Do people with social anxiety experience this?

Hello everyone, so I'm not diagnosed with SA but I am 99.9% sure I do have it. The main reason for this is because of something I've been experiencing since Year 8 (12 years old) and I'm 16 right now. I live in the UK BTW. I wanted to post this thread so as to get advice from you guys and see if anyone on here diagnosed with SA has experienced this.

So I basically always have this lump in my throat and I can't swallow my spit. I know it might sound a bit weird but I'll just try to explain it as best as I can. This always happens in class when I'm listening to the teacher talk, watching something on the interactive whiteboard, reading something, doing a test, when in assembly etc. etc. Whenever I want to swallow my spit, I always have to look at my watch, down at my feet or just grab or fidget with something. But sometimes I just hold it in because I'm afraid other people will notice me fidgeting so much and so I then just end up gulping. Honestly it's literal HELL when we the teacher talks for so long or when we have to watch a video or movie in class because I have to do it every 10 BLOODY SECONDS. There's no way I can control it. I just feel that everyone can notice this and that I'm nervous, someone even asked me why I look so nervous all the time. I have no idea why this always happens to me but it has really affected my life. Before Year 8 I never even thought about swallowing my spit because it wasn't even something I was aware of.

This also happens when I go out, like sometimes if I'm walking past someone or I'm at an appointment or something. I can literally never escape from it unless if I'm at home. Right now I'm not thinking about it AT ALL. I've kind of forgotten how it feels like because I haven't been at school (or gone out LOL) since March but I'm going to Sixth Form in September so it'll be a whole different school and I know this thing will be the worst it's ever been.

Can you guys PLEASE give me some advice? I kind of want to go to a doctor but I'm nervous to talk about it and I'm scared that they won't take it seriously or whatever because I'm just a teenager, and EVERYONE thinks they have an anxiety disorder these days. Before that, I'm thinking of taking probiotics because I'm GASSY lmao and I've heard they also can help with anxiety. Do you guys think I should go to a doctor and would anxiety medication help with this?

THANK YOU in advance to anyone who reads this and gives me some input.

MAN this is LONG AF I'M SORRY

Hi

Nobody on here can diagnose, including me, but I will do my best to offer some advice.

Firstly, its very common for anxiety to manifest as a lump in the throat. So yes, its a fairly common anxiety symptom. Secondly, the "having" to do something to relieve it, is a little bit on the OCD side. Thirdly, I am going to save you some time, and a lot of frustration, and hopefully help you nip this in the bud, if possible.

Your compensatory behaviour (having to look down) is actually what is exacerbating the situation. Your brain is getting caught up in a loop. Its mostly unconscious.. it goes something like this:

1. Notice throat sensation (very very common, if i think about my throat here, I will notice this)
2. Worry that people will notice you swallowing (less common, but i can totally understand why this might happen)
3. Compensatory behaviour to avoid the catastrophic reaction your mind has come up with for if people see you swallowing (think about this btw, what do you fear?)
4. The catastrophe doesn't happen!!! the compensatory safety behaviour worked! Nobody reacted.
5. Better make sure to do it again next time to prevent the bad outcome. (go back to 1).

Here is what will make the situation worse.. thinking that you need to "treat" the throat sensation.. thinking you have abnormal levels of social anxiety... thinking you might have ocd... going to the doctor and getting prescribed an SSRI, or have them not understand. Feeling ashamed in any way. Feeling you are abnormal, or broken, or anything else.

Here is what will make the situation better.. remove the safety behaviour, the need to look down to swallow. You need to not do this, and then let your unconscious learn the safety behaviour isn't actually doing anything.

Two ways to go about this.

1. literally time yourself with a stopwatch to see how long you take before you need to swallow. If its really 10 seconds, day 1, push yourself to do 12 seconds. You can absolutely last another 2 seconds, because you already do 10.
2. next day, 14 seconds
3. next day 16 seconds
4. next day 18 seconds
5. next day 20 seconds

congratulations, your problem is now half as bad..

