. M. (Eds.) (2017). Applied Social Psychology: Understanding and Addressing Social and Practical Problems (3rd ed.). Thousand Oaks, CA: Sage Publications.
Social anxiety noticeably surged with the onset of COVID. My mother was diagnosed with COVID and had to be hospitalized during the holidays. Upon her return home, she developed social anxiety very similar to the example you provided. To this day, she struggles to venture outside, even for simple errands like grocery shopping. COVID undoubtedly played a significant role in triggering my mother’s social anxiety.
Much like the example you mentioned, a biomedical approach was initially employed in my mother’s case. Medication did help alleviate her social anxiety to some extent, but it didn’t fully resolve the issue. What made a substantial difference was adopting the biopsychosocial approach. This holistic approach has been instrumental in helping my mother effectively manage and alleviate her social anxiety.As mentioned in “although it is clear that the role of biology will always be important in explaining illness, the biopsychosocial model demands that we also pay attention to psychological and social influences”(Gruman, Schneider, & Coutts, 2016). By carefully examining the underlying causes of social anxiety, we can pinpoint more effective approaches to help individuals struggling with it.
Gruman, J. A., Schneider, F. W., & Coutts, L. M. (2016). Applied Social Psychology : Understanding and Addressing Social and Practical Problems. (3rd ed.). SAGE Publications
It is so sad to hear about how debilitating social anxiety can be. This hit so close to home because I actually have social anxiety and obsessive compulsive disorder too. Covid made my disorders so much worse and it made it hard to even leave the house so I can relate to her story. I agree a biopsychosocial model approach to treating a mental disorder such as social anxiety is so vital. Like you said, Covid significantly worsened her symptoms that she already had. She may have had a chemical imbalance with either her serotonin or dopamine before but the fears of this virus that shook the world added to her feelings she was already experiencing. Therefore, it was completely necessary she was treated with social and psychological factors in mind and not only biological factors. This would enable her to speak through her fears. I am happy to hear she is doing better and she is able to put herself in mildly uncomfortable situations now with proper treatment. This idea that she has been able to be in an uncomfortable situation and push through has actually triggered a thought for a treatment that could be worth looking into for her to further her progress. This treatment is Cognitive Behavioral therapy. There is exposure to uncomfortable factors or fear in some kinds of cognitive behavioral therapy and according to the Mayo Clinic “You may feel emotionally uncomfortable at times. This is because CBT can cause you to explore painful feelings, emotions and experiences. You may cry, get upset or feel angry during a challenging session However, working with a skilled therapist will minimize any risks. The coping skills you learn can help you manage and conquer negative feelings and fears.” (Mayo Clinic, 2019). This type of therapy is used a lot for social anxiety and was recommended to me when I had specific fears such as Covid or public meetings. There is some research that has found that this kind of therapy can even have better effects than medication for particular disorders. According to the article, The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses, “CBT for social anxiety disorder evidenced a medium to large effect size at immediate post-treatment as compared to control or waitlist treatments, with significant maintenance and even improvement of gains at follow-up (Gil, Carrillo, & Meca, 2001). Further, exposure, cognitive restructuring, social skills training and both group/individual formats were equally efficacious (Powers, Sigmarsson, & Emmelkamp, 2008), with superior performance over psychopharmacology in the long term” (Fedoroff & Taylor, 2001). This kind of treatment would also be considered a biopsychosocial model approach. If this seems to be something she would be interested in asking her mental health care team about to see if it is appropriate, the rest of the research used in this post can be found below.
References
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive therapy and research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1
https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610