Catherine Falalis opens up about her 20-year journey with Social Anxiety Disorder (SAD). An exhausting cycle which, when at its worst, makes even the most mundane daily activities unbearable.
Eight-year-old Sarah grips her mother’s hand tightly as they walk into the local shopping centre to try on some new shoes for school. She feels her heart beating faster. Erratic. Her breathing becomes shallow and quick. She feels light-headed and her throat begins to swell before uncontrollably spiralling into a coughing fit. Trying not to vomit in front of the sales assistant, she can see the confusion in her mother’s face. Sarah’s cheeks flush red as the embarrassment begins to take over. Feelings of guilt, imperfection and fear wash over her and settle deep inside her thoughts. “Why can’t I just be normal, like all the other kids?” she asks herself. Sarah and her mother leave the store without the shoes and she takes it upon herself to write her mum an apology letter as soon as they return home in attempt to rid herself of the overwhelming humiliation she has caused.
This sequence of events happens again when Sarah goes to the supermarket, to the movies with friends and when she is invited to play in the street with the neighbourhood kids. It happens at every party and social event. Sometimes it even happens at school.
The truth is, Sarah’s experience was my reality. Now, at 28 years old, I have been battling Social Anxiety Disorder (SAD) for more than 20 years. An exhausting cycle which, when at its worst, makes even the most mundane of appointments and daily activities unbearable.
I didn’t understand what it was back then and information surrounding social anxiety in children wasn’t as readily available nor spoken about, so my parents can be forgiven for not quite understanding it themselves. Thankfully, a lot has changed.
According to Beyond Blue, it is normal to experience some level of nervousness when we are placed in social situations where we might come under the scrutiny of others. Work presentations or giving a speech at a wedding are examples of this. However, for people who experience SAD, being the focus of other people’s attention can lead to intense anxiety.
“They may fear being criticised, embarrassed or humiliated, even in everyday situations. For example, the prospect of eating in front of other people in a restaurant can be daunting for those with social phobia. SAD can be generalised, where people fear a range of different social situations,” defines Beyond Blue.
Clinical psychologist Catherine Madigan from Anxiety Treatment Australia has substantial experience in the cognitive behavioural treatment of disorders such as SAD and seconds this sentiment. “Some people have generalised social anxiety where they have multiple social fears, but others may just fear one or two scenarios such as public speaking or job interviews,” she says. “Sufferers may think they are boring, silly, incompetent, inferior or that others will notice their anxious symptoms and judge them for it. Often they fear their mind will go blank and won’t say the right things.”
SAD common physical symptoms:
- Excessive perspiration
- Blushing or stammering when trying to speak
- Nausea or diarrhoea
- Panic attacks
Post-event rumination is one of the most debilitating aspects of the disorder, aside from panic attacks themselves. This process involves thinking about an event over and over again, comparing one’s situation with an unachievable standard. This maintains negative beliefs about a scenario, ultimately inhibiting people from critically evaluating past events. The next time they are in a similar social situation, it triggers them to anticipate the same result, meaning they enter with a higher level of anxiety.
Sufferers of SAD also exhibit safety behaviours. These are behaviours that make people feel more comfortable in a situation by providing temporary relief from anxiety. “Safety behaviours may include avoidance, reduced eye contact, speaking only when spoken to, saying the bare minimum, asking too many questions so the focus isn’t on themselves, speaking too fast and even rehearsing sentences before saying them,” explains Catherine.
The most recent ABS National Survey of Mental Health and Wellbeing was conducted in 2007. Findings showed that almost 11 per cent of the Australian population experiences social phobia during their lifetime. More women than men appear to develop the disorder and the condition often starts in childhood or adolescence. Causes range from individual temperament (childhood shyness, timidity), family history (genetic predisposition) or learned behaviour/environment (such as being bullied at school). This statistic may have increased since then and it’s a great shame that the survey, which was expected to be conducted again in 2017, was not funded by the government.