6. next day 25 seconds (it should get easier)
7. next day 30 seconds
8. next day 35.... you get the idea

Its going to be uncomfortable, but you can do it, and take your time, do it gradually, the gradual approach is the key here, if you do too much you wont get there. Slow, slow slow.

Altternatively, it might be worth visualising the situation and trying to recreate the sensation now, when you arent in class (its worth doing this anyway tbh), and practice lasting longer. Really try to *feel* the sensations and invite the uncomfortable sensation when you aren't there. Then time it and see how it goes. This should be safe, so you should be able to do longer, but again, if you struggle, increase as per above.

What you can do is visualise the hell out of it, time it, and go for 5-10 more seconds than your daily goal in class, do this in the am, then achieve your goal in class.

The solution is to face up to the problem now, while its relatively minor, trust me. This is called exposure and response prevention, its a part of CBT, and its your best option to get the job done.

Go slowly, slowly, slowly.

If it doesn't work for you, type in IAPT provider and your area in the UK, and find somewhere that can offer CBT therapy, it should be quick (ish), but you might as well have a bash at this on your own.

Above all. More important than anything, be very very kind to yourself. It's extremely easy to get caught in these kinds of loops. Don't label yourself as socially anxious (please, it will only make things worse), just treat it as an artefact of having a human brain (it is). Our brains pull all kinds of unexpected things on us, its okay, its a loop.

If you struggle with the speed, slow it down. All you need to do here is very very slowly push back in the other direction, do this, and you will prevent the safety behaviour, your mind will catch up, and it will become manageable.

Be kind to yourself, and good luck. You can do it.

As a further example of the how the safety behaviour needs to be stopped...

If someone randomly punched me in the face, and it hurt, I might start to (understandably) be scared of being punched in the face.

1. I am nervous I will be punched in the face
2. I make a silent prayer to mooman, the god of cows
3. I walk past someone and they don't punch me in the face
4. My unconscious learns that making prayers to mooman prevents being punched in the face.
5. I have to make a silent prayer to mooman every time i walk past someone

It's a more silly example, but hopefully you can see that here, the treatmet is to remove the safety behaviour, remove the prayer, and tolerate the discomfort, and eventually the unconscious will catch up.

This isn't medical advice or anything, and I am not a trained professional, but I have some understanding of certain therapies.. this would be how i would deal with it on myself.

I know you replied to this a long time ago and I am thankful for you trying to help out but honestly it's not as easy as it seems.

First of all, I don't notice the throat sensation, it's just there. Haven't you ever felt a lump in your throat when you're really nervous? I have it all the time and I think it's a product of me being very nervous and hyperaware when in social situations. It's also not necessarily the fact that I'm worried people will notice me swallowing my spit but it's of them noticing me acting all nervous BECAUSE of this feeling.

What I want is to not only remove the safety behaviour but for this feeling to just disappear because I know normal people don't deal with this. I thought coming here and asking about it would help as maybe I could find some people who have also experienced this, but now I just feel more alone. I really do feel taking medication will help with this symptom since it might make me more relaxed and less on edge all the time and help with my other physical symptoms. Honestly, It's not something 'minor', it has really affected my life and you'll only be able to understand if you've experienced it yourself.

You may think I'm not socially anxious because the lump in the throat is the only thing I mentioned but I get incredibly nervous in social situations. I've always been a shy and anxious person but I know in these past few years it has manifested into a disorder. I only ever leave my house to attend school and appointments because just walking out in public makes me very nervous. This lockdown life is no different than my normal life. I always have this tight feeling in my chest before I go to school and my legs shake when I'm walking to school. I had issues with my attendance in secondary because I always avoided going to school because of certain classes and the school had to have meetings with my parents. My legs felt like jelly whenever I had to walk to the classes I had no friends in and that were filled with popular people. I used to bunk lessons in the bathroom because I was so scared. Even walking through the school hallways makes me incredibly anxious.

I keep meaning to call my doctor but I'm too nervous and I don't think I'll get the help I need since I'm presuming many people are calling right now because their mental health has deteriorated in lockdown.

Honestly I'm lost.

