Social Anxiety and ADHD: How to better manage anxiety with supportive planning and preparation

,person with ADHD and social anxiety smiling and socializing with two friendsSocial anxiety is a fear that people will scrutinize you in either familiar or unfamiliar social situations, and this negative judgment will have harmful effects on you. These worries about humiliation and rejection are persistent, often last six months or more, and restrict your activities, interests and relationships. The Anxiety & Depression Association of America (ADAA) states that approximately 15 million adults in the U.S. (6.8% of the population) meet the criteria for Social Anxiety Disorder, also called social phobia, and it typically starts in adolescence–around 13 years old. Overcoming social anxiety is not easy, and it’s a common struggle for children, teens and adults with ADHD. About 50% of adults with ADHD and up to 30% of children with ADHD also have a coexisting anxiety disorder. While you may not be able to overcome social anxiety overnight, you can learn to manage it better with a few key strategies.

Does this sound familiar?

“I feel that a lot of times I genuinely do want to socialize and get to know people. But trauma and fear of rejection disables me from doing it. It’s hard to fight my brain to meet this goal.” – Gunther, age 18

“I have ADHD and social anxiety. The ADHD makes you physically awkward and it makes you stand out. I’m in my 30s and I’m terrified of socializing. It started when I was a kid. It’s terrible. I’m a complete hermit.” – Anthony, age 35

When you worry so much about being negatively judged, you can’t really be yourself, make rewarding friendships, or build a satisfying life. Instead, social anxiety blocks you every step of the way.

Sources of social anxiety

Overcoming social anxiety begins with understanding its root causes. It most often stems from one or more of the following:

outcast teen left out of group

  • Limited exposure to positive social experiences
  • Genetics (people with anxious parents are more prone to anxiety)
  • History of being bullied
  • Memories of public humiliation
  • A general discomfort communicating with people

Other causes of social anxiety may come from feeling that you can’t relate to people or you haven’t learned proper social skills. For teens especially, dating, bullying and peer pressure all contribute to social anxiety. Social anxiety goes beyond shyness or introversion. One of its most important traits is a response to a trigger or situation which is above and beyond the actual threat of that situation.

For example: You are so freaked out that everyone is looking at you when you are in line at the café that you don’t even try to stay and order a coffee. In reality, nobody is looking at you other than the server who takes your order.

The worst part of social anxiety is that you know what you are doing makes no sense, and yet you can’t stop it anyway.

Symptoms of social anxiety

Some symptoms of social anxiety overlap with the characteristics of ADHD which makes diagnosis and treatment particularly complicated. People with ADHD who already struggle with understanding or missing social cues and wrestling with big emotions are particularly vulnerable to social anxiety.

Common symptoms:

woman looking out window

    • Feeling uncomfortable and self-conscious when talking to people outside of your immediate family and/or keeping conversations very short
    • Having trouble making or keeping friends
    • Worrying for days or even weeks before a social event
    • Being intensely afraid other people will negatively judge you
    • Avoiding experiences or places where social interaction will occur (parties, classes, stores, restaurants, gyms, grocery stores, etc.)
    • Being embarrassed to eat in front of others
    • Experiencing panic attacks including nausea, shaking or perspiration in social environments

Managing social anxiety 

Teens and adults with ADHD may experience social anxiety differently depending on the situation.  You may be anxious about talking in class but be comfortable with working out at the gym. It’s important to understand in which environments you experience discomfort, and work on developing coping mechanisms for those settings.

1. Start with small goals

Instead of pressuring yourself to hang out with a group of people on multiple occasions, set up some one-to-one get-togethers with friends or family. These will help you practice your social skills in less overwhelming situations, where you can talk and listen without the distraction of larger crowds.  

2. Create a strategy for larger gatherings

overcoming social anxiety talk to trusted friend

Talk through a coping strategy with a parent, sibling, counselor or coach. Think about who feels safe to talk to, who understands that you struggle with social anxiety, and whom you want to avoid.

Prepare a one-liner response for when people ask how you are doing: “Nice to see you,” “School/work is going well,” “How are you?”

3. Plan your escape

Decide in advance what you will do if you feel overwhelmed or uncomfortable. Where will you go? The bathroom is always a safe bet as everyone uses it, and it won’t seem odd that you are going there. When you are feeling overloaded, step outside for a few minutes to regroup.

4. Plan for recovery time

overcoming social anxiety relaxing with catMost people with social anxiety need time to recover from the output of energy, thought and emotion that interactions demand of them.

Make a list of things you like to do that will help you chill out and nurture yourself. Post this list in your room and remind yourself to use it!

Many people with social anxiety feel badly about themselves and wish they were different. The truth is, there shouldn’t be any shame in feeling socially anxious, and it’s common for people with or without ADHD. You are not alone, and you can manage social anxiety effectively with the right support.


Read more blog posts:

Watch on Dr. Saline’s YouTube Channel:

Deeper Dive:

You Can’t Stop Anxiety. You Change Your Relationship with It. (Handout)

Home Study Seminar: What Your Child With ADHD Wishes You Knew and How You Can Help


Sources:

Adult ADHD (Attention Deficit Hyperactive Disorder). Anxiety and Depression Association of America, ADAA. (2021, October 19). Retrieved October 19, 2021, from https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/adult-adhd.

Coexisting Conditions. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Retrieved October 19, 2021, from https://chadd.org/about-adhd/coexisting-conditions/.

Relationship Between ADHD and Anxiety. Healthline. (2016, December 15). Retrieved October 19, 2021, from https://www.healthline.com/health/adhd-and-anxiety.

Understanding Anxiety & Depression: Facts & Statistics. Anxiety and Depression Association of America, ADAA. (2021, September 19). Retrieved October 19, 2021, from https://adaa.org/understanding-anxiety/facts-statistics.