How to Deal with Social Anxiety in a Post-Pandemic World with Dr. Dawn Potter

Podcast Transcript

Cassandra Holloway:

Hi, thanks for joining us for this episode of the Health Essentials podcast. My name is Cassandra Holloway and I'll be your host. Today we're talking about working through your social anxiety and relearning face-to-face social skills as the pandemic nears an end.

We're here with clinical psychologist Dr. Dawn Potter. Dr. Potter, thanks for taking the time to speak with us and welcome to the podcast.

Dr. Dawn Potter:

Thanks for having me.

Cassandra Holloway:

So the role of vaccines has obviously brought us hope, as well as some of the new guidelines for those who are considered fully vaccinated and with this return to normal on the horizon for so many of us you might find yourself starting to feel some sort of social anxiety after more than a year of virtual meetings and being in quarantine.

So today we'll be chatting with Dr. Potter about social interaction and life as we know it as we learn to navigate this post-COVID world. So with that being said, Dr. Potter, I want to first start off by asking if you'll tell us a little bit about your practice at Cleveland Clinic and some of the types of patients that you see.

Dr. Dawn Potter:

Well I consider myself a generalist so I'll really work with most adults with most kinds of mental health or behavioral health problems. But those problems definitely include things like social phobia, agoraphobia, which means the fear of being in crowds or sometimes just fear of being outside the home in general and obsessive compulsive disorder, which all three of the types of fears could cause people to feel extra nervous when they're returning to our new normal.

Cassandra Holloway:

Yeah, so I guess I want to hit the ground running here and first thing I want to ask you, is it normal to feel this sort of anxiety about starting to see people in person again after we've been isolated for this past year? Are these feelings normal?

Dr. Dawn Potter:

Mm-hmm (affirmative). Yes, I think it's definitely normal to feel some nervousness or anxiety, especially if you've been relatively isolated or in a small bubble during the pandemic and you're starting to socialize in larger groups again or socialize with people you haven't seen for a year or something like that.

Cassandra Holloway:

What about feeling anxiety in general about the state of the world? Obviously, so much is still unknown and things change every day, is it normal just to feel anxious about what's going to happen in the future or the future as we know it?

Dr. Dawn Potter:

This past year has been, I think, a really difficult year both because of the pandemic and also because of a lot of other types of social issues that have come up. So a lot of people may feel nervous or anxious or have felt a lot of anxiety due to concerns about safety and things like that during the pandemic.

Cassandra Holloway:

What exactly is social anxiety disorder? Can you talk a little bit about what that means and what are some of the symptoms that go along with it?

Dr. Dawn Potter:

Sure, so social anxiety disorder is broadly just like ... like it sounds, right. The experience of anxiety in a social context. However, it's more than just feeling a little bit nervous. So people with social anxiety will often worry that others will notice how nervous they're feeling. So they'll worry that they're blushing. They'll worry that they're sweating. They'll worry that they're going to trip over their words.

People with social anxiety sometimes underestimate their social skills so they feel like people are going to be laughing at them or judging them when oftentimes they're not. So there's a lot going on in the mind of a person with social anxiety, which can be distracting and make it difficult for them to actually engage effectively in a social situation. It can be limited to certain settings like public speaking or it can be broader where it applies in a lot of social situations any time you're not with familiar or close people.

Cassandra Holloway:

Is there a difference between stressing about how we'll react when we see people for the first time in a while and then stressing about the germs that have been associated with COVID and that OCD thought pattern?

Dr. Dawn Potter:

Yeah. Yeah, there's definitely a difference. So with social anxiety a person would be more likely to be worried about doing something right. So they may stress about something similar to what a person with OCD might stress about like, "Oh, am I supposed to hug them? Am I supposed to do a handshake? Am I supposed to do an elbow bump"? Or, "How close should I stand to them?"

However, the person with social anxiety will be worried about not getting the social norms correct, about making a misstep and not knowing what to do. Whereas, the person with OCD may be much more concerned about what's safe and not safe. Am I going to make the right choice?

Cassandra Holloway:

What advice do you have for people who are stressing or anxious about the change to their routine or just starting to see people again? Maybe they've been working at home for the past year and their routine has been very scheduled and now they're starting to come back into the office. What advice do you have for people to work through this anxiety?

