Social Anxiety

It’s a shrinking world for those suffering with social anxiety disorder

By David L. Podos


Social anxiety can be a debilitating mental health condition.

It slowly shrinks the world for those who are experiencing it. Social anxiety affects both men and women, but due to cultural conditioning particularly in the United States, men seem to suffer the most because they are supposed to be strong and through denial end up suffering for longer periods.

Women, on the other hand, have a greater propensity to be more open with their feelings and to seek help. While this does not take away any anguish they are experiencing, it does help accelerate their recovery. Social anxiety that is not treated can lead to other more complicated and dehumanizing mental health issues such as agoraphobia.

According to the Anxiety and Depression Association of America, some people stop going into situations because of a fear of being overwhelmed by anxiety and not being able to escape or get help. These people have agoraphobia, and they typically avoid places where they feel immediate escape might be difficult, such as shopping malls, public transportation, and other open places like parking lots or enclosed places like theaters.

Agoraphobia is particularly common in people with panic disorder, which can feel like immense dread and lead to difficulty breathing, chest pain, and confusion.

Their world may become smaller as they are constantly on guard, waiting for the next panic attack. Some people develop a fixed route or territory, and it may become impossible for them to travel beyond their safety zones without suffering severe anxiety.

In very severe cases, social anxiety left untreated can morph into the worst case of agoraphobia. Those suffering on this level become virtually shut-ins, never leaving their place of residence or even stepping outside to retrieve the morning paper or mail.

According to, there’s no one thing that causes social anxiety disorder.

Genetics likely has something to do with it: If you have a family member with social phobia, you’re more at risk of having it too.

It could also be linked to having an overactive amygdala — the part of the brain that controls your fear response. Social anxiety disorder usually comes on at around 13 years of age. It can be linked to a history of abuse, bullying, or teasing.

Shy kids are also more likely to become socially anxious adults, as are children with overbearing or controlling parents. If you develop a health condition that draws attention to your appearance or voice, that could trigger social anxiety as well.

Expert insight

Dominick Nicotera is the director of DRN Counseling and Consulting Services in Utica, and he works with many people who suffer from social anxiety and agoraphobia.

Nicotera is a licensed mental health practitioner. He holds a master’s degree in social work from Syracuse University with a clinical psychotherapist track, and he has been in private clinical practice since 2003.

“I would say the majority of people I see in my practice — both men and women — have some sort of anxiety issues that they are dealing with,” Nicotera said. “Men are less likely to talk about issues of anxiety that they are experiencing, so oftentimes it is difficult to have a more precise percentage of actual numbers, but I do see many men in my practice seeking help for social anxiety issues.”

Nicotera further explains that men display anxiety issues differently than women.

“For men dealing with anxiety, they often display anger more readily than women. I have seen this in many domestic violence situations. In either case, regardless if you’re a man or woman, social anxiety begins when someone stops doing something social that they have done before without a problem. For example, they start to avoid crowds, or they can’t be in certain situations where they are the center of attention. It can progress from there as they continue to avoid more and more social functions and then become agoraphobic where a person can become a shut-in, so it can graduate over time.”

Nicotera commented on the genesis of social anxiety. “It’s the old adage, nature versus nurture. Many people are pre-disposed to anxiety issues so there is a DNA marker,” he said. “Social anxiety can be rewarded through a negative reward system. For instance, I go into a crowded situation, and I leave because I don’t like it and decide never to do that again. So I avoid all crowds, and I just gave myself a negative reward.”

“We are individuals that process things differently, that in return could cause someone to have social anxiety. For example, a person who was a witness of a violent act, or someone who has experienced a very bad divorce, could be triggered to develop social anxiety,” he said.

“The good news is this: I believe prognosis is very good for these people. It’s very tangible, we identity it, and we work on it. We have innovative ways to work on recovery and healing, such as cognitive behavioral therapy, guided meditation, clinical hypnotherapy, and bio-chemical brain stimulation,” he added.

The face of anxiety

(Editor’s note: The source for this story requested anonymity).

“Peter” is a former combat veteran who was deployed to the Gulf and Iraq wars and is a client of DRN Counseling and Consulting Services in Utica.

His post-traumatic stress disorder began in April 2016.

Peter explains his symptoms of PTSD: “The anxiety starts and it’s like a flashback being back in a traumatic situation.

“I don’t leave the house for the most part, and I am paranoid being in a crowd,” he said. “My wife and Dominick try to get me out of the house to be in small situations, but I am basically a shut-in.

“Thankfully with the encouragement from my wife, I am able to at least go to therapy even though I do experience anxiety in the car as we drive there. My wife does all the driving as I do not drive anymore.”

Peter advises anyone who is experiencing anxiety or PTSD to seek anxiety treatment but has a special message for males.

“Oftentimes, males who are going through a very severe emotional trial often try to be the strong one and suck it up, but this you can’t beat on your own you have to get help,” he said.