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Understanding Social Anxiety with Dr. Seema Sehgal

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[Music] thank you hi Dr Seema Segal Welcome to our course platform so you've been uh practicing psychiatrists in a community for 25 years I'm so glad you're here to be an expert on arca's platform uh welcome tell me a little bit about you Bali it is so exciting I feel privileged to be part of you know this movement that I see you starting I have been a practicing psychiatrist in Fremont for over 25 years and have had a really wide and varied experience in Psychiatry uh you know from my time um working for Alameda County where I saw the really extreme ends of the mental health Spectrum with diseases like schizophrenia severe bipolar disorder all the way now to a lot of depression and anxiety and uh you know the aftermath of the pandemic that we are hopefully here to speak about a little bit today yeah so you talked about what are the things that have changed recently let's talk about one issue that we have heard a lot of people talk about social anxiety we've seen a rise of it in the last few years first of all just like can you tell us what social anxiety really is sure um you know how people think behave and feel in Social situation varies right from person to person because our behaviors are influenced so much by our own uh wiring our upbringing our parent and you know apparenting Styles our own childhood experiences so all of us have a certain degree of anxiety when we have faced you know in novel situations by say the need to public speak during interviews or meeting people for the first time you know there are people who are traditionally shy now social anxiety is a specific disorder uh where people's anxiety starts to really escalate even through everyday interactions causing them severe embarrassment self-consciousness they have a fear of being scrutinized or being humiliated uh they fear being criticized by people they are around and so it leads to a real uh impact on their functioning and you know this this piece about function functioning is what separates what could be just shyness or you know mild anxiety in someone from a disorder that requires treatment because you know people with social anxiety uh disorders start to have an impact on their relationships on their work relationships their ability to interview to speak up in projects presentations you know it starts to impact that peer relationships and um in order to avoid the embarrassment and fear and humiliation they start to isolate so their world starts to really shrink and sometimes they can even you know use maladaptive mechanisms like substance use to try and manage these really uncomfortable symptoms yeah no that is really informative right I mean it can go from one end to the other pretty quickly is that true uh you know usually we see it starting to develop in the sort of mid to late teens so 13 14 year olds are where we see it first emerge and then it gradually sort of builds and so the the age group that well experience it probably the most is probably between 13 and about 23 24. so and you know as you can imagine this is the time of most rapid uh brain growth and so all experiences they have you know whether it is their outside experiences how they are perceived by the world what is their own world view all begin to really have lasting um Impressions and you know they can take these forward into life yeah so when is it that like you said like social anxiety when is it the right time to visit a professional like when you get professional what are the symptoms that you decide that okay now this is the next step that we have to seek professional help right so you know this is a this is an interesting and important question because remember when it first starts it's happening to a child right and so the child has really no way of knowing that this is something that is unusual that it's even a disorder or something that requires professional help and parents if they are not educated about signs and symptoms to look out for could easily miss it and you know it is sort of pushed under the under the sort of uh Banner of I have a very shy child or you know I have this uh very quiet introverted child all a while not knowing what is truly going on in the mind of the child so you know when I think of symptoms I think of putting them in two buckets you know the first is sort of the psychological and emotional symptoms which is really what's going on in the mind of the child and the second bucket is the physical symptoms that is the actual symptoms that are being experienced by the by the patient or the child so under the psychological symptoms you basically have thoughts right there is the fear the fear of being humiliated the fear that people are you know going to laugh at you that you're going to be bullied or you're not going to be accepted or you know you're being judged by people and um you know the pure the thoughts they sort of can increase in intensity and then lead to avoidance behaviors so avoidance where you refuse to be out with friends you start to isolate you know there's fear in simple activities like going and talking to a bank teller to a checkout person at the grocery store there's difficulty making eye contact and you know the fear and the thoughts and the worries about how the world or people in it are perceiving you rarely become big and gradually what happens is that that same criticism and judgment starts to become internalized we start to then judge our own self you know we start beating up on ourselves becoming critical and this further erodes self-esteem um you know our self-worth our self-confidence and so you can see how you know it starts to sort of build this trajectory and so it's important to really come in and contain it the physical symptoms are those of you know pretty much any anxiety disorder where the person experiences uh you know feelings of being sweaty or blushing or flushing or stammering not finding the right words uh feeling this you know terrible feeling in the pit of their stomach so really if you think of a panic or a fight-or-flight response those are the physical uh symptoms to watch for so you know for the parents it's important to remember that often there will be either a change in their child's Behavior they become more clingy you know they refuse to go out they throw Tantrums they're making excuses and when they do go out they're not having a good time or they come back and they're in a really bad mood because um you know if social anxiety is left untreated um it leads to depression and you know and that is something that we want to avoid at all costs so we want to be able to catch it and get the children the help that they need once a person has these symptoms and they diagnosed with their social anxiety disorder what do you suggest they do next Nepali what I would strongly recommend is that if someone thinks that they have um the social anxiety disorder or you know they worry that they are not doing as well as they had been it's always a good idea to talk to a professional and you know that professional need not be a therapist or a psychiatrist that is hard to find you know in this current day and age but your primary care physician your pediatrician if you know you're under 18 they are great resources and First Steps so someone that you can talk to freely about your feelings and emotions and and you know the circumstances that bring these emotions up is a good first step and at the end of the talk we've listed some resources that are also wonderful to get more information about these illnesses and disorders with tips and strategies that you can use to make your life better even on a day-to-day basis as you're waiting to see someone great thank you so much you're welcome

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