Social Anxiety Disorder, also known as social phobia, occurs when an individual experiences intense and sometimes debilitating anxiety in certain, or all, types of social situations. This disorder (also known as SAD or SAnD) affects close to 15 million people in the United States alone.
Essentially, social anxiety disorder is tied to a fear of public scrutiny and being judged by others. The individual is afraid of this scrutiny and the anticipation of public humiliation leads to anticipatory or concurrent anxiety.
The DSM-IV defines social anxiety disorder as pervasive anxiety experienced when the affected individual encounters social or performance situations. The individual fears being exposed to scrutiny and public embarrassment, and may or may not realize that this fear is perhaps misplaced or excessive. Exposure or anticipation of exposure can trigger physiological responses or avoidance strategies that may interfere with the individual's ability to function.
Types of Social Anxiety Disorder:
Social anxiety disorder can be specific and occur when certain social situations or circumstances instigate anxiety (for example, the individual experiences anxiety specifically while waiting in line at the grocery store, or during group meetings or parties).
Social anxiety disorder can also be general, and can be best described as chronic fear of scrutiny by others. This negative attention (and the fears of judgment by others, resulting in humiliation and embarrassment to the individual) may be entirely perceived or may be completely founded, depending on the situation.
Examples of situations that can trigger social anxiety are:
- Public speaking
- Interviews or meetings
- Talking to strangers
- Talking on the phone
- Activities that take place in public settings such as shopping or parties
- Team sports
- Large or crowded venues such as theaters or stadiums
Causes of Social Anxiety Disorder:
While the specific causes are unclear, there are some probable causes that can be linked to the disorder:
Genetics: Anxiety can be a familial trait; however, this can be both inherited or conditioned behavior.
Personal History: When a child is ridiculed, bullied, or socially abused, they become more prone to this disorder. Other negative experiences during social interactions, conflicts, or abuse can lead to development of this disorder.
Chemical imbalance: People with the disorder can display hyper-sensitivity to the chemical serotonin, which regulates emotional responses and moods.
Brain structure: Individuals with an overactive amygdala could experience higher levels of social anxiety (it is thought that the amygdala influences the body and brain's responses to fear).
The average age of onset is in adolescence, around 13 years of age. Over a third of people with this disorder experience symptoms for a decade or longer before consulting a professional or beginning therapy.
Symptoms of Social Anxiety Disorder:
Symptoms are generally triggered by a perceived fear of scrutiny, criticism, or judgment; this anxiety can manifest itself in the following physical responses:
- Increased pulse rate
- Nausea or vomiting
- Shortness of breath
- Difficulty with speech or eye contact
- Avoidance of situations where the perceived threat may be an issue
It is normal to feel some anxiety prior to giving a speech or another sort of public event; however, those with social anxiety disorder find that this fear can be incapacitating. This anxiety interferes with the individual's ability to function and maintain a daily routine.
Diagnosis of Social Anxiety Disorder:
A physician can make a diagnosis of social anxiety disorder. The process usually involves a physical exam to rule out other health conditions, followed by a psychological assessment. Assessments may be performed by a psychologist and include questionnaires that catalog symptoms.
To receive a diagnosis of Social Anxiety Disorder, the Diagnostic and Statistical Manual of Mental Disorders states that the following factors are present:
- Anxiety in social situations
- Avoidance of situations of a social nature that may cause anxiety
- Recognition that the worry associated with the situation is excessive
- Feelings of fear of social situations due to the possibility of being judged by others, possibly with a related worry of behaving in a way that would draw attention
- Anxiety are impacting everyday life
Social anxiety is often confused with panic disorder; however, individuals who suffer from panic disorder believe that the panics are due to a real and tangible physical condition or illness. Individuals with social anxiety do not believe that their physical symptoms are attributable to a medical illness; rather, they understand that the physiological symptoms they're experiencing are due to anxiety and fear triggered by the social situation.
If you believe that you or a loved one may be affected by this disorder, please consult with your doctor.
Treatment for Social Anxiety Disorder:
Treatments for social anxiety disorder can include psychotherapy (psychological counseling) and cognitive behavioral therapy (CBT). Psychotherapy can help the patient recognize negative thought patterns and behaviors, and work to change these habits. CBT can also include controlled exposure therapy, which can be difficult as the patient is exposed to situations that trigger the anxiety; however, this can be very helpful in aiding the patient to learn coping mechanisms and develop confidence.
Your doctor may choose to prescribe medication, as well, which may consist of serotonin and norepinephrine reuptake inhibitors, antidepressants, anti-anxiety medications, or beta-blockers, which block epinephrine (adrenaline).
No matter what treatment option is chosen, it's important not to give up. It can take weeks, months, or years to overcome social anxiety disorder, especially if other factors are present (such as substance abuse, depression, or other conditions). But you can do it!
Additional Resources For Social Anxiety Disorder:
Social Anxiety Support - A web-based community with information, treatment options and reviews, groups and forums.
OCD Center of Los Angeles - The OCD Center specializes in treating OCD, social anxiety, and related conditions. The website contains information about how OCD can be related to social phobia and provides treatment options, telephone and online therapy.
Mental Healthy is a UK-based website dedicated to providing support and advice to those who are looking to improve their state of mind, with free guides to anxiety, depression, schizophrenia and more. Mental Healthy provides a great online resource and community for those interested in living a healthy life from the inside out.
Living With Anxiety- A site devoted to building a community and support for those living with anxiety disorders or those who are caring for someone with an anxiety disorder. Blogs, vlogs, forums and articles create a wonderful place for information. The site also highlights some wonderful books to help those dealing with anxiety.
Meditation and Anxiety - Natural and spiritual ways to calm yourself while in an anxious state. Some people find a few minutes of meditation when in a situation that causes anxiety significantly reduces the length of their anxious episode.
Anxiety Disorders Association of America - Offers great information and resources for local support groups. There is a "find a therapist" tool and personal stories that will offer support and a sense of community.
What is Anxiety? - An excellent page with videos describing the various types of Anxiety Disorders and also a video about anxiety through the eyes of a sufferer.
National Panic and Anxiety Disorder News is an informational website for sufferers of Anxiety Disorders.
AnxietyTribe.com - A resource for support groups, forums and chat rooms for anxiety sufferers.