Introduction to Social Phobia

Do you feel anxious before you even leave the house? Does your heart pound and your palms get sweaty as you come close to people? Do you feel like everybody’s eyes were on you? Maybe your problem is more than just being shy.

What is social phobia?

Phobias do not just cover irrational fear over spiders and the like, as it also involves feelings of anxiety and self-consciousness in everyday social situations. This type of fear is called "social phobia," also called "social anxiety disorder."

People with social phobias have intense, persistent, and chronic fear of being watched and judged by other and of doing things that they think would embarrass them. This can be triggered by perceived or actual scrutiny by others. They tend to worry for days before a dreaded situation.

This fear can become so severe that it interferes with their work, school, and other ordinary activities, and can be difficult for them to make and keep friends. Diagnosis can either be of a specific disorder, when only some particular situations are feared, or a generalized disorder.

Research suggest that distress due to generalized social anxiety disorder is more likely when social encounters were unfamiliar, involved power or status differences, differences in gender, or the presence of a group of people. Meanwhile, those with specific social phobias may experience anxiety only in a few situations.

For instance, the most common of this type of phobia is "glossophobia" (the fear of public speaking or fear of performance, also known as stage fright). Other examples include "scriptophobia" (fear of writing in public) and "paruresis" (fear of using public restrooms).

Differences between social phobia, shyness, and panic disorder

It should be noted that shyness is not an indication of social anxiety disorder, although they both share several features such as development of negative thoughts in social situations, heightened physiological activity, a tendency to avoid social situations, and decrease in social skills. Social phobia differ from shyness because it is more chronic, persistent, and functionally debilitating.

Meanwhile, social phobia should not be confused with panic disorder. People who suffer from panