Social phobia, also known as social anxiety, is the world's 3rd largest mental healthcare problem. The disorder revolves around a fear of being in the midst of a social situation that would require interacting with other people. In other words, a person with social phobia is overwhelmed with the fear of being scrutinized and judged by other individuals, which he or she believes can occur in a number of situations.
Background
Several studies have shown that speaking in public is the most feared situation by people suffering from social phobia. Others are: meeting new people, situations in which they are expected to be assertive, social gatherings, and formal performance events. Fear of more than one social situation appears to be more the rule rather than the exception in social phobia.
At any given time, social phobia affects more than 7% of the U.S. population. The percentage of developing social phobia at any time during an individual's life – also known as the 'lifetime prevalence rate' – is greater than 13%. Social phobia sets in most commonly during the teen years, but there have been records of cases starting as early as age 5 to as late as age 35.In the context of epidemiological studies, there are more females affected by social phobia than males, while the reverse is true for clinical studies.
Studies have revealed that phobias are the single most common mental disorders in the US. For social phobia, the onset may be as young as five years of age and as old as 35 years. The peak age of onset is in the teen years. In regard to gender, females are affected more often than males in epidemiological studies, yet, in clinical studies, the reverse is found. A reason for the discrepancy is not known.
One is diagnosed with this condition if the symptoms have been observed for at least 6 months. Social phobia is commonly mistaken for panic disorder, but the major difference is patients of the latter usually run to the emergency room after a panic attack, as they feel that they have an underlying medical condition that causes panic, while social phobia patients attempt to deal with the problem on their own.
Symptoms
Despite the fact that the fears of victims are real, they are well aware that these are unfounded. Socially phobic individuals constantly feel as if people around them are probing, watching, and judging, or staring at their every move. This is why they find it difficult to relax or let their guard down. They also avoid these situations when they can.
In some sufferers, the fear doesn't even have to involve large crowds. A person with social phobia may dread having to walk down the street for fear of bumping into someone he or she knows and consequently being obligated to acknowledge or talk to that person. And because the unpleasant feeling is overwhelming, that person may avoid any form of human interaction.
Other people see these individuals as disinterested, aloof, unfriendly, introverted, nervous, and inhibited. Most patients of social phobia, however, are wrongly perceived as such because they actually wish to also have friends, interact socially, and live a normal life.
Symptoms that trigger social phobia:
• Being required to say something in a public situation
• Being the center of attention
• Worrying over a forthcoming social event where there would be other people
• Meeting important people or interacting with authority figures
• Being criticized or teased
• Having eye contact with other people
• Using public restrooms
• Being observed and/or critiqued
• Being introduced to other individuals
• Being in social situations where they are expected to converse with others
These are in no case the only triggering symptoms of social phobia. There are other instances when a person may feel embarrassed and insecure, and the degree of the triggering symptom may differ from one patient to another.
Emotional symptoms of social phobia:
• Increased heart rate
• Increased blood pressure
• Dryness in the mouth
• Excessive sweating
• Clamminess
• Blushing
• Twitching of muscles, or tics
• Trembling
• Anxiety
• Nausea
• Intense fright
• Difficulty talking
• Involuntary negative thinking cycles
The most common emotional symptom of social phobia is intense and constant fear. Sufferers are aware of the fact that their fears are unfounded; however, when left untreated, the fears would persist and may intensify over time.
Diagnosis and Treatment
Social phobia is a treatable condition. The first step is to visit a doctor, who would then make the necessary interviews and tests to make sure that there are no other health conditions that are causing the symptoms. A lab evaluation must be conducted to rule out causes of anxiety that are said to be organic, such as abnormalities in the adrenal and thyroid gland. Social phobia can also be made distinct from avoidant personality disorder through psychological testing. If social phobia is suspected, the doctor would then refer the patient to one or more of the following: a specialist in mental health, a psychiatrist, or a psychologist.
It could be said that the simplest solution to social phobia is avoidance of the anxiety-causing situation. However, it is not always possible to avoid situations that a socially phobic person avoids. It is thus helpful to seek the aid of a psychotherapist who could utilize insight-oriented therapy. This type of treatment introduces the patient to safe ways of tackling the anxiety-causing factor.
One treatment for social phobia that has been found to be highly successful is cognitive-behavioral therapy (CBT). This employs programs that help change an individual's behavior, feelings, thoughts, and beliefs and create a shift from a life lived in fear to one that is no longer controlled by anxiety.
Especially useful is being involved in an active behavioral therapy group where people with the same condition discuss subjects such as their own fear 'hierarchies' in simulation, and applying principles in real life. Hypnosis is also an alternative treatment for social phobia.
Anti-anxiety agents have been employed for the treatment of generalized social phobia. Benzodiazepine is found effective for this condition, as well as serotonin-specific reuptake inhibitors (SSRIs) and beta-blockers.
Risks
When left untreated, social phobia may lead to complications of a psychiatric nature – examples are other types of anxiety disorder and major depressive disorder stemming from isolation and loneliness. There is also the danger of a patient self-medicating with marijuana, and substances known to alter the mood; he or she may also turn to alcohol to fight anxiety. Personality disorders may also stem from social phobia, and it can also lead to panic attacks.