Understanding Social Anxiety with Dr. Seema Sehgal

0:00 [Music] 0:07 thank you 0:11 hi Dr Seema Segal Welcome to our course 0:14 platform 0:16 so you've been uh practicing 0:18 psychiatrists in a community for 25 0:20 years I'm so glad you're here to be an 0:24 expert on arca's platform 0:26 uh welcome tell me a little bit about 0:28 you 0:30 Bali it is so exciting I feel privileged 0:33 to be part of you know this movement 0:36 that I see you starting I have been a 0:40 practicing psychiatrist in Fremont for 0:42 over 25 years and have had a really wide 0:47 and varied experience in Psychiatry uh 0:50 you know from my time 0:53 um working for Alameda County where I 0:55 saw the really extreme ends of the 0:58 mental health Spectrum with diseases 1:00 like schizophrenia severe bipolar 1:02 disorder all the way now to a lot of 1:06 depression and anxiety and uh you know 1:09 the aftermath of the pandemic that we 1:12 are hopefully here to speak about a 1:13 little bit today 1:15 yeah so you talked about what are the 1:19 things that have changed recently let's 1:21 talk about one issue that we have heard 1:23 a lot of people talk about social 1:25 anxiety 1:26 we've seen a rise of it in the last few 1:28 years first of all just like can you 1:31 tell us what social anxiety really is 1:35 sure 1:36 um you know how people think behave and 1:39 feel in Social situation varies right 1:42 from person to person because our 1:45 behaviors are influenced so much by our 1:48 own uh wiring our upbringing our parent 1:52 and you know apparenting Styles our own 1:54 childhood experiences so all of us have 1:58 a certain degree of anxiety when we have 2:00 faced you know in novel situations by 2:03 say the need to public speak during 2:05 interviews or meeting people for the 2:07 first time you know there are people who 2:09 are traditionally shy now social anxiety 2:13 is a specific disorder uh where people's 2:17 anxiety starts to really escalate even 2:21 through everyday interactions causing 2:24 them severe embarrassment 2:25 self-consciousness they have a fear of 2:27 being scrutinized or being humiliated uh 2:31 they fear being criticized by people 2:33 they are around and so it leads to a 2:36 real uh impact on their functioning and 2:40 you know this this piece about function 2:42 functioning is what separates what could 2:45 be just shyness or you know mild anxiety 2:48 in someone from a disorder that requires 2:52 treatment because you know people with 2:54 social anxiety uh disorders start to 2:56 have an impact on their relationships on 3:00 their work relationships their ability 3:02 to interview to speak up in projects 3:06 presentations you know it starts to 3:08 impact that peer relationships and um in 3:11 order to avoid the embarrassment and 3:14 fear and humiliation they start to 3:16 isolate so their world starts to really 3:19 shrink and sometimes they can even you 3:22 know use maladaptive mechanisms like 3:24 substance use to try and manage these 3:27 really uncomfortable symptoms 3:29 yeah no that is really informative right 3:32 I mean it can go from one end to the 3:34 other pretty quickly is that true uh you 3:37 know usually we see it starting to 3:39 develop in the sort of mid to late teens 3:43 so 13 14 year olds are where we see it 3:46 first emerge and then it gradually sort 3:49 of builds and so the the age group that 3:52 well experience it probably the most is 3:54 probably between 13 and about 23 24. so 3:58 and you know as you can imagine this is 4:00 the time of most rapid uh brain growth 4:03 and so all experiences they have you 4:06 know whether it is their outside 4:08 experiences how they are perceived by 4:10 the world what is their own world view 4:12 all begin to really have lasting 4:16 um Impressions and you know they can 4:18 take these forward into life yeah so 4:21 when is it that like you said like 4:24 social anxiety when is it the right time 4:26 to visit a professional like when you 4:29 get professional what are the symptoms 4:30 that you decide that okay now this is 4:32 the next step that we have to seek 4:33 professional help right so you know this 4:36 is a this is an interesting and 4:38 important question because 4:40 remember when it first starts it's 4:42 happening to a child right and so the 4:45 child has really no way of knowing that 4:49 this is something that is unusual that 4:51 it's even