2020 saw thousands of Australians locked up in their homes for months due to the Coronavirus pandemic. These people then had to assimilate back into society and re-learn how to interact in social settings once restrictions eased. Many within my circle confided in me about their fears and having to be social again. This was the catalyst for me to open up about a topic I’m all too familiar with in the hope that my story may help others who are quietly experiencing SAD themselves.
Until recently, I had spoken only to my partner, immediate family and a couple of close friends about my struggles. Throughout high school and university I would pretend to be okay and disguise my anxious coughs as “tickles in the throat”. Back then, the subject was taboo and I feared being judged by those around me — a classic social anxiety trait!
Catherine believes people are more open about psychological issues nowadays because of media coverage and education, making it less stigmatised. She also explains that SAD can often be accompanied by other mental health issues such as depression, abuse of drugs or alcohol, panic attacks, agoraphobia and body image issues. This is why it is super important to get help if you begin to notice symptoms.
Seeking help is something I’ve taken seriously over the last few years. A breakup in 2015 resulted in my anxiety spiralling out of control even further. Unable to leave the house or keep food down, a trip to the GP enabled me to jump on a mental healthcare plan, giving me 10 rebated sessions with a psychologist that year. This is when I also began my journey with antidepressants. Since then, I’ve tried emotional freedom technique (EFT) and neuro-linguistic programming (NLP). All have given me management tools to better cope with my anxiety.
“Cognitive behavioural therapy (CBT) looks at the interaction between thoughts, feelings and behaviours and by changing one’s thoughts and behaviours, one can decrease their anxiety,” explains Catherine. “Sufferers learn to stop avoiding feared social interactions and drop their safety behaviours. They also learn to challenge their negative self-talk. Some people do work hard and overcome their anxiety, but every individual has a different story, level of severity of symptoms, and willingness to do the work to overcome their disorder.”
Try this quick breathing technique for immediate anxiety relief…
- Hold breath for six seconds
- Breathe in through the nose for three seconds
- Exhale through the mouth for three seconds
- Repeat this 10 times then;
- Hold breath again for six seconds
- Repeat process for five minutes
When medication is needed
“Medication can certainly be helpful for some sufferers. People with severe social anxiety may find it helps them to get started by relieving some degree of their anxiety and decreasing their depression, which may reduce their motivation to engage in treatment,” explains Catherine.
There is no shame in taking medication if this is what you need to help you function. I personally relapsed twice after attempting to gradually stop it, so for now I’m not prepared to risk my mental health by not taking it. “If you think you might have mild or severe forms of SAD, get help,” encourages Catherine. “Your GP can assist you with a referral to see a psychologist and if your anxiety is severe, they can prescribe medication.”
Since COVID-19, Telehealth appointments are available so you can chat to a psychologist on the phone or online if you prefer that. I implore you to seek help if you need it.
Life for me is looking bright at the moment and I attribute this to my recent ability to be honest about my struggles and also to my commitment to equip myself with the tools needed to manage my anxiety.
If I had the opportunity, I would tell eight-year-old me to not be scared. That she will grow up to be an intelligent woman with a successful business and have a loving partner and beautiful family and friends by her side to support her through all the highs and lows. I’d tell her that she won’t have to hide or pretend anymore and that she will feel free once she speaks her truth. And we will giggle together as we exit the shoe store, one hand embracing each other and the other hand carrying our bag of new kicks.
- Overcoming Social Anxiety and Shyness 2nd Edition by Gillian Butler
- Change Your Thinking by Sarah Edelman
- But First, We Make the Beast Beautiful by Sarah Wilson
- Centre for Clinical Interventions
- Clinical Research Unit for Anxiety & Depression
- Smiling Mind
- Headspace Guide to Meditation on Netflix
- The Mind, Explained on Netflix
Catherine Falalis is a born and raised Melbournian who spends her days helping wellness brands tell their stories online via her copywriting and social media agency Content Savvy. Supporting fellow women in business and advocating mental health awareness are greatly important to her, with a strong focus on integrative medicine for anxiety management.