Dr. Dawn Potter:

I mean, if your schedule's dictated by your employer you may not have this flexibility but however, if you do, try to take it slow. If you can start out going back to the office one day a week if you haven't been in to the office at all and just see how you feel. People may find it more tiring when they start to do these things that they haven't been doing because of trying to relearn all those little social things that they haven't been as active with.

Luckily, relearning stuff is much easier than learning it for the first time. So I think that people will bounce back faster than they may worry that they will. The other thing I would say is just take care of yourself beforehand. So oftentimes when I work with individuals who want to talk about the concept of coping ahead. So if it's Sunday night and you know that Monday's going to be your first day back in the office, make sure you have a healthy meal, go to sleep early, avoid alcohol, avoid things that will make you not feel great the next day. Try to take it easy the day before you have something big going on so that you start off on the right foot.

Cassandra Holloway:

What about when it's time to seek help from a mental health expert or just seeking support from those around you, what advice do you have for that?

Dr. Dawn Potter:

So some nervousness may be totally normal and again, it will probably go away pretty quickly, maybe after a couple days back in the office. However, if nervousness persists or if it interferes with concentration, if it makes you feel symptoms of panic, which means having trouble breathing, having your heart racing, feeling shaky, feeling faint, that may be time to talk to your doctor or talk to a mental health professional. Milder symptoms of anxiety may benefit from just social support, talking to somebody close to you, maybe just talking to other people about, "How did you feel the first time you got back in the office? What was that like for you? How did you deal with it?"

Cassandra Holloway:

Yeah, I love that advice, just reach out to those around you and really just going slow, working on your routine, like you said, showing yourself some compassion and I love the fact that you said it's usually a lot easier than people think and we relearn a lot more quickly the second time around.

Dr. Dawn Potter:

Mm-hmm (affirmative). Yeah. Even with social anxiety anticipating something is often worse than the actual event itself. Again, some nervousness is normal. However, you need to remind yourself that it's not going to be as bad as you think it is. The more nervous or anxious we anticipate the worst and the worst rarely is what actually happens.

Cassandra Holloway:

Right. Exactly. So with people, obviously going back in the office maybe one or two days a week and starting to take it slow, like you recommended, if they can, what should we know about that office chitchat. When we used to water cooler talk and talking about the weather in the office with someone. Many of us have missed out obviously on those little conversations over the past year. Is office chitchat good and what should we know about just the mental health aspect of having these small conversations?

Dr. Dawn Potter:

Yeah. I definitely think it's good and I think that individual differences will vary based on personality dimensions like introversion and extroversion. So extroverts may get much more energy and value from office chitchat. However, I think even people who are more introverted and are a little less outgoing probably it's one of those things where we don't really know how much we missed it until we get it back.

Cassandra Holloway:

And then what's your advice for that office or work gossip? Obviously, gossip is a quick way to bond with people but obviously it's not the best case for conversation and for a work environment. So what's your advice for gossip, first establishing those personal connections again to really work on your bond with your coworkers?

Dr. Dawn Potter:

Mm-hmm (affirmative). No, that's an interesting question. Well I guess if you're in a conversation with another person and the two of you are talking about somebody that isn't present I think you need to always be thinking about your intentions. So when we talk about somebody else when they're not there it definitely has the potential to go into gossip, especially if our goals are to make light of somebody else's problems, to be making fun of them, stuff like that.

However, if you're talking about somebody else who's not there with a sign of concern or with, "Wow, did you hear what so and so did? That was such an awesome project that they worked on." That would be great. I think always just thinking about, what is my intention when I'm talking about this person who's not here to give their own perspective.

Cassandra Holloway:

Yeah, that's a good way to think about it for sure. What about just reestablishing healthy conversation practices, not interrupting each other, obviously a lot of us have been on these virtual meetings where it's hard to tell when the next person is going to talk so there's a lot conversational interruption or just the use of tone or taking a breath before someone speaks. What tips do you have for just reestablishing those normal conversation practices that we haven't been able to do for the past year?

Dr. Dawn Potter:

I think that that's one of those things that will probably again come back pretty quickly once we get used to it. I suppose one thing that may be different is for people who've been very isolated, who maybe haven't been doing as many professional meetings is reminding yourself of the setting that you're in.

If a lot of us have been working from home we're probably dressing more casually. We're probably mostly interacting with friends and family where we're going to be using language that we wouldn't use in the workplace or just thinking about things much more maybe personal or not ... it's just a different kind of conversation. So try to get yourself back into that vibe of, "I'm in the workplace now. What would I really share with so and so that I don't know super well?"