a disorder or something that 4:54 requires professional help and parents 4:57 if they are not educated about signs and 4:59 symptoms to look out for could easily 5:02 miss it and you know it is sort of 5:04 pushed under the under the sort of uh 5:07 Banner of I have a very shy child or you 5:10 know I have this uh very quiet 5:12 introverted child all a while not 5:15 knowing what is truly going on in the 5:18 mind of the child so you know when I 5:20 think of symptoms I think of putting 5:22 them in two buckets you know the first 5:24 is sort of the psychological and 5:26 emotional symptoms which is really 5:28 what's going on in the mind of the child 5:30 and the second bucket is the physical 5:33 symptoms that is the actual symptoms 5:35 that are being experienced by the by the 5:38 patient or the child so under the 5:41 psychological symptoms you basically 5:43 have thoughts right there is the fear 5:45 the fear of being humiliated the fear 5:49 that people are you know going to laugh 5:50 at you that you're going to be bullied 5:52 or you're not going to be accepted or 5:55 you know you're being judged by people 5:57 and um you know the pure the thoughts 6:00 they sort of can increase in intensity 6:03 and then lead to avoidance behaviors so 6:06 avoidance where you refuse to be out 6:09 with friends you start to isolate you 6:12 know there's fear in simple activities 6:14 like going and talking to a bank teller 6:17 to a checkout person at the grocery 6:19 store there's difficulty making eye 6:22 contact and you know the fear and the 6:24 thoughts and the worries about how the 6:27 world or people in it are perceiving you 6:29 rarely become big and gradually what 6:33 happens is that that same criticism and 6:36 judgment starts to become internalized 6:38 we start to then judge our own self you 6:42 know we start beating up on ourselves 6:43 becoming critical and this further 6:46 erodes self-esteem 6:48 um you know our self-worth our 6:50 self-confidence and so you can see how 6:53 you know it starts to sort of build this 6:55 trajectory and so it's important to 6:58 really come in and contain it the 7:01 physical symptoms are those of you know 7:03 pretty much any anxiety disorder where 7:05 the person experiences uh you know 7:08 feelings of being sweaty or blushing or 7:12 flushing or stammering not finding the 7:15 right words uh feeling this you know 7:17 terrible feeling in the pit of their 7:19 stomach so really if you think of a 7:22 panic or a fight-or-flight response 7:25 those are the physical uh symptoms to 7:28 watch for so you know for the parents 7:30 it's important to remember that often 7:34 there will be either a change in their 7:37 child's Behavior they become more clingy 7:39 you know they refuse to go out they 7:41 throw Tantrums they're making excuses 7:43 and when they do go out they're not 7:46 having a good time or they come back and 7:48 they're in a really bad mood because 7:51 um you know if social anxiety is left 7:54 untreated 7:55 um it leads to depression and you know 7:58 and that is something that we want to 8:00 avoid at all costs so we want to be able 8:04 to catch it and get the children the 8:06 help that they need 8:08 once a person has these symptoms and 8:11 they diagnosed with their social anxiety 8:13 disorder what do you suggest they do 8:15 next 8:17 Nepali what I would strongly recommend 8:19 is that if someone thinks that they have 8:24 um the social anxiety disorder or you 8:26 know they worry that they are not doing 8:28 as well as they had been it's always a 8:31 good idea to talk to a professional and 8:34 you know that professional need not be a 8:36 therapist or a psychiatrist that is hard 8:38 to find you know in this current day and 8:40 age but your primary care physician your 8:43 pediatrician if you know you're under 18 8:45 they are great resources and First Steps 8:48 so someone that you can talk to freely 8:51 about your feelings and emotions and and 8:54 you know the circumstances that bring 8:56 these emotions up is a good first step 8:58 and at the end of the talk we've listed 9:01 some resources that are also wonderful 9:03 to get more information about these 9:06 illnesses and disorders with tips and 9:08 strategies that you can use to make your 9:11 life better even on a day-to-day basis 9:13 as you're waiting to see someone 9:16 great thank you so much you're welcome