Is social anxiety holding back workers?

It was an employee recognition event that made headlines.

A U.S. employer was charged US$450,000 after throwing a surprise birthday celebration for one of its workers.

The employee – who has anxiety disorder – had asked his employer not to mark the occasion but his request was forgotten, so the upset worker ended up leaving to have lunch in his car.

Further conflicts arose and eventually the individual was fired – only to file a lawsuit alleging disability discrimination and retaliation.

A lot of people with social anxiety don't like to be celebrated, says Ellen Hendriksen, a clinical psychologist on the faculty at Boston University's Center for Anxiety and Related Disorders (CARD).

“They don't like to be the centre of attention… And it sounds like he was clear about that and said, ‘I do not love this.’ And so if you cross somebody's boundary like that, that's not OK.”

That said, people with social anxiety are often “spectacular” employees, she says, because social anxiety has a lot of “superpowers” such as high conscientiousness, being diligent and responsible, and taking their jobs seriously.

“It's exactly the kind of employee you would want. So I think that it's important not just to focus on the struggles of toxic social anxiety, but to remember that there's a lot of good that comes bundled together in that package.”

Many workers are uneasy about discussing mental health at work, according to a separate report.

An issue of severity

Social anxiety is a very normal experience, and to some extent, society relies on this condition because we don’t want people to violate social norms, says Stefan Hofmann, professor of psychology in the Department of Psychological and Brain Sciences at Boston University.

But it’s an issue of severity.

“If the anxiety is so severe that it interferes with people's lives, if it either distresses them significantly and/or interferes with daily routines, with jobs, with work activities, with socializing, then it can become a problem,” he says.

“It's very much a self-related problem, it’s a self-perception problem. We know that it's also highly related to depression, so they think very poorly of themselves as a social object, they kind of don't like themselves as a social being. In some severe cases, they don't even like looking at themselves in the mirror, they have this very distorted sense of self.”

There are other criteria, especially when it comes to social anxiety disorder or SAD, such as the condition lasting at least six months, says Hofmann.

“The core of social anxiety in the case of social anxiety disorder is the excessive fear of negative evaluation by others; that's the defining feature. So people are afraid that others will judge them negatively. And then people avoid a number of things like public speaking, going to gatherings, going to parties, introducing themselves to people, etcetera.”

SAD is one of the most commonly diagnosed mental disorders after depression and alcoholism, with a rate of 12 or 13 per cent in the population, says Hendriksen.

That said, 40 per cent of people identify as shy, “which is just the colloquial way of saying socially anxious,” she says.

“They don't necessarily meet the criteria for the disorder. But… there is a perception that something is wrong with us. And that unless we work really hard to hide or conceal that perceived inadequacy, it's going to be revealed to everyone around us, and we’ll be judged or rejected because of that.”

Of course, it’s important to emphasize that this is a perception — it’s not true, says Hendriksen.

“’Imposter syndrome’ is the perfect example. There's a sense that ‘I'm not qualified’ or ‘I'm inadequate’ or ‘I'm not competent.’ So there's a sense of perceived inadequacy, that people with social anxiety, or people who are shy even, will work very hard to try to cover up.”

Social anxiety is maintained by avoidance, by not doing the things that people are scared of, which can be fine if it means avoiding things like big house parties, she says.

“But when it starts to impact living the life we want to live — so maybe we would find it hard to go out and meet our partners, friends, or we would turn down a promotion… at that point, it starts to impact one's life and it ceases to be a preference and starts to be avoided.”

A person with social anxiety disorder is also predisposed to other serious problems, such as depression, substance use and suicidality, says Hofmann, who is also an Alexander von Humboldt professor at Philipps-Universität Marburg in Germany.

“People use substances or might have an extra drink in order to deal with the social world or they get depressed because nothing is more toxic than loneliness — we want to be around people, there's a human desire to connect with others. And people with social anxiety, they do want to connect but they can't because they're socially anxious… and that often leads to depression.”

EY is one of several companies that’s embracing a talent pool made of neurodiverse people.

Workplace implications

With many employees returning to the office after isolating during the pandemic, the issue of social anxiety may flare up, he says.

“The pressure to go back to the real world and businesses opening up and then going back to work, that is a highly challenging time for people with social anxiety. We also know that the COVID pandemic is leading to a massive surge in mental disorders generally.”

On the employment front, social anxiety can be an issue for people when it comes to interacting with others or being the centre of attention. As a result, people with the disorder might choose careers where they can be more isolated, says Hofmann.

And that can be a challenge because often the most successful employee is not necessarily the best employee.

“[That’s] the person who schmoozes the best and talks the best and knows what to say in the right situation. And it's not necessarily the skills that set them apart… for that reason, social anxiety can have a serious impact on a person's career,” he says.

The anxiety can take different forms, with many people fearing performance situations such as public speaking, while others are OK with small gatherings but not large group events, says Hofmann.

“The commonality is that it's social — there are other people around and they're always afraid of what people think of them, they feel like they’re in the spotlight.”

Classic examples are situations where there’s a lack of structure, such as parties, and people can feel overwhelmed, says Hendriksen.

“Public speaking is another big one. Having to give a presentation at work. ... meeting a friend's friend, being alone with one other person in an elevator, having to talk to somebody in authority like a boss.”

Providing support

The good news? There are psychological and medication treatments such as Paxil that can be quite effective, says Hofmann.

But more education and awareness are needed, which is true for most mental disorders, he says.

“I would say this is particularly true for anxiety disorders which is often considered not a real problem, but people are suffering greatly from it.”

Social anxiety disorder should be treated as any other mental disorder in the workplace, and destigmatizing the issue can only help, says Hofmann.

That means educating and encouraging people to speak up when they’re struggling “because it is considerably more costly for employers to deal with absenteeism, with sick days… This is massively more costly than actually treating the problem directly and adequately. This is called the cost offset, so the indirect cost of these disorders far outweighs the direct cost of treatment.”

And if an employer offers an employee assistance program (EAP) or employee benefits for counseling or medication that could help with social anxiety, employees should be made aware of this, says Hendriksen.

Read more: As many employers start to call their staff back to the office, the Ontario Association of Social Workers (OASW) is calling on Canadian companies to provide better mental health benefits.

Since social anxiety is changeable and treatable, employers and managers can also work with employees to help them thrive, she says.

“If it is something that is impacting one's job, like you are supposed to give presentations or it really would be important to go to satellite offices and meet people or train the new intern or whatnot, if we are unable to do our job because of it, I think managers can… be an employee's champion to say, ‘Hey, is there something you would like to work on this quarter? Or this year? Do you want to work on public speaking and getting better at that? I can have you introduce the guest speaker or I can have you moderate a panel. What would be comfortable for you now? And how can we work up to where you want to be?’”

Employers should also accommodate employee preferences, especially when it's something optional like an office birthday party in Kentucky, says Hendriksen.

“There are lots of ways to appreciate our employees, and it doesn't have to involve a surprise party with lots of people. It could involve… a heartfelt thank you or maybe a quiet lunch would have been more appropriate? Or communication: ‘How would you like to be celebrated?’” she says.

“What is fun for some people is not fun for everybody.”