Cassandra Holloway:

Right. It's like that advice, read the room and act from there.

Dr. Dawn Potter:

Exactly. Yeah.

Cassandra Holloway:

Okay, so what about dealing with people who might be rude and aggressive in these situations who are just feeling that angst of the pandemic. Obviously, we've all been through a lot this past year and those people who are just angry about how things turned out or just acting aggressively. It feels like people's boundaries have shifted and they will act or say things that they wouldn't have previously said. Is that normal and then how do we go about working through this aggressive behavior I guess from strangers or coworkers? Talk about that a little bit.

Dr. Dawn Potter:

Yeah. That's a really interesting question. The question of is this normal I think depends on the degree of the aggression and also whether it's normal or not, is it okay, is it healthy is a separate question. So when people feel afraid often they do ... that fear does come out as anger and the uncertainty of the last year I think has been really difficult on a lot of people and uncertainty frequently causes fear and anxiety. And so, it is normal? Yeah, probably a certain degree of anger and frustration is normal.

However, if a person is unable to control how they're expressing that and that's hurting other people's feelings just because it's normal doesn't mean it's okay. And so if you're on the receiving end of aggressive or inappropriate communication it can be tough to know what to say and usually I recommend being pretty direct but centering what you're saying on your own feelings.

So rather than being, "You're being really rude right now," because that can feel uncomfortable to the person saying that. They don't want to escalate the conflict. You can say, "Hey, I don't know if you meant that that way but that really hurt my feelings. That was pretty intense what you just said there." Centering it on yourself and how you feel rather than on them in a way that might make them feel defensive if they're already upset or frustrated.

The other thing when dealing with somebody who's very upset there's a conversational technique called disarming. So you can try to validate something from their point of view even if you don't agree with their point of view because we can't always agree with everybody on everything.

              However, we do still probably want to keep a cordial relationship, right. So if you disagree with someone's point of view but you can agree, "Yeah, that must have been really frustrating for you." You express empathy for that. So we don't be dishonest when we're trying to empathize with somebody but we try to validate something of what they're saying and that helps take the wind out of that person's sails so they don't feel as aggressive because they're not still trying to make their point because they feel heard.

Cassandra Holloway:

Yeah, like you said you disarm them and then you start that open conversation, get to the root of the problem, what really is wrong here, what can we do. So what about greeting people in this post-pandemic world, whether it's a handshake or even a hug, how do we navigate these situations if we're uncomfortable still with starting that physical touch at this point?

Dr. Dawn Potter:

Mm-hmm (affirmative). Well, I think the first thing is to really be kind to yourself and respect your own boundaries. So a lot of people are going to have different viewpoints on what's safe and not safe. I would say if you feel pressured to be close with somebody, to greet somebody in a way that you're not comfortable with, don't push yourself.

Be brave and try to get out there in general and socialize within the realm that you feel is okay. However, if somebody goes in for a hug and you're not okay with it you do the, "It's not you it's me," thing. "I know you're vaccinated and you probably don't have COVID but I'm just not ready yet. I just don't feel comfortable." And again, you own your feelings. You don't put it on them.

Cassandra Holloway:

Yeah, I love that advice for sure. What about people who are heading back into work or just a social setting, meeting friends here and there, people who are worried about this idea that they don't really have anything new or exciting to talk about? Maybe they feel that for the past year nothing has really happened to them. They've had a repetitive and boring experience. What types of things can people say or ask or I guess even prepare topics for to have at these conversations and these get together?

Dr. Dawn Potter:

I think that's something that's going to be really common that people are going to be feeling. I would say one thing is even if a person feels like they didn't do anything exciting over the last year, whichever, they probably did. They're probably discounting themselves and their own experience and also the frustration with, I think, the boredom and the sense of being cooped up that I think a lot of people have really, really felt because they haven't been able to do the same type of travel or sports or whatever they would normally like to do that would have been dangerous.

However, they probably did still do something and so, one, don't discount yourself. Number two though, if you really can't think of anything that you want to share then you can shift the conversation to, "Now that things are opening up again these are the things I'm still wanting to start doing again. I want to start playing tennis again or I want to start traveling to such and such place that I used to always go or I'm so excited to get back into this group that I used to be a part of and do these new things or my book club." Talking about the future and I think that everybody wants to feel more hope. So I think that's a great place to start.

Cassandra Holloway:

Yes, I love that advice. And also just talking about what you went through in quarantine I feel like is a big bonding aspect, whether you're venting together or talking about, "Oh my gosh, I can't wait to go to this restaurant." Like you're saying, future plans but just we all suffered through this together, obviously in varying different degrees but we did do it together. I mean, we all went through it at the same time. I think that says a lot.

What about avoiding the awkward silences? What can we do if we find ourselves in these situations, panicking that we cannot find anything to say. Do you have any advice for those awkward moments?

Dr. Dawn Potter:

Yeah, I think remembering that there's always two people in the conversation. So each person shares 50% of the burden of filling that air space and then secondly, usually if it becomes uncomfortable pointing it out defuses that tension. "Well, I guess we've talked about everything we needed to talk about." "Well, yeah, I really, really don't know what to say here." And that usually the other person is like, "Oh, thank God. Because I don't know what to say either."

Cassandra Holloway:

Yeah, absolutely. Yeah, just addressing it makes it less awkward I feel.

Dr. Dawn Potter:

For sure.

Cassandra Holloway:

Do you have any advice for interacting in person with someone for the first time who you know has differing opinions than you? How do we prepare for those uncomfortable conversations?

Dr. Dawn Potter:

That's something that I think a lot of people are probably going to be facing no matter what their opinions are and so there's two facets to that conversation, when it comes to just the theoretical nature of should we have been wearing or not wearing masks, do we believe in COVID or not? I think it's a personal choice of how much you really want to get into discussions and debates about that. And that's just one thing to remember is if you do want to get into it on that intellectual level with somebody who disagrees with you always try to be respectful, hear out the other person's side, validate their point of view even if you don't agree with it and that helps keep discussions civil.

When it comes to somebody with different opinions on the pandemic than you whose behavior is maybe making you uncomfortable then we need to think about communicating assertively and centering the conversation on ourselves and our needs versus trying to take care of that other person's feelings. When we talk about assertive communication, which is what is needed in those type of situations where somebody's pushing on our boundaries maybe because of different beliefs then we need to stay away from both passive communication on one end of the continuum and aggressive communication on the other.

So passive communication would be things like shifting uncomfortably in your seat when someone's standing too close to you or just moving away a little bit or just walking out of the room because that doesn't necessarily teach somebody that what they're doing is making you uncomfortable. People don't necessarily pick up on passive cues. On the other hand, being like, "Back off," is maybe not effective in the workplace or with a boss or a supervisor and it's not going to make you any friends in your social situations either, right, if it's with somebody who you really want to maintain the relationship.

So aggressive communication as the opposite of passive communication centers on your needs without regard for the other persons where passive communication is really trying to put that other person's needs and feelings first, you don't want to hurt their feelings. You don't want to say, "Hey, you're making me uncomfortable."

Assertive communication lands us in the middle where we respect ourselves by respecting our own boundaries and putting our own feelings out there in an appropriate way. We also respect the other person by not falling over them or making unreasonable demands. So it is not unreasonable if you are returning to work and you're feeling uncomfortable because somebody's standing too close to your desk to just say, "Hey, I'm really not ready for that. Is it okay if we just keep doing a little bit more social distancing in the office as I get used to it? I know you don't mean any harm, however, I'm uncomfortable."

Or if somebody wants to do a handshake or a hug, again, like I said before, it's okay to say, "You know what? Let's just wave or let's just do an elbow bump or again, I need time to work into it, right. It's not that you are doing something wrong. It's okay for you, however it's not okay for me."

Cassandra Holloway:

So from a psychological perspective overarching do you think that most people will be dealing with the mental health repercussions from this pandemic for the rest of their lives or for the next couple months or years? What's your professional opinion on just the mental health repercussions of everything that has happened collectively over the past year?

Dr. Dawn Potter:

It would be hard to put a timeline broadly because even though we've all been through this together some people have had ... for some people it's been much ... there's been much more loss. There's been much more trauma and for others it has honestly been easier and so some people ... I don't think anyone will forget, right? No one will forget the pandemic. However, people can recover from loss and trauma and they can also show resilience so that even if they go through something really difficult they may not show clinically significant symptoms.

