Now that mask mandates have been lifted in the United States, people are dining out and starting to gather again in larger groups with lots of concert announcements for this summer and fall. So it would seem like a sense of normalcy is on the horizon. But for some, after a long pandemic, that transition back to "normal" may be more difficult in the psychological sense, which feels really understandable.

So today we're going to talk about social anxiety, and I have an expert on the line, an associate professor of clinical psychology at the University of Minnesota: Dr. Shmuel Lissek.

Block Quote

Every Wednesday morning at 8:30 CST, Jill Riley connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health. Subscribe to Wellness Wednesday as a podcast on Spotify, Apple, RSS, Radio Public, Stitcher, or Amazon Music.

Jill Riley: What are some of the problems you're observing in terms of social anxiety with people "returning to normal" after a long pandemic?

Shmuel Lissek: I think the kinds of anxiety related to increasing experiences of being in close proximity with others really come from two sources. One is less classically associated with social anxiety, though related, which is physical threat of transmission. And the second is fear of negative evaluation from others. So let's start with the physical threat of transmission. Many of us have learned to fear social closeness because it increases risk. And it will actually take some time for many, many of us to unlearn this.

This fear of physical threat is also related to social anxiety, which is more about the fear of social scrutiny. A person might be concerned that their worries about safety while in close proximity with another will compromise their ability to be the best version of themselves. That is, they may find it hard to relax during live social interactions, leading to concerns that you're not coming across well to the person you're interacting with, fear of negative evaluation from others. Basically, one of the sources is concerns that others will be critical of vaccine and social distancing decisions a person makes. And you know, the fact that there's such a wide variation across Minnesota in how people are approaching COVID-related precautions sort of sets us up for being concerned that others may disapprove of the particular approach we take. People are currently feeling a bit unsure of how to proceed, and they may be more likely to blame themselves for making a bad decision, when others show disapproval.

I can understand that. It's like okay, well, I'm wearing a mask just because I want to be more safe in this situation. But does that mean people are going to think that I'm not vaccinated? Or are they going to think I'm being overly cautious? I get that point of the negative evaluation causing anxiety? Like, am I being weird? Am I talking too much? I don't remember how to talk to strangers. It's being amplified as we head toward this post-pandemic world. I wonder, does a person need to have a diagnosed social disorder to struggle with social anxiety? What you're talking about is pretty relatable.

Yeah. I think most people experience some level of social anxiety, but when it passes the threshold of clinical significance — which is operationalized as either causing dysfunction in your life, avoiding going out on dates, which leads you to feel isolated and unfulfilled in terms of your intimacy needs, or if the social anxiety causes personal distress, to the point that it substantially reduces your quality of life. So those two things are what turns social anxiety into something worthy of treatment, into something worthy of diagnosis. Essentially, if it's interrupting your ability to function in important areas of your life, work or personal, or if it's causing you undue distress.

Is it possible to experience certain aspects of PTSD because of the pandemic?

Yeah, absolutely. Particularly if COVID has brought threat of death or serious injury, or if you've witnessed others dying or experiencing harmful consequences, then yes. It wouldn't necessarily be in the realm of PTSD if it's just sort of the stress related to COVID. It has to be more actual or threatened death, and you've had the PTSD related symptoms as a consequence, which would include things like hyper arousal, so constantly feeling on edge. Re-experiencing, which is having the traumatic experience of being constantly cued by the melee in your environment that reminds you of the trauma. Undue avoidance of things that remind you of the trauma, changes in cognition, like believing that the world at large is dangerous. You have all these kinds of symptoms, which again, like social anxiety disorder, needs to cross that clinically significant boundary. So those symptoms resulting from COVID-related trauma need to either cause dysfunction or personal distress.

What are some strategies we can use to navigate the social situations that we haven't had to deal with in many months? Can you leave us with some suggestions or, again, some strategies?

Yeah. First and foremost, people should be kind and patient with themselves and others. As we resume live social interactions, we should understand that we are doing the best we can with limited information, and others are as well. We need to have sort of a generosity of spirit toward ourselves and others as we reintegrate. Another thing is to remember that the social skills you've acquired over a lifetime haven't gone anywhere — and they may not be as rusty as you think. Many of us have continued to exercise them through online interactions with others during the pandemic. It's impossible to adopt COVID-related safety measures that will please everyone. We should move forward by following rules that make sense to us, given recommendations from trustworthy outlets.

Well, that's some good advice. Again, if you are struggling or you know, someone that is struggling, there is no shame in reaching out for help, because something like social anxiety or the symptoms you're feeling: they can be helped.

Oh, absolutely. You know, if a person believes that their quality of life has been substantially decreased due to social anxiety, that's what psychology and psychiatry are there for: there to relieve human suffering resulting from emotional and cognitive problems. So yes, you should avail yourself of those treatments, which are quite effective.

Wellness Wednesday is hosted by Jill Riley, and produced by Anna Weggel and Jay Gabler. Our theme music is a portion of the song "F.B. One Number 2" by Christian Bjoerklund under the Non Commercial Share Alike 3.0 International License.