Return to Office: Social Phobia

What is it?

Social phobia (also known as social anxiety disorder) is characterised by an intense fear of being negatively judged by others in social settings. Persons with social phobia are excessively worried about being embarrassed or humiliated. It is more than mere shyness and can leads to avoidance of the office or team activities. It tends to start at an early age and affects women more than men5. Prevalence may be as high as 4%6. They are often highly self-critical and have self-esteem issues.

While the pandemic has allowed people with social phobia to dodge stressors such as lunches and face-to-face meetings, it also deprived them of opportunities to confront their fears for the past two years. As employees return to the workplace, some are experiencing “reopening anxiety”. They worry whether others will like them or judge them in the office or social gatherings.

How does returning to office affect them?

Not only do they have to deal with working in an office, they also have to deal with crowded coffeeshops and packed trains. In the office, they find it hard to make friends and run the risk of being isolated. Many employees who joined in the last two years may not even have met their colleagues in person. 

People with social phobia find solo projects a lot easier to manage as they are not assertive enough to voice their opinions in teams. They often have more work as they do not dare to turn down their managers. They may refrain from asking others for help as they fear being seen as incompetent. Some may experience panic attacks during meetings and social gatherings. 

In some cases, they worry about eating with bosses and colleagues and getting into embarrassment situations like choking, vomiting or being asked why they are unable to finish their food. They may even tremble when they use utensils.

Long-standing social phobia is detrimental and can lead to depression, other types of anxiety disorders like panic disorder, and alcohol or hypnotics use disorder.

How can we help them?

People with social phobia can try simple techniques based on Cognitive Behaviour Therapy (CBT)7.  The aim is to de-sensitise them through gradual graded exposure to social situations. They can try dining at the coffeeshop opposite their office, and look into the office building, but not go in. If they have trouble speaking during meetings, try making just one comment in every meeting. Having a relaxing activity at the end of the day will help. Regular exercise may reducing anxiety too.

Some may do better on hybrid work arrangements so that they can work from home on some days of the week and slowly get used to working full-time in office. 

If the anxiety is very distressing, consider seeing a psychologist for CBT but they should be motivated to attend at least 6 sessions over a few months.  Selective serotonin reuptake inhibitors (SSRIs) are effective and should be titrated from a low dose8. They may worsen anxiety in the initial week. Benzodiazepine should be avoided or given short term only as it can lead to dependence. 

Managers can consider assigning a helpful colleague as a buddy in the first month.  Managers should check in regularly on employees to ask about their mental well-being.  For those who are having a hard time adjusting, HR can help by allowing some form of hybrid working arrangements.  Increasingly, companies are more aware of supporting employees mental health, and some extend medical coverage for mental health or subscribe to an Employee Assistance Program. These efforts reduce the barrier for their staff to get help.

Dr Victor Kwok
Dr Tay Kai Hong
Private Space Medical