              We also have a concept of post traumatic growth so many people during this time may have found new strengths that they didn't know they had or built new coping skills that they were never forced to use before that will carry them through. So people could come out of this stronger. Some people will come out of this continuing to be depressed, continuing to be anxious and if that's the case then seeking medical care, seeking mental health care is the best thing to do because treatment is out there and most people can recover from many, many things.

Cassandra Holloway:

I'm curious, do you think that people will burn out more quickly after the pandemic is over. We always hear about work burnout and working yourself to the core but since we aren't used to that busyness or the demands of what life used to be do you think people will have a shorter burnout time?

Dr. Dawn Potter:

I think it's totally possible, yeah. I think, again it's going to depend on the person and the personality because for people who do tend towards being more introverted, being more ... maybe having social anxiety or having some social anxiety type of tendencies even if they wouldn't be in that clinical zone of social anxiety, they may burn out more quickly because it would take a lot of emotional energy to reintegrate.

However, people who are more extroverted and who really thrive on social interaction and get energy from being with other people, from being in busy settings. They may find that they actually ... the opposite, they are more energized. They're more productive now that they're able to return to the office versus when they're just stuck at home working alone or working with phone or video meetings interspersed, right. So I think it could really diverge.

Cassandra Holloway:

And then do you have any warning signs or symptoms that we should look for if we are doing too much too soon? I know your advice was to take things slow but if we find that we've gone too fast, what are some of those warning signs that we should be on the lookout for?

Dr. Dawn Potter:

I think excessive fatigue, having trouble enjoying things, feeling down or depressed, having trouble with motivation outside of work could be a sign of doing too much. Having trouble concentrating, any of those anxiety symptoms that we've already talked about as well, of course.

Cassandra Holloway:

Do you have any advice for people whose jobs never slowed down, maybe they are an essential worker or they've been working nonstop since the pandemic started? What advice do you have for them about just taking care of their mental health and avoiding this idea of burnout?

Dr. Dawn Potter:

I think and I mean burnout in the medical professions and in other essential workers is a huge, huge concern right now and I would say if you have vacation days, take them. If you can take them, take them. You need time for yourself to recover. If you can't, you need to be being honest with supervisors.

              Oftentimes, burnout, job related burnout, is caused by systems problems and during the pandemic there weren't a lot of choices. Some people just couldn't take time off. There was a shortage of health professionals to take care of sick people, right, and as things get better there will ... hopefully that will get better. So again, being real with supervisors of, "No, I really need this day off. I'm really getting burned out. I'm really having trouble. I'm afraid it's going to impact my work." It's scary to say that stuff but you need to.

Cassandra Holloway:

Yeah, just being an advocate for yourself and your mental health and then the whole idea of obviously self-care comes into play. How do you recharge? How do you feel better so that you can show up every day to work as your best self?

Dr. Dawn Potter:

Mm-hmm (affirmative). Exactly.

Cassandra Holloway:

So I keep reading about how the 1920s followed the 1918 flu and how the Roaring Twenties was this era of social interaction and parties and dressing up. Do you think on the opposite end of the spectrum of what we've talked about today that the pandemic will motivate and inspire some people to get out there more and experience life more and meet new people?

Dr. Dawn Potter:

I hope so. I mean, I think that sounds like it would be pretty positive on the end of what we've all just been through. I wouldn't be surprised. It'll be interesting to see what happens.

Cassandra Holloway:

Yeah, absolutely. So my last question for you today then is what parting advice do you have for listeners about moving past the nerves and anxiety about returning to life and starting to interact face-to-face with people again? If you could give them one piece of advice or encouragement even, what would you say to our listeners?

Dr. Dawn Potter:

Mm-hmm (affirmative). I'd say be brave, put yourself out there within what your boundaries are in terms of safety. There's been a lot on the news about these new variants and we know the vaccines are great and effective, however, if you are still concerned then know what you're okay with and stick to it but be brave and remember that humans are social creatures.

Human beings have been through other pandemics. Human beings have been through a lot of different things and we are wired to connect socially and to adjust to different social settings. Big social changes are hard so the shift that we did make with this pandemic was hard and so a little bit of nervousness, a little bit of difficulty bouncing back is normal. However, your skills are probably going to return much faster than you think they are.

Cassandra Holloway:

Wonderful advice to end on. Dr. Potter, thank you so much for being here today and sharing your insight with us.

Dr. Dawn Potter:

Thank you.

Cassandra Holloway:

To learn more about mental health visit clevelandclinic.org/behavioralhealth.