“Q: My Fear of Rejection Keeps Me Socially Isolated”

Social anxiety and rejection sensitive dysphoria cause people with ADHD to feel isolated, self-conscious, and stressed. Here are expert tips on how to improve social skills and alleviate your social anxiety.

Woman in bubble representing social isolation caused by social anxiety

Q: “I want to socialize more with my co-workers and neighbors, but my fear of rejection — thanks to my ADHD — keeps me from reaching out. I’m afraid I’ll say or do the wrong thing. How can I overcome this?”

Social anxiety is a debilitating fear of judgment, humiliation, or rejection by others in social situations. Socially anxious adults carry distorted, negative self-perceptions driven by a core belief of deficiency. This restricts their participation in activities, relationships, and other areas of life.

We know that anxiety and ADHD frequently co-occur. Experiences common to ADHD, like rejection sensitive dysphoria, shame, and emotional dysregulation, may exacerbate social anxiety. ADHD symptoms, like hyperactivity and inattention, may also undermine social skills and cause difficulties. Social anxiety treatment often involves behavioral interventions and working to improve social skills.

Signs of Social Anxiety

Intense fear of negative judgment from others is a common marker of social anxiety disorder. Other signs include:

  • Discomfort interacting with people outside the immediate family
  • Difficulty making or keeping friends
  • Excessive worry in the days or weeks leading up to an event
  • Fear of being observed (e.g., when eating and drinking)
  • Fear of performing in front of others
  • Avoiding places or events that involve socializing
  • Nausea, shaking, or excessive perspiration in social environments

Fear, anxiety, or avoidance of social situations must cause clinically significant impairment and persist for at least six months to merit a diagnosis.

[Self-Test: Does My Child Have Generalized Anxiety Disorder?]

Social Anxiety Treatment: Behavioral Interventions

Cognitive behavioral interventions effectively target the distorted thoughts that fuel social anxiety. Medication for anxiety may help, but as with ADHD, pills don’t teach skills. To cope with social anxiety, find ways to reduce your worries.

  1. Shift your thinking. Identify limiting core beliefs and notice negative self-talk. What social situations trigger those thoughts and worries?
  2. Recall positive social experiences. Anxiety erases memories of courage and success. Think back to times when you rose to a challenge despite your fears. What steps did you take?
  3. Stay in the moment. Show curiosity about others and practice reflective listening, such as nodding. Notice your surroundings. Take deep breaths to quell physical symptoms.
  4. Build up tolerance. Gradually expose yourself to low-risk, uncomfortable social situations. Join a hiking group, for example, and smile at a few new faces. On the second hike, talk to a few people. You might feel awkward and nervous, but you’ll see that you’ve survived.
  5. Foster connection. Pay attention to body language that signals interest (like a relaxed posture) versus discomfort (looking away). Ask open-ended questions to encourage conversation and let others know that you’re listening.

[Download: Social Anxiety Facts and Falsehoods]

Improve Social Skills with an APPLE

To navigate social situations:

  • Ask to join in a conversation.
  • Physical proximity and volume. Are you too close? Too loud?
  • Participate with curiosity. Use reflective statements and ask open-ended questions.
  • Listen and lay off the self-criticism.
  • Enjoy connection. Share what’s special and fun about you.

Social Anxiety in Children: Next Steps

Sharon Saline, Psy.D., a licensed clinical psychologist, is an expert in how ADHD, learning disabilities, and mental health issues affect children, teens, and families. She is the author of What Your ADHD Child Wishes You Knew.

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