Social Anxiety Disorder Information

This Fear of Social Situations Is Also Known As Social Phobia

anxious woman at airport
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Social anxiety disorder was previously known as social phobia. Although many people think that social anxiety is a fear of other people, it's actually a fear of a variety of social situations.

The anxiety disorder can be divided into two main types: specific, in which one or more situations are feared, and generalized, which encompasses multiple situations. 

For example, if you have social anxiety disorder, you may be afraid of speaking in front of others, performing in front of others or simply being around other people.

Whatever specific situations you fear, all forms of social anxiety disorder share several common characteristics.

Social anxiety disorder can be treated so that you can live a less anxious life around others.

Symptoms of Social Anxiety Disorder

Each person's symptoms are a little bit different. The exact symptoms that you may experience depend on many factors, including the severity of your social anxiety. Common symptoms of social anxiety disorder include, but are not limited to:

  • Fear: You may feel a sense of dread or doom beginning in the days leading up to a scheduled social event. During the event, your dread may become overwhelming.

  • Physical Symptoms: You may have a physical reaction similar to a panic attack. Intense blushing, shaking, palpitations, and stomach distress are particularly common.

  • Self-Judgment: Many people with social anxiety disorder feel that they are being intensely scrutinized by those around them. You may become hyperaware of the way you walk, talk, chew and perform other everyday actions. Becoming very critical of yourself is also common.

    Keep in mind that the symptoms of social anxiety disorder are quite similar to those of other disorders such as panic disorder, as well as certain physical conditions. Your health care provider can determine the cause of your symptoms and decide on an appropriate treatment

    Diagnosing Social Anxiety Disorder

    Like any phobia or other mental health disorder, social anxiety disorder can be diagnosed only by a trained professional.

     

    One of the most critical elements of diagnosing any phobia is the fact that it must significantly impact the sufferer's life. If you have a fear of public speaking, for example, but have created a life that does not require this skill, then you may not have a phobia. Someone who makes his living as a lawyer, however, could be severely disabled by the same fear.

    Progression of Social Anxiety Disorder

    Each case of social anxiety disorder is different, so your particular phobia may not follow a "typical" pattern. In general, however, it appears that untreated social anxiety disorder tends to worsen over time. Social anxiety often progresses from fear of a single social situation to multiple situations or even an overall fear of people. In extreme cases, untreated social anxiety disorder can lead to isolation, depression, other anxiety disorders or even agoraphobia.

    The following progression may be considered typical:

    • Early Warning Signs: Many people who go on to develop social anxiety disorder showed signs of timidity and social anxiety in early childhood.
    • Age at First Onset: Although social anxiety disorder may appear at any age, it typically begins at around age 13. It's normal to have occasional social anxiety at that age. Social anxiety disorder in teens and children is only diagnosed if it persists for more than six months.
    • Progressive Effects: Untreated social anxiety disorder can lead to many complications, including difficulty with jobs and social relationships. Increasing isolation can lead to the development of other disorders.
    • Concurrent Disorders: The isolation and anxiety that comes with social anxiety disorder can lead to depression, substance abuse and further anxiety disorders.
    • Prognosis: Untreated social anxiety disorder can become chronic and increasingly life-limiting. Over time, it can become more difficult to fight the phobia and maintain a normal life. With treatment, however, the prognosis is extremely positive.

    Treating Social Anxiety Disorder

    Social anxiety disorder can be treated in any of three ways: medication, therapy or alternative methods. Many practitioners choose to use a combination of treatments.

    Medication Options

    The medications used in treating social anxiety disorder fall into four main categories:

    • SSRIs: Selective serotonin reuptake inhibitors, or SSRIs, work by affecting the level of serotonin in the brain. They're usually prescribed for depression, but they're also effective in treating anxiety disorders, including phobias.

    • MAOIs: MAOIs, or monoamine oxidase inhibitors, block an enzyme that breaks down certain neurotransmitters in the brain. These medications are popularly prescribed for depression, but they have an impact on anxiety as well.

    • Benzodiazepines: Benzodiazepines are mild sedatives commonly used to treat anxiety. They can ease phobias by addressing the associated anxiety.

    • Beta Blockers: Most popularly prescribed for high blood pressure and certain heart conditions, beta blockers work by suppressing the effects of epinephrine (adrenaline) in the body. Some studies have shown that beta blockers can be particularly effective in relieving certain aspects of social anxiety disorder.

    Therapy

    Numerous types of talk therapy may be effective in treating social anxiety disorder. For a variety of reasons, cognitive-behavioral therapy is one of the most popular forms of treatment for phobias. Psychoanalysis, intensive group seminars and behavioral techniques have also all been found to be effective in some cases. 

    Alternative Treatments

    Many people find relief from social anxiety disorder with a wide range of alternative treatments. Hypnotherapy, aromatherapy, guided imagery and homeopathy are among the most popular. However, not all of these remedies have been well tested. If you choose to pursue alternative treatments for your social anxiety disorder, it's best to do so only under the guidance of both a licensed mental health professional and an expert in the chosen remedy.

    Living With Social Anxiety Disorder

    If you're suffering from social anxiety disorder, you face many of the same challenges to daily living as those with any other phobia. Depending on the severity of your social anxiety disorder, it may be a manageable annoyance or a devastating condition. Because social anxiety disorder involves a fear of being around other people, it can also present unique challenges, particularly in situations such as dating.

    Traveling with social anxiety disorder can be an obstacle. Flying involves close contact with strangers, and enhanced airport security measures can trigger an intense reaction. Road trips may be a bit more manageable, but only if you are extremely comfortable with your traveling companions.

    Social anxiety disorder can seem worse during the winter holidays. Shopping malls are packed to overflowing with hurried strangers. You may be expected to make the rounds of holiday parties hosted by people you barely know. Even if you generally love the holiday season, you may find the most mundane tasks more difficult to accomplish.

    Because social anxiety disorder can cause so much difficulty in daily life, it's important to seek professional help as soon as possible. Social anxiety disorder is extremely treatable, but left untreated, it can be extremely disabling. Contact your mental health provider to develop an individualized treatment plan that's right for you.

    Source:

    American Psychiatric Association. Social Anxiety Disorder Fact Sheet. May 2013.

    American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th Ed.)

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