Nearly one in five people have pretended to be sick to avoid having to attend a Christmas party – and it’s not because they dislike the people attending, or have a strong aversion to festive jumpers. They’re overwhelmed with anxiety.

Ellie Pool, 20, from Cheshire, describes a day-long Christmas party she attended in 2017 as “one of the most difficult days” of her life. “It involved being far from home, relying on public transport, saying no to alcohol, eating in a restaurant and other activities where I didn’t know what to expect,” says Pool.

Social anxiety isn’t just nervousness or shyness. It’s a long-lasting and overwhelming fear of social situations. It can also manifest in physical symptoms, like feeling sick, sweating, trembling or a pounding heartbeat.

While most people feel nervous about some social situations, people with social anxiety can feel overly worried before, during and after the event. And triggers can vary from person to person.

For Pool, who works in content marketing, events that involve food make her particularly nervous due to underlying health issues (“I have problems with my stomach and bowel,” she explains), as do events which are far from home.

“I live about a 20-minute train journey from Manchester, so a lot of social events take place there, but the added anxiety of being away from my hometown, with public transport added into the equation, makes it worse,” says Pool, who also feels anxious about her appearance, “so depending on where the social event is, I’ll begin to overthink about who will be there and what they’ll think of me.”

“Christmas means there are so many more social events,” Pool says, “so there are so many more of these anxious thoughts taking over my body and mind.”

With all of these thoughts racing through her mind, it can be hard pushing herself to leave the house. But she deliberately goes out of her way to say ‘yes’ to events, as she believes avoiding such situations will only worsen her anxiety.

Being open about how she’s feeling helps. “I definitely hide my social anxiety from most people, but if it is an event with my close friends I will tell them any anxieties I have and that will automatically calm my nerves,” she says.

There are workarounds she finds helpful. With the nightmarish Christmas party in 2017, Pool broke the day down into chunks, creating a list on her phone, like an itinerary of the day, and every time she completed something, she ticked it off her list to remind herself she was one step closer to being home.

For some, the mental illness can be debilitating, affecting every aspect of daily life. James Cavell, who is in his thirties and based in south east England, became housebound at the age of 18 because of his social anxiety disorder.

For eight years, he wouldn’t go further than his front and back garden. “I hid myself away from the world and everyone in it, because they were the source of my pain.” Cavell adds that he’s unemployed as a result of his condition.

The Christmas period has never been especially difficult, he says, as he only surrounds himself with immediate family. But there have been a few occasions more recently where he has braved events – including a mental health charity’s Christmas party in 2014 and a festive meal with his wider family in 2017.

Some of Cavell’s happiest childhood memories were spending Boxing Day with his aunts, uncles and cousins at his grandparents’ house. But when his anxiety began to worsen in his late teens, he stopped attending altogether.

By 2017, the Boxing Day get-together had become an annual family meal at a restaurant, rather than his grandparents’ place. Cavell had made some progress in his recovery thanks to support from a charity, to the point where he’d been on a successful outing during the summer. 

So he decided he would brave the festive meet-up, too.

Cavell runs through the steps he took before and during the meal to calm his anxiety. He began by only telling his mum and sister that he was planning to go so there was no expectation from others. The meal was also within walking distance of his home, which calmed his nerves – like Pool, travelling far from home is out of the question.

“I had set out to my mum and sister beforehand that I was only going to go in, see my family, and then leave before they sat down to eat. That way, even if I did start to feel anxious, I would be out and on my way home within minutes,” he recalls. This tactic worked. Cavell was able to spend some quality time with his wider family for the first time in 15 years.

On the night itself, he kept reassuring himself it would be just a couple of minutes more and then he’d be going home. He didn’t eat or drink as he didn’t want to end up feeling physically ill. “I have to admit that my anxiety did spike a few times,” he says, “but reassurance that I really wasn’t trapped, that I was still in full control of leaving, and that everything was ok eased it to a point where it was manageable.”

The evening turned out to be a huge success – he stayed for the whole meal and even featured in a family photo for the first time in more than a decade.

“It meant a lot to me to be there and I know it meant a lot to my family too, especially my grandparents,” says Cavell, who wasn’t able to go last or this year, as the venue changed to one beyond walking distance. “But I’m happy with what I achieved that Christmas.”

For Faye Newman, becoming the “queen of maybes” means she now feels less pressured to turn up to events. It’s one of many coping mechanisms she’s adopted over the years.

But it wasn’t always this way. Newman, now 24, says she was always one of the more confident kids at parties, but when she turned 18, anxiety hit her “like a tonne of bricks” and she just didn’t want to go out and socialise anymore. “It was very overwhelming,” she tells HuffPost UK. “It’s only recently that I’m getting myself through it again.”

The marketing executive, who lives in Beckenham, finds Christmas hard difficult because there are so many social plans, through work and with friends – and alcohol is not a welcome factor either. “I don’t tend to go out with work as much just because I don’t want to do anything that I would regret in the morning,” she says. “I’m the queen of maybes, where I’m like: ‘Yeah I’ll see what I’m doing and see if I can come along or show my face’ – and quite often I don’t.”

When she does attend an event, there are several coping mechanisms Newman uses to help her through. “I just need to reevaluate and tell myself I can leave if I want to leave,” she says. “I’m quite big into mindfulness, if I need to have some headspace for a moment I will just take myself outside, or go to the toilets, and retune, just to recalibrate what I’m doing.”

Other tactics include spelling people’s names backwards when she feels on the verge of a panic attack in social situations and reciting her seven- and eight-times tables in her head when she feels anxious on public transport. “I’ll just go through them for ages in my head, and then I’ve forgotten what I was even worried about,” she says.

But the most important thing of all is honesty. “I’ve had it so many times where I’ve had to say last minute that I can’t go [to an event],” admits Newman. “My friends have started to gauge that, they know what I’m like with it. I don’t care who knows about my anxiety, because, yeah, it might get in the way at times, but it’s not me being a bad person if I cut off last minute, it’s me self-caring.”

Useful websites and helplines:

• Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
• Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI – this number is FREE to call and will not appear on your phone bill.)
• The Mix is a free support service for people under 25. Call 0808 808 4994 or email: help@themix.org.uk
• Rethink Mental Illness offers practical help through its advice line which can be reached on 0300 5000 927 (open Monday to Friday 10am-4pm). More info can be found on www.rethink.org.