When someone we love is struggling, our natural instinct is to see them to check in. But, what should you do when the source of their struggle is a fear of exactly this?
Social anxiety disorder, sometimes known as "social phobia", is one of the more common forms of anxiety disorder. The 2007 National Survey of Mental Health and Wellbeing found 4.7 per cent of people (and 5.7 per cent of women) had experienced social anxiety in the previous 12 months, although it is thought that it will affect around 10 per cent of the population at some point in their lives.
The condition is a fear of negative evaluation by other people, explains Professor Caroline Hunt, head of the University of Sydney's Clinical Psychology Unit, stressing it is different to just feeling self-conscious and not wanting to be the centre of attention (i.e. shyness).
"The person feels that they may do something embarrassing or silly," she explains. "But [also] that there's a high cost to that."
Sometimes manifesting in panic attacks or other physical symptoms of anxiety, the condition can occur generally, or in certain situations.
"The obvious one is giving a presentation at work or doing something that is more of a performance type thing," says Professor Hunt. "But for other people it can be eating, drinking, or signing your name in front of somebody else."
People who experience social anxiety disorder are self-conscious of how others perceive them: they might be worried they will say the wrong thing, or appear not socially skilled, or that they don't have anything to say. The result can often be that they withdraw from social events: not attending parties, or cancelling plans last minute.
So, how should one go about reaching out to a friend or family member who seems to be withdrawing, without overwhelming them?
"The fears, to them, are very real, so what doesn't work is to say, 'Oh that's ridiculous, of course they're not doing that,'" says Professor Hunt. "Because that means you're not understanding what they are going through and seem to be trying to shut down the conversation."
Instead, she recommends acknowledging their fears as real, but also asking some questions about the likelihood of people really thinking less of them for being anxious in social situations.
"You could say something like, 'I've never noticed you shaking in social interactions, I wonder if other people do?' or 'Has anybody told you this?' or 'Do you think it matters if the person in the coffee shop sees you shaking when you're holding your cup?' It's good to remind them that maybe people are not that critical."
Clinical treatment for social anxiety includes cognitive behavioural therapy (CBT), a type of psychotherapy focused on changing negative thought patterns. Professor Hunt says an important part of helping people overcome social anxiety is exposing them to social situations, so they can learn they are not as bad as they perceive.
"Something which can be good to do is to help them to be social in a way that is not too overwhelming for them," Professor Hunt says. "So, you could say, 'Let's go to that party, we can always just leave and go and do something else.' Or, if the person doesn't want to go out with a whole group of people, you could meet with coffee the next day. It's trying to encourage them to do things socially, but making sure the things are not so anxiety-provoking."
But, ultimately, it is very likely that someone experiencing social anxiety will not be the first to RSVP to your big party, and it is important to not take that personally.
"I guess you just need to understand that, if anxiety is the motivation, that will be stronger than their ability to be a 'good' friend or family member," she says. "It probably isn't that they don't want to see you – they probably do – but it's the fear that stops them and, if people don't experience that level of anxiety themselves, it can be quite difficult to understand that."