I wonder, have you thought about speaking to your Doctor about this? Talking to a trusted mature person face-to-face can have a huge beneficial impact on us... Please give it some serious thought as you do seem to be struggling with this, and your Doctor is the best person to approach etc. Hope this helps

@whelve my apologies, I didn't mean the post to come across as minimising your experience, or making you feel like it was something simple to fix. Nor did I intend to suggest you don't have social anxiety.

I meant to say that in cases of anxiety, whilst you might want the uncomfortable sensation to go away (this is only natural), its the pursuit of making it go away, or the avoidance of it, that actually worsens the problem.

Regarding identifying as socially anxious, identifying is the key term, because when you adopt an identity you adopt the norms of that identity, in the case of social anxiety the norms are avoidance and not doing social situations. That is the danger, because it means you gradually withdraw from everything, which helps in the short term, but makes the problem worse in the long term.

@whelve

I have OCD and I thought exactly the same thing @SplendidBob thought when I read your post.

There's a type of OCD called sensorimotor obsessions which sounds a lot like what you're describing. I suffer from sensorimotor obsessions myself (I've been suffering from hyperawareness of my heartbeat for weeks now, and it's driving me absolutely insane). Ofc, I'm not a professional and I can't offer a diagnosis.

As to the social anxiety, I don't doubt that you experience it. But lots of people with anxiety have both, so having one doesn't preclude the other. It's not a typical feature of Social Anxiety Disorder, however, which is one reason you're not getting a lot of replies.

It's always better to deal with these kinds of things sooner than later, so I recommend making an appointment with a professional. You might want to see if you can find one that deals with anxiety specifically. They're not likely to dismiss your symptoms out of hand and will be in a better position to offer a diagnosis than a GP.

One thing you shouldn't do is feel like you're alone - I can identify with this very closely. Sorry, I didn't see your original post before.

I don't have it there all the time - but as you mentioned it doesn't sound like it's always there for you either, you mentioned that you hadn't felt it for ages because you're at home now? As you said - it's the fear that someone else will see that we're nervous.

Mine would happen more if I knew I had to give a talk in class or read aloud. My throat would literally feel like it was locking up. The crazy thing is later in life I often had to take classes and do talks at my work. It was terrible.

I did an entire course on Serepax (Serax in the US) - a benzodiazepine. This is not a great idea and it won't completely take it away, but trying to find a decent therapist - one that actually knows how to treat anxiety disorders might help. (as @truant mentioned)

Yes I have, but I keep putting it off. I'm just scared they won't understand. Also right now my gp is doing telephone appointments so i feel like it's harder to explain how I feel because they can't see my face. Every time I'm at school and feeling really nervous, I tell myself 'I need to make an appointment' but then I end up not doing it. But I will try and speak to a doctor soon. Thanks

No worries. And yes I do understand what you're saying, and your advice probably does help in a lot of situations, but I just don't think it will in this particular circumstance. For the last paragraph, that does make sense. Again thanks for taking the time to write your previous advice. Sorry if I seemed ungrateful.

Not at all .

I've never heard of sensorimotor obsessions, it's actually really interesting. Honestly I feel a sense of relief that there is actually something that can explain this constant lump in throat feeling. Thank you for mentioning it. As for speaking with a professional, I think the only way I can do that is by talking to my GP first and then them referring me to a specialist. However I feel like it'll take several months for me to actually be able to speak to one since of waiting lists. I am planning on talking to my GP soon if I have the balls to. Thanks again.

Finally someone else here can relate. I did start school in September again and I constantly had the lump in throat feeling - no surprise there! It was honestly so awful to experience it to that extent again after months of not having it. But right now schools are closed because of lockdown (UK) so I'm quite relieved. But the lump in my throat is there the whole time when I'm at school except If I'm just sitting down doing my work and the class is kind of loud. It's incredibly bad when I'm listening to the teacher talk and I just can't help it. Most of my lessons the teacher is just talking so I have the lump in my throat the whole lesson. I feel like everyone's watching me and can notice I'm acting weird and it just sucks so bad. I barely can find anyone else who experiences this, and to the extent I have it and it just makes me feel like I'll have to live with it for the rest of my life. If I didn't have this symptom, then I probably wouldn't have really thought about getting help and just lived with being socially anxious. Despite the other symptoms I deal with, it's not half as bad as the lump in my throat. It's honestly had a huge impact on my life. There have been times where I have come home and cried because I though everyone noticed me acting nervous. I do really want meds that can help improve this symptom, can Serepax actually help with it?

