The COVID-19 vaccination rate continues to increase. As more people are vaccinated, the push to re-open businesses and relax social restrictions is also growing. The decrease in social regulations and the increase of companies, organizations, and people returning to normal can escalate social anxiety disorders in those with a substance use disorder (SUD). 

As people and businesses re-acclimate to meeting people in-person instead of through Zoom, Google Meet-ups, or another video conferencing app, some with combined SUD and social anxiety can worry about socializing.

COVID-19 Vaccination Rates

One-third of the United States population received a COVID-19 vaccination as of late April. The rate of people will continue to increase as more Americans have access to vaccination sites. Those with vaccinations will feel safer in their interactions with others, allowing them to meet up, travel, or socialize in groups without fear of catching COVID-19. Socialization, a push to get back to offices, or other public events can raise concerns about integrating back into society. 

Substance Use Disorder and Social Anxiety Disorder

Substance use disorder is when a person’s use of a substance creates issues at work, school, with friends, or family. In some cases, their SUD can cause health problems like:

• Liver disease
• High blood pressure
• HIV/AIDS

There is an increased risk of alcohol use disorder (AUD) and cannabis use disorder (CUD) for those with social anxiety.

Social Anxiety Disorder 

At one point or another, most people will experience social anxiety and will avoid situations or events that cause distress. Some of the cases are:

• Approaching or talking to strangers
• Continuing a conversation after introductions
• Speaking in front of or in a group

When a person is in a social situation, they can rely on body language to gauge directions. Regulations regarding mask-wearing and social distancing can increase anxiety because it’s harder to see how a person responds. 

The New Normal

Isolation, stress, or anxiety can increase the risk of relapse. As information changed about the disease, regulations shifted to fit discoveries, and mental health and addiction services moved to telehealth; those with SUD or social anxiety disorder had to adapt. The restrictions also created a longer wait to access services like detox. 

Before anyone can consider what life will consist of after the lessened pandemic restrictions, they should look at their life before COVID-19. Perhaps before COVID-19, a person with social anxiety was not aware of their need for interaction. The chance to see people can decrease their urges for substances or their feelings of anxiety. 

Adapting to Post-COVID Society

In times of uncertainty, it is essential to look inward. Every individual can turn to themselves or others for help—the choice to adjust how events or situations are vital to a person’s well-being. COVID-19 created adversity, and people can form new ways to cope. 

A few healthy habits are:

• Rethink communication—the written word, verbal cues, tone of voice, body language, active listening, or making eye contact can decrease anxiety or worry.
• See opportunity in socialization—COVID-19 stunted social interactions. As a result, expectations during interactions decreased. The decreased expectations can increase the chance of becoming more comfortable in situations. 
• Seek addiction help if needed—perhaps a person recognizes an increased use of substances; entering a detox program is the first step to sobriety.
• Mix online socialization with in-person socialization—many groups or organizations remain online, slowly transitioning from one form of interaction to another can create a sense of control. 

To help patients with social anxiety disorder, therapists can address their concerns by discussing their anxiety about the gradual re-opening of businesses and social gathering spots. For instance:

• Start a conversation, whether it’s an email, text, or a telehealth appointment, about resuming sessions at the office. In this conversation, discuss a slow transition from telehealth to office sessions if the patient is unsure about continuing in-office therapy. You can begin with 25% of the sessions in the office and gradually increase the frequency.
• COVID-19 social restrictions can affect everyone’s ability to communicate or interact with another. Therapists and patients may be uncertain how to re-connect in a face-to-face situation. Therapists can re-examine how they communicate with others since the restrictions. Returning to pre-COVID-19 verbal and nonverbal skills can improve an in-person therapy session. 
• Patients who may be hesitant to return to in-person sessions may harbor some worries about their safety. Information that explains the policies and procedures regarding COVID-19 implemented in the office can reduce anxiety.
• Those with social anxiety often avoid situations that cause distress. Discuss with patients how they coped with not worrying about work or social situations. Did they miss interacting with others? Were they relieved to not be in social situations?
• What does the patient want now that social distancing restrictions are loosening? Do they want to explore connections they made with those they quarantined with or met in a support group online? 

COVID-19 restrictions changed how people communicate with each other. The decrease in face-to-face contact forced some to adapt to alternate ways of communication. Before COVID-19, those with social anxiety experienced anxiety or worry when they were in social situations. Their fear of speaking to others, being judged, or embarrassing themselves led to avoidance of people or places. 

As the country comes out of strict COVID-19 restrictions, there remains the need to continue mask-wearing and social distancing. While these precautions safeguard health, they can also decrease a person’s ability to read facial cues and body language. Instead of thinking of these blocks to communications as bad, find a positive. The restrictions can make it easier to interact with others because social expectations have adapted to life with COVID-19; these changes can carry over to life after COVID-19. The lives led before are affected by the pandemic, the life after can lead to a better, healthier life.

The increased risk of substance use disorder exists for those with a social anxiety disorder. When the country shut down because of COVID-19, people adapted how they communicated and interacted to reflect the safety and health precautions. While this shift increased opportunities for those who experience social anxiety, the isolation felt while in quarantine also increased the risk of substance use. The transition back to in-person socialization can cause feelings of worry, stress, or anxiety for those with social anxiety disorder. Coping strategies that include incorporating new ways to communicate with others can help address anxiety. The shift from viewing social interactions as a form of distress to recognizing everyone is learning how to communicate can aid in a healthy transition from isolation to socialization. Alta Centers, located in Los Angeles, is committed to providing an exceptional substance abuse program. We dedicate ourselves to treating each individual as a person, not a disease. Call (888) 202-2583 for more information.