At its worst the fear of social situations can lead to a life of debilitating isolation. Darren Devine hears from individuals who battled social anxiety, to learn how they challenged themselves to avoid becoming prisoners of their condition.

Gripped by fear, panic attacks and racing thoughts Eleanor Segall’s social anxiety can leave her feeling like she can’t face the world  — a captive of the social anxiety disorder she first battled more than a decade ago.

The 30-year-old writer, from London, uses exposure therapy — facing her fears in small, manageable doses — to help her overcome her struggles.

Her mother will take her for a drive and she also attempts to go for walks alone as part of the exposure therapy.

In an email she wrote: "My social anxiety at its worst causes panic attacks where I have racing thoughts about the fear, get sweaty and pumped with adrenaline and can’t push myself through it so have to cancel the event."

"I also get night time anxiety where I can’t sleep."

Segall, who writes about mental health for newspapers and magazines, said sometimes she still struggles with crowded events like birthday parties and weddings and doesn’t like clubbing.

Giving talks and going to job interviews can also be off-limits.

However Segall stresses her ability to cope is mood dependent and she has “learnt to live with it” and do as much as she can despite it.

At the moment she is "able to do things and go places".

But battling anxiety has been almost a lifelong struggle that started when she was 15. It saw her take six weeks off school during her GCSE year.

Four years later she started her first course of cognitive behavioural therapy (CBT).

Vicious cycles

CBT takes different forms but is based on ideas that thoughts, feelings and sensations are connected and mindsets trapping people in destructive cycles.

Segall, who is penning a book on her mental health struggles with the working title Be Your Own Light, completed three courses of CBT.

Though it gave her some tools to understand her anxiety, she felt it did not reconcile emotions prompted by subconscious influences.

Later Segall, who is also on medication for bipolar disorder, turned to talking therapy focused on exploring past traumas, meditation and exposure therapy.

Psychologist Dr Lisa Orban says CBT is the “gold standard” treatment for social phobia.

Orban says she complements CBT with mindfulness and compassion-focused work with the patients she treats for social phobia.

Defined in NICE clinical guidelines as a long-lasting and overwhelming fear of social situations, social phobia can also be treated with antidepressants.

London-based psychologist Orban said CBT would attempt to challenge unhelpful beliefs contributing to the social phobia, such as “everyone’s looking at me”, “there’s something wrong with me”, “I can’t stand feeling uncomfortable in public”.

Orban said she may tell an individual: “Could you really not stand it if you felt uncomfortable in a public situation? Granted it might feel a little uncomfortable, or even a lot."

"However, typically the body can only maintain anxiety for so long, so it would come down and it passes."

One woman, who did not wish to be identified, told how she can remember battling social anxiety from the age of six when she walked out of school.

The 44-year-old mother of two cannot identify a single trigger, but says she had a troubled home life with an alcoholic mother, who herself suffers from anxiety.

She says she had only a “formal” relationship with her father and was bullied at school.

A trained social worker, the mother has a 12-year-old son, who was recently diagnosed with autism, and a 15-year-old daughter. Both children suffer from anxiety.

She wonders now whether her social phobia is simply a symptom of a deeper, underlying condition like autism, or results from an attachment disorder relating to her childhood.

But she feels knowing the root cause would be of no benefit.

She said: “Labels have both a positive and a negative to them. Whether that label is autism, whether it’s anxiety, it’s about remembering that it doesn’t define you. It’s only a key to unlocking the skills to deal with those difficulties.”

With thanks to

Image: Writer Eleanor Segall, who uses a mix of exposure, talking therapy and meditation to tackle her social anxiety.