If you suffer with social anxiety, you may have experienced what is known as a "panic attack" in social or performance situations. Although panic attacks are generally thought of in relation to panic disorder, panic can also be a problem for those with social anxiety disorder (SAD). The difference is that panic is triggered by a specific type of social or performance situation.
For example, imagine that you are required to give a speech. For days and weeks ahead of the event, you might experience anticipatory anxiety about the performance. Although that anxiety is uncomfortable, it usually is not the same as the dread and terror that are experienced during a panic attack.
In the moments leading up to your speech, and during the time that you are in front of the audience, you may feel as though you start to lose control. Your heart races, your hands shake, your mouth goes dry and you feel nauseous. In order to gain control of your panic symptoms, it can be helpful to understand the physiological reaction that underlies them.
The first trigger in the chain of events happens in your brain. Chemical messengers known as neurotransmitters send signals to different brain structures that influence processes in your body. In the case of panic, it is believed that levels of the neurotransmitters norepinephrine and serotonin, and the brain structures known as the amygdala and hypothalamus, play a primary role.
Once signals are initiated in the brain, there is an activation of the sympathetic nervous system, which is responsible for the "fight-or-flight" response you experience while giving your speech. Adrenaline is released into your bloodstream, which causes feelings of panic along with a host of bodily changes, such as increased heart rate, shortness of breath, sweating and dizziness.
The evolutionary purpose of this reaction in your body is to mobilize you to deal with a physical threat. The body is preparing you to run, fight, or flee the situation by directing blood flow toward vital organs and slowing your digestion. The problem is that there is no physical threat, and the excess energy is detrimental to your situation, rather than helpful.
As you notice the symptoms of panic in your body, you may make the situation worse. Perhaps you are speaking to the audience and have trouble catching your breath. Anxiety causes you to take even more shallow and rapid breaths, leaving you feeling dizzy and faint; a very real result of hyperventilation. Fear of your symptoms creates a vicious cycle whereby anxiety prolongs the release of adrenaline.
Although it can be difficult to control your emotions, the best reaction to a panic attack is to allow the feelings to come and then go. Your parasympathetic nervous system will eventually return your body to a state of rest as adrenaline is reabsorbed. Your reaction to panic can, in part, determine how long the attack will continue.
It is important, however, to learn how to cope in the future so that you can enter these types of situations without the same fear and dread.
If you suffer from panic in social or performance situations and have not seen a mental health professional or medical doctor, it is advisable to make an appointment. Obtaining a proper assessment of your symptoms is the first step toward overcoming social anxiety. If a diagnosis of social anxiety disorder (SAD) is given, you will then be offered treatment, such as medication or cognitive-behavioral therapy (CBT) that will help to control your symptoms.
Boeree G. The emotional nervous system. Accessed August 22, 2011.
Bourne EJ. The anxiety and phobia workbook. Oakland, CA: New Harbinger; 2005.