Coping with anxiety is something that most people have probably dealt with at some point in their lives. Being nervous and twitchy about something is a natural reaction, particularly in a world of lawsuits, divorce papers, terrorist threats, and Orwellian paranoia. To top those off, there are also concerns about one's social status and place in the social hierarchy, which can sometimes compound social anxiety on top of regular anxiety. This multitude of factors makes coping with anxiety that much harder in modern society. While most people inevitably learn how to adapt, for others, coping with anxiety and having to deal with social anxiety can become a less than productive activity.

People with subtle mental issues, such as malignant narcissism, are hard to spot, though most experts agree that stressing out an already unstable mind can be a disastrous activity. Social anxiety is already seen as a common denominator among the psychological profiles of modern serial killers, with some people in the field believing it to be one of the root causes of the deviant behavior exhibited by such individuals. Others similarly theorize that the behavior of a serial killer is a way of coping with anxiety, albeit one that is affected by other psychological conditions.

Interestingly, people coping with anxiety and social anxiety do so in different ways, particularly in different cultures. For example, some Japanese people, buckling under the pressures of Japanese society and social duties, have found an unusual way of coping with anxiety. While the hikikomori tactic, which involves withdrawing from all social activity and interpersonal interaction for extended periods, is more accurately seen as running away from social anxiety, it is nonetheless their means of coping with the societal pressures in their lives.

Other Japanese people, generally males, have become drawn into otaku behavior as a means of dealing with social anxiety. In Japanese culture, an otaku is an obsessive fan of a particular show or series that ends up collecting each and every piece of merchandise of that specific obsession. While not as completely cut off from the rest of society as a hikikomori, an otaku is nonetheless a person that has little in the field of social skills, or at least perceives himself to lack such skills. To a degree, the otaku is using his obsession to substitute for human social interaction, though it also promotes meeting with similar individuals to locate potential buyers when the otaku eventually sells his collection in favor of starting a new one.

In Western culture, particularly in the US, social anxiety is seen as a weakness and something that is "not entirely normal." Society has a tendency to push people that are socially withdrawn into the social arena, without any regard for their psychological capacity to adapt to such circumstances. In rare cases, when in conjunction with other mental disorders, these people can lash out at society, generally by openly rebelling against the social norm of their particular community. An example of this would be the "Goth" culture that crops up in some schools, which stand in direct defiance of the homogeneous social policies of most high school student bodies.

However, it is the ones that strike back covertly that one should be wary of. These people may not necessarily turn into serial killers along the lines of Dennis Rader, the infamous BTK strangler or Ted Bundy, they can potentially turn into another Dylan Klebold or Seng Hui Cho. The difficulty here lies in the fact that people tend to ignore the signs of this sort of backlash until the guns have already started blazing.

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