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Anxiety disorders are incredibly common. In fact, according to diagnostic interview data from the National Comorbidity Study Replication, almost 20 percent of American adults are affected by a form of anxiety on an annual basis.
Many forms of anxiety are particularly common in adolescent and young adult women, who are significantly more likely to develop symptoms of anxiety than men.
Whether you have generalized anxiety disorder (GAD), panic disorder or social anxiety disorder, it’s easy for the symptoms of anxiety to get in the way of your ability to maintain friendships.Â
Anxiety can make meeting new people difficult. It can make connecting with your closest friends a stressful experience, even when you know there’s no logical reason for things to be this way.
The good news is that with appropriate treatment, it’s usually possible to gain more control over your mental health and prevent high anxiety levels from affecting your social relationships.
Below, we’ve explained how anxiety can affect your friendship quality and ability to develop new relationships.Â
We’ve also talked about what you can do, as an anxious individual, to control your levels of anxiety in social settings and make spending time with friends an easier, less stressful experience.Â
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Anxiety can affect your friendships in several ways, from making it harder to connect with people and develop new relationships to making you worry that your positive friendships aren’t as close as they seem.Â
Below, we’ve shared seven ways that severe or persistent feelings of anxiety can get in the way of developing and maintaining friendships.
One of the most common anxiety disorders is social anxiety disorder, which is also sometimes referred to as social phobia. This form of anxiety involves a persistent fear of social situations, such as performing in front of others or meeting new, unfamiliar people. An estimated eight percent of women in the United States are affected by this condition on an annual basis.
If you have social anxiety disorder, you might worry that you’ll embarrass yourself when you’re around other people, even if you don’t have any rational reason to feel concerned.
If you have this form of anxiety, you might feel your heart race when you meet new people, or worry that someone will judge you negatively if you start a conversation with them.
This fear of judgment or embarrassment can make meeting new people difficult, even if you think someone could be a good social “match” for you.
Social anxiety symptoms and severity can vary from person to person. For some people, it’s a mild fear that’s controllable with the right techniques, while for others, it’s a severe problem that could lead to panic attacks.
Not only can anxiety make meeting new people difficult, but it can also make opening up during conversations a serious challenge.
Even if you’ve met someone and already gotten over the hump of developing a friendship, the idea of keeping up a conversation — or worse yet, starting one on your own — could feel like a virtually impossible challenge.Â
You may notice that you speak in a soft voice, avoid making eye contact or do other things to avoid standing out too much, even around people who are already your friends.
In some cases, you might even tremble or sweat when your friends ask you about something they might think is completely innocent.
These physical anxiety symptoms may make your feelings of anxiety worse, especially if they’re visible to others.Â
Overall, the persistent fear and worry that comes with social anxiety can make even the shortest and simplest conversations — at least by your friends’ standards — feel like a series of hoops you need to jump through to avoid the perception of being judged negatively.Â
When you feel anxious, whether it’s around other people or simply in general, you might rely on your friends to set up social engagements instead of taking the initiative to do it yourself.
This could happen as a result of feeling fatigued or finding it difficult to focus, which are common symptoms of generalized anxiety disorder. Alternatively, you might worry about feeling rejected if your friends don’t respond to your invitation or just aren’t available when you are.
Social anxiety often involves a persistent fear that people judge you negatively. When a friend or new acquaintance doesn’t contact you for a few days, or takes longer than expected to get back to you, it’s easy to feel anxious about the state of your friendship.
In a study published in the Journal of Abnormal Psychology, researchers found that people with social anxiety disorder typically gave lower scores for perceived “friendship quality” than friends who were also asked to rate the quality of their friendships.Â
Put simply, the study participants with social anxiety perceived their friendships more negatively, even though their friends typically rated them as having strong friendships.
If you have a form of anxiety that causes you to worry excessively in certain situations, such as a crowded environment, you might find yourself instinctively avoiding certain social events and gatherings.
For example, many people have phobias of being part of a large crowd, spending time in open spaces or being away from home by themselves.
These phobias can get in the way of taking part in events and may cause you to withdraw from friendships and other relationships.Â
Fear of missing out, or FOMO, is a feeling of apprehension that other people are taking part in fun, fulfilling activities that you’re missing out on.
The rise of FOMO closely follows the development of social media. In fact, the term itself came into use in 2004 — one year after MySpace launched and the same year that Facebook became available to college students.
FOMO can potentially make many anxiety symptoms worse, including feelings of loneliness and social inferiority. You may notice this problem more if you’re prone to anxiety but spend a lot of your time on Facebook, Instagram and other social media platforms.Â
Anxiety can vary hugely in severity. For some people, it’s an occasional issue that might make it harder to meet new people or speak in public. For others, it’s severe and intense, causing panic attacks and a feeling of impending doom.
