Social Anxiety in Older Adulthood
By: Danielle Palli
What does it mean when you have a racing heart, trembling hands, muscle tension, and shallow breathing? No, this is not the medical condition you think it is. Here are a few more symptoms: avoiding eating with others or answering the phone when someone calls, and quickly checking the mail with eyes lowered (so you don’t have to talk to your neighbor). Excessive rumination and self-flagellation over past social events; feeling judged by others (particularly those in authority, such as a doctor); playing ‘worst-case scenarios’ about future social interactions; and a constant awareness of how you think you look, and are being perceived, in social situations.
If you’ve experienced some or all of the above symptoms, you have also likely experienced social anxiety (aka social phobia), which can worsen as we age if left unchecked.
Pre-pandemic, a whopping 31% of the population has experienced clinical-level anxiety in their lifetime. Up to 13% of adults have experienced social anxiety, specifically, and these numbers are climbing in the time of Covid. Among older adults, general anxiety has been reported to affect up to 15% of the population. Anxiety is also twice as common among older adults who have depression. Additionally, more than 6% of the older population reported having experienced social anxiety disorder. The stress here is on the “reported,” as people with social anxiety are not inclined to tell people about it (people are scary, remember?). Which is also why these numbers will vary depending on which study someone references.
An Unhealthy Brew
Why does this matter? People experience anxiety. It’s a part of life. So what? Unfortunately, chronic stress has been linked to cognitive impairment and can lead to depression, both of which can be precursors to dementia. Social anxiety also causes people to self-isolate, and we know isolation and loneliness raises one’s risk of mortality by 26%. Add in other stress factors such as neurogenerative conditions, isolating because of hearing impairment, suffering due to grief and loss of a loved one, financial fears, loss of independence, and health and safety fears that have been exacerbated due to Covid, and we’ve got a homebrew of potentially bad outcomes. And, if someone already has a mild case of social anxiety, these factors can make it worse over time.
What Can We Do? Four Tips to Combat Social Anxiety
When we’re stuck self-isolating but need to be with others for our own health and wellbeing, what can we do? While not a catch-all, here are a few tips to get you through the proverbial door.
1. Reach Out. This is counter-intuitive for someone with social anxiety who wants to do anything but (and certainly not to someone they may view as an authority figure). However, this is a critical step. Consider one person you trust, be it a primary care physician, a friend, a coach, or a team member in your community. Can you share how you are feeling with that person? What about an online group where you can participate without the need to talk unless you choose to? For example, Masterpiece Living offers the Master-PEACE Circle via Zoom or phone three times a week, where people practice a mindfulness activity together, followed by discussion. Those who want to participate choose how much or how little they wish to talk. Look for opportunities such as this one that are short (less than an hour) and provide a safe space. Gathering positive experiences, and receiving support from others, can help us overcome social phobia.
2. Check the Story You’re Telling Yourself. Psychotherapist Jane Parker suggests in the Roger & Friends: The Bright Side of Longevity podcast that, during this pandemic, we take a closer look at what we’re thinking about ourselves and the people and situations around us. Are they accurate? Are they helpful? She also gently challenges us to ask ourselves, “what else is true?” Instead of only predicting what can go wrong in a social situation, what could go right?
Clinical psychologist Dr. Ellen Hendriksen proposes that we confront our inner critics and ask questions such as “what is the worst that can happen?” and “how will I cope?” (Yes, I know you might be saying, “Danielle, this is a pandemic. The worst thing that can happen is that I could die!” But we’re talking about virtual outreach in this scenario.) She also offers a free, online assessment tool for people who want to measure their social anxiety levels.
3. Look for Glimmers and Positive Moments. Jane Parker also suggests in the same episode that we “look for glimmers.” Seek out positive moments throughout the day. In terms of social connection, notice positive encouragement from people, smiling faces (another benefit to video chats – no masks that hide facial expressions), and acts of kindness. Consider how the people around us are stepping up in support of one another. If they didn’t love us, they would not act this way. Certified Coach and Dr. Roger & Friends co-host, Teresa Beshwate, often tells us that “with all that we don’t have control over, the one thing we can control is our thoughts.” Can we choose to think thoughts about ourselves that are kind and authentic, and validate that we are valued and someone people want to be around?
4. Practice Mindfulness. Whether this comes in the form of meditation, prayer, journaling, creative endeavors, or taking a walk out in nature, tuning inward is a precursor to tuning outward. Regular stress-relieving practices help keep all types of anxiety at bay by calming our nervous system and activating our parasympathetic response. This will help us be more present when we are around others, and focus on those around us while quieting the inner critic. Self-compassion meditations are also powerful tools.
Quick Tip: When feeling stressed, take a deep breath in through your nose and sigh it out through your mouth to slough off tension. Then, take a few relaxed breaths, in and out through your nose. Do this for a few minutes, and you may start to notice your exhale becoming slightly longer than your inhale – this is an effective way of calming anxious thoughts and feelings.