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Social Anxiety and Generalized Anxiety

Key points

  • Generalized anxiety and social anxiety have some things in common but are different in some ways.
  • People with generalized anxiety and social anxiety usually both need to work on dealing with uncertainty.
  • Children often have both generalized anxiety and social anxiety.
  • In therapy and stuck? Maybe you don't just have one but both of these disorders. 


You may have found this page because you wonder about the difference between generalized anxiety and social anxiety.


People with generalized anxiety worry all the time about everything.

Worry is a way of thinking about the future that leaves you anxious. If you have generalized anxiety disorder, you likely think up about future scenarios. They often involve something terrible happening. It may make you believe you have to do a lot of preparing for the worst. The content of your thoughts is anything and everything.


When you think of the scenarios, they make your body feel bad. All this worrying can result in muscle tension and pain that makes you:

  • physically tired
  • irritable
  • have sleep problems
  • feel fidgety or revved up.

People with social anxiety worry about being judged by others. The content of the worried thoughts is only about others judging you and your performance in various settings. Although sometimes you are not aware of it. That is the basis of social anxiety. It comes from our deep need to be part of a tribe. During tribal times, if you the tribe kicked you out, you died! At one point in time, this was extremely beneficial; this anxiety helped us survive. But now, not so much. 

 


There are many pages on this website on social anxiety, like causes here and CBT for it here and depression here children here anger here .



Social Anxiety and General Anxiety differ in Content of Worry

If you have social anxiety, you may be afraid of going to work because of a specific worry, such as meeting with your boss, presenting at a meeting, or turning in a project. If you generalized anxiety, you may have: multiple worries, have physical symptoms, have sleeplessness, trouble concentrating, and not even know where to begin with identifying your fear because there are so many. 


There are things that people with social anxiety and generalized anxiety have in common.


People who suffer from social anxiety and generalized anxiety both appear to have an underlying mechanism driving some of their worry, which we call intolerance of uncertainty. 


Like you can imagine, this means being uncomfortable with the unknown.


Unfortunately, everything is uncertain, although we do things to try to convince ourselves otherwise.

People engage in worry as a way to gain a sense of certainty.

If you have generalized anxiety and social anxiety, you may have some traits. 

You likely view your problems as negative and overwhelming ( we call this negative problem orientation). Therapy can help you to see problems as something you can tackle. This mindset makes you more resilient and reduces your anxiety.

You also are likely to procrastinate and avoid dealing with problems until the last minute as a way to prevent your anxiety. Avoidance makes everything worse even though at the moment, it may seem to make things better. You can learn to work on this as well.

Accepting and dealing with uncertainty is the main challenge for people with generalized anxiety disorder and part of the challenge of dealing with social anxiety disorder. It's essential to work on because life is uncertain, and getting comfortable with this and living your life anyway will decrease your anxiety and improve your life.

People who have an intolerance of uncertainty behave in these ways. 

Intolerance of uncertainty is the most predictive factor of worry in adults. It is more associated with generalized anxiety disorder but it is present in social anxiety as well as obsessive compulsive disorder. 

Safety behaviors.


Both people with Generalized anxiety disorder and social anxiety disorder have safety behaviors. Safety behaviors make a person feel more comfortable by providing temporary relief from anxiety, but they make the anxiety worse. At the moment, you escape the situation with this safety. Unfortunately, you reinforce the idea that what you are anxious about is dangerous, therefore maintaining your anxiety.

An example of a safety behavior is bringing your best friend with you who is more social to avoid talking. Avoidance or drinking can be a safety behavior as well.



Social Anxiety and Generalized Anxiety: Safety Behaviors

You can discover your safety behavior by asking yourself :

"When I feel anxious and can't avoid the situation, what do I do to help me cope?"

To explore this more, ask yourself:

"What do I learn from coping in this way?"

"What would happen if I stopped coping in this way?"


In childhood, pure forms of social anxiety  and generalized anxiety are highly uncommon. In one study of 488 youth aged 7-17 64 percent had both generalized anxiety and social anxiety. Some estimates are even higher for child rates of comorbidity! We think this is because pure forms of anxiety disorders are harder to find in childhood because they are less differentiated then. It takes a while to look like how they describe them in our manuals, although they seem to start to show themselves in childhood. We also aren't too sure our discrete categories are right. 


We use diagnostic categories to help people, study therapy, and medicine that works, but the categories may not be entirely separate in some ways. 


Do you think you might have both social anxiety and generalized anxiety ?


You aren't alone! If you do, it's essential to get the right help. You might be failing to get the proper treatment or struggling with your current therapy if you aren't diagnosed correctly. 


Particularly for people with Social anxiety disorder, as many as 90 percent of patients have another psychiatric diagnosis. It is not uncommon for you to struggle with two anxiety disorders. Still, it makes your treatment more complicated, and it makes you more vulnerable to depression. Your therapist may need to be more knowledgeable and aware of what to do to help you. If you are not getting better, it is not because there is something wrong with you. There is another anxiety hiding under the first one.

References for social anxiety and generalized anxiety

Hearn, C.S., Donovan, C.L., Spence, S.H. et al. What's the Worry with Social Anxiety? Comparing Cognitive Processes in Children with Generalized Anxiety Disorder and Social Anxiety Disorder. Child Psychiatry Hum Dev 48, 786–795 (2017). https://doi.org/10.1007/s10578-016-0703-y

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