Why can't I communicate with people anymore and what can I do about it?

Dear Captain Confused, 

Life can become challenging when we find ourselves struggling with the things we once felt comfortable doing. Reaching out, as you have, is a great first step in addressing what’s going on. You mention feeling flustered, turning red in the face, and struggling with making eye contact when speaking to others. It may ease some of your concerns to know that having those types of reactions can be normal when someone is shy.  However, since you mention that this problem is having a significant impact on your social life and has lasted for over a year, you may want to see a health care provider about the possibility that you aren’t simply just shy, but there's something else going on.  The good news is that there are resources available to help you address how you're feeling and ways to manage the symptoms (more on this later). 

You mention that this isn't always how you've felt. It might be helpful to see if you can pin this change in your social comfort level on a specific incident. Do you feel this way when you have a certain observation or realization, or maybe you had a humiliating experience? Has anything happened to you in the past year that made you feel very embarrassed in a social circumstance? Have you perhaps gained some new awareness of a characteristic of yours that’s making you socially self-conscious? Have you been openly rejected by someone recently? Have you noticed an increase in your anxieties post-COVID-19? Any of these types of occurrences might set off a physical reaction to the social discomfort you’re currently experiencing. Outside of a specific incident, you may consider reflecting on some more general trends you're noticing: 

• How do you feel before you go out to meet friends? Do you ever avoid social situations because of your worries? 
• Does anyone else in your family feel nervous speaking at social functions? With new people? In a work setting? 
• Try to describe what it is about being in social situations scares you. In the past year, have you always had this immediate reaction to social situations or only specific occasions? 

Answering these questions could help you and your health care provider determine what’s going on. Something you might talk to your provider about is social anxiety disorder, which is characterized by extreme and excessive worry and fear of social situations that affects your personal, academic, and professional life. Social anxiety disorder can impair your ability to perform day-to-day activities. Since the COVID-19 pandemic around 76 million cases of anxiety related disorders have been diagnosed, which is a 26 percent increase from pre-pandemic diagnoses placing it as the third most common mental health condition. 

Like many other mental health conditions, social anxiety can arise from a complex interaction of biological and environmental factors. Getting a physical exam from a health care provider might help determine whether an underlying health condition may be contributing to your feelings of anxiety. Conditions that may increase anxiety can include heart disease, diabetes, thyroid problems, or asthma. Another route you may seek is speaking with a mental health professional. They may suggest cognitive-behavioral therapy (CBT). This is a type of talk therapy that focuses on addressing fears and altering reactions to anxiety-causing circumstances. Psychopharmacological medications are also effective at reducing anxiety and are typically combined with talk therapy. There are a number of avenues you can consider, but it's all about finding the best fit for you. 

With the support of professionals, you'll be taking another step toward mastering your discomfort. Best of luck!