If you have a severe anxiety disorder, you might feel the need to avoid social situations entirely when your symptoms become a significant problem for you.Â
This could cause you to miss out on opportunities to spend time with friends, which may weaken your social connections over the long term.Â
Everyone experiences at least some degree of friendship or relationship anxiety at certain times in life, whether it’s before talking to someone you’re romantically interested in or organizing a big event with your friends and family.
Occasional feelings of worry are normal. However, if your anxiety is starting to get in the way of your ability to connect with friends, meet people or simply maintain your existing friendships, it’s important to take action.Â
The good news is that most anxiety disorders, including social anxiety, can be treated with a mix of medication, therapy and simple changes to your habits and lifestyle.Â
If you think you have a clinical anxiety disorder, such as generalized anxiety disorder or social anxiety disorder, one of the most important things you can do is to have a conversation with a mental health provider.Â
A psychiatrist — a type of medical practitioner that specializes in mental illnesses — can assess your symptoms and, if appropriate, suggest medication and/or therapy.
Many people with anxiety disorders benefit from antidepressants and forms of therapy such as cognitive-behavioral therapy, or CBT for anxiety.
This type of therapy involves learning different methods of thinking to help you get more control over your thoughts and emotions in situations that cause you to feel anxious.Â
Both medication and therapy take time to work, but for many people, they produce real benefits for reducing the symptoms of anxiety. In turn, this makes maintaining friendships, romantic relationships and family bonds much easier.Â
We offer online psychiatry and individual therapy as part of our range of mental health services, where you can connect with a provider and access personalized care from the privacy and comfort of your home.Â
In addition to using medication and taking part in psychotherapy, making changes to your habits can often make the symptoms of anxiety easier to deal with.Â
These can include stress management techniques to deal with tense situations, physical activity, mindfulness meditation and a support group with other anxiety sufferers.
Our guide to controlling anxiety shares simple but effective techniques that you can use to gain more control over your feelings and limit the effects of anxiety on your social life.Â
Sometimes, the easiest way to deal with anxiety around your friends is to simply let them know how you’re feeling.Â
If you’re worried about how you’re perceived by others, consider letting your friends know that you have an anxiety disorder and might occasionally struggle with things like shaking or maintaining eye contact during conversations.Â
There’s no need to go into detail unless you want to. Instead, simply letting your friends know why you’re sometimes worried or uncomfortable can often make a real positive difference.Â
Instead of judging you negatively for suffering from anxiety, you might find that your friends are understanding and eager to assist you.Â
Have you ever spent time around your friends and worried that one, several or all of them were secretly judging you? You probably weren’t the only one — in fact, several of your friends might have all had similar worries that people were secretly judging them.
It’s far from uncommon to feel anxious in certain social situations, especially when you’re doing things like seeing an old friend for the first time in years, going on a date or meeting someone new.
Remember that anxiety disorders are common. Some of your friends may also suffer from their own forms of anxiety or related mental health issues, giving you something similar to bond over rather than a problem to worry about.Â
When you feel anxious around others, it’s easy to look at a natural social butterfly and wish you could be like that person.
Remember that everyone is different, and there’s no need for you to be equally as “successful” at making friends as other people. There’s no perfect level of sociability, and feeling anxious is not a sign that you’re “worse” at being a friend than anyone else.
In other words, don’t try to become another person. Instead, accept that you are you, and that anxiety is a part of your life that you can manage and, in many cases, overcome with the right approach.Â
Anxiety and depression are frequently comorbid, meaning they often develop at the same time. In fact, research suggests that between 20 and 70 percent of people with social anxiety disorder also develop depression at some point in life.
Like with anxiety, many of the symptoms of depression can affect your social life and make it more difficult to maintain friendships.
Common depressive symptoms include persistent feelings of sadness, a pessimistic outlook, loss of interest in your hobbies, difficulty sleeping, decreased energy and a belief that you’re guilty, worthless or unable to be helped.Â
Some of these depressive symptoms might make it harder to keep in touch with friends or make anxiety reactions more severe when they occur.Â
Pervasive anxiety disorders, such as generalized anxiety disorder and social anxiety disorder, can have a serious impact on almost every aspect of your life, including your ability to connect with people and maintain friendships.
Many of these anxious symptoms are treatable with changes to your daily lifestyle and options such as medication and therapy.
We offer a range of mental health services online, allowing you to gain more control over your feelings of anxiety, maintain stronger interpersonal relationships and enjoy a higher quality of life.
You can also find out more about common anxiety symptoms, causes and successfully dealing with anxiety in our detailed overview of anxiety disorders.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.