If it helps I would be the same. Talking to a Doctor probably seems daunting, and then having to speak over the phone aswell, not the best... Could talking to a teacher help? They will have your best interest at heart, and if this is affecting your studies it's very relelvant. Please give this some thought, you really have nothing to fear, just speak to them in private so that everything you say is totally confidential and not over heard etc. Hope this helps

Hi, and sorry for not noticing you lived in the Uk before.

The problem here is that once you start taking a benzo (they are hard to get nowadays because of their addictive qualities etc) - you'll want to take them all the time. Believe me - I know and understand why anyone would want to. I've done that as well - and then spent multiple times trying to get off them in rehab centres and hospital. (I know that sounds melodramatic - but unfortunately it's true - benzos can really get you hooked if you're not very careful with them.)

Another problem is the very first time you go to see a GP they will most likely want to put you on an antidepressant. (probably an SSRI or an SNRI) These are pretty much the first line treatment nowadays for anxiety as they do often have some effect on anxiety as well. Unfortunately they don't always work, and trying to find one that does can be a bit of a procedure.

I wish I could tell you exactly what to do. If you were my son I'd try to find a therapist first before I went down the medication route. The problem here is social anxiety - you're afraid someone in the class will see your anxious and so every time your in that same situation the same thing happens. We need to try and decrease the anxiety - in general and especially in those situations. Maybe a decent therapist can help with that.

I did actually try many years ago to find some help - but I'm a lot older than you are (I'm now 62) - so trying to find a therapist back then was difficult. I ended up just sort of muddling through - taking medication when I could and just forcing myself to handle it other times. (which is horrible I know)

I really hope you can get some help with this mate - whatever you do don't give up. There are others that know exactly what you're going through.

Right now I don't have school because of lockdown but I don't want to talk to a teacher about it since it won't help anything and I really think I need professional help. In secondary my teachers did know I had anxiety issues and did put some arrangements in for me but they didn't know about the lump in my throat thing. Honestly mentioning it to them won't help anything and they'll probably just tell me to talk to my doctor. I was offered counselling but I refused since I was uncomfortable with it. But if I do get diagnosed with social anxiety maybe I will mention it to my teachers.

Yeah it does seem like anxiety meds would be addictive and knowing me I'd be so scared to go off them because I'd be anxious of all my symptoms coming back. However I do really think I need them to cope with my physical symptoms, I really don't think therapy can get rid of this lump in my throat but for other symptoms like overthinking and avoiding situations I do think it can help. The problem is actually the lump in my throat which then causes me to become even more anxious because I'm scared people will notice I'm acting weird. But I'm pretty sure I get the lump in my throat in the first place because I'm so anxious which is something I can't help. I don't want to be prescribed meds off the bat after talking to a GP since I really want to talk to a professional about this so that they can go through everything with me and accurately diagnose me and then discuss appropriate treatment. I don't really think the GP will give me meds straight away though since I'm only 16. And BTW just wanna tell you that I'm a girl since it seems like you think I'm a boy lol. Are you still dealing with social anxiety right now? Honestly I feel really bad if you're at that age and still have to deal with this horrible disorder. But thanks a lot for your advice and I also really hope I can get some help.

I used to have things like that as a teen, when they were bad I used to nip myself pretty hard so it was painful enough to distract myself from irrational thoughts briefly, not ideal.

Could you maybe ask for a glass of water, or maybe have a bottle of water nearby to sip it might help.

You could also try something simple like taking a multivitimin as many people are deficient in something to see if it helps as low magnesium for example can exasperate underlying conditions like anxiety, depression, vitamin C also helps lower cortisol levels, a stress hormone etc.