[Music]
thank you
hi Dr Seema Segal Welcome to our course
platform
so you've been uh practicing
psychiatrists in a community for 25
years I'm so glad you're here to be an
expert on arca's platform
uh welcome tell me a little bit about
you
Bali it is so exciting I feel privileged
to be part of you know this movement
that I see you starting I have been a
practicing psychiatrist in Fremont for
over 25 years and have had a really wide
and varied experience in Psychiatry uh
you know from my time
um working for Alameda County where I
saw the really extreme ends of the
mental health Spectrum with diseases
like schizophrenia severe bipolar
disorder all the way now to a lot of
depression and anxiety and uh you know
the aftermath of the pandemic that we
are hopefully here to speak about a
little bit today
yeah so you talked about what are the
things that have changed recently let's
talk about one issue that we have heard
a lot of people talk about social
anxiety
we've seen a rise of it in the last few
years first of all just like can you
tell us what social anxiety really is
sure
um you know how people think behave and
feel in Social situation varies right
from person to person because our
behaviors are influenced so much by our
own uh wiring our upbringing our parent
and you know apparenting Styles our own
childhood experiences so all of us have
a certain degree of anxiety when we have
faced you know in novel situations by
say the need to public speak during
interviews or meeting people for the
first time you know there are people who
are traditionally shy now social anxiety
is a specific disorder uh where people's
anxiety starts to really escalate even
through everyday interactions causing
them severe embarrassment
self-consciousness they have a fear of
being scrutinized or being humiliated uh
they fear being criticized by people
they are around and so it leads to a
real uh impact on their functioning and
you know this this piece about function
functioning is what separates what could
be just shyness or you know mild anxiety
in someone from a disorder that requires
treatment because you know people with
social anxiety uh disorders start to
have an impact on their relationships on
their work relationships their ability
to interview to speak up in projects
presentations you know it starts to
impact that peer relationships and um in
order to avoid the embarrassment and
fear and humiliation they start to
isolate so their world starts to really
shrink and sometimes they can even you
know use maladaptive mechanisms like
substance use to try and manage these
really uncomfortable symptoms
yeah no that is really informative right
I mean it can go from one end to the
other pretty quickly is that true uh you
know usually we see it starting to
develop in the sort of mid to late teens
so 13 14 year olds are where we see it
first emerge and then it gradually sort
of builds and so the the age group that
well experience it probably the most is
probably between 13 and about 23 24. so
and you know as you can imagine this is
the time of most rapid uh brain growth
and so all experiences they have you
know whether it is their outside
experiences how they are perceived by
the world what is their own world view
all begin to really have lasting
um Impressions and you know they can
take these forward into life yeah so
when is it that like you said like
social anxiety when is it the right time
to visit a professional like when you
get professional what are the symptoms
that you decide that okay now this is
the next step that we have to seek
professional help right so you know this
is a this is an interesting and
important question because
remember when it first starts it's
happening to a child right and so the
child has really no way of knowing that
this is something that is unusual that
it's even a disorder or something that
requires professional help and parents
if they are not educated about signs and
symptoms to look out for could easily
miss it and you know it is sort of
pushed under the under the sort of uh
Banner of I have a very shy child or you
know I have this uh very quiet
introverted child all a while not
knowing what is truly going on in the
mind of the child so you know when I
think of symptoms I think of putting
them in two buckets you know the first
is sort of the psychological and
emotional symptoms which is really
what's going on in the mind of the child
and the second bucket is the physical
symptoms that is the actual symptoms
that are being experienced by the by the
patient or the child so under the
psychological symptoms you basically
have thoughts right there is the fear
the fear of being humiliated the fear
that people are you know going to laugh
at you that you're going to be bullied
or you're not going to be accepted or
you know you're being judged by people
and um you know the pure the thoughts
they sort of can increase in intensity
and then lead to avoidance behaviors so
avoidance where you refuse to be out
with friends you start to isolate you
know there's fear in simple activities
like going and talking to a bank teller
to a checkout person at the grocery
store there's difficulty making eye
contact and you know the fear and the
thoughts and the worries about how the
world or people in it are perceiving you
rarely become big and gradually what
happens is that that same criticism and
judgment starts to become internalized
we start to then judge our own self you
know we start beating up on ourselves
becoming critical and this further
erodes self-esteem
um you know our self-worth our
self-confidence and so you can see how
you know it starts to sort of build this
trajectory and so it's important to
really come in and contain it the
physical symptoms are those of you know
pretty much any anxiety disorder where
the person experiences uh you know
feelings of being sweaty or blushing or
flushing or stammering not finding the
right words uh feeling this you know
terrible feeling in the pit of their
stomach so really if you think of a
panic or a fight-or-flight response
those are the physical uh symptoms to
watch for so you know for the parents
it's important to remember that often
there will be either a change in their
child's Behavior they become more clingy
you know they refuse to go out they
throw Tantrums they're making excuses
and when they do go out they're not
having a good time or they come back and
they're in a really bad mood because
um you know if social anxiety is left
untreated
um it leads to depression and you know
and that is something that we want to
avoid at all costs so we want to be able
to catch it and get the children the
help that they need
once a person has these symptoms and
they diagnosed with their social anxiety
disorder what do you suggest they do
next
Nepali what I would strongly recommend
is that if someone thinks that they have
um the social anxiety disorder or you
know they worry that they are not doing
as well as they had been it's always a
good idea to talk to a professional and
you know that professional need not be a
therapist or a psychiatrist that is hard
to find you know in this current day and
age but your primary care physician your
pediatrician if you know you're under 18
they are great resources and First Steps
so someone that you can talk to freely
about your feelings and emotions and and
you know the circumstances that bring
these emotions up is a good first step
and at the end of the talk we've listed
some resources that are also wonderful
to get more information about these
illnesses and disorders with tips and
strategies that you can use to make your
life better even on a day-to-day basis
as you're waiting to see someone
great thank you so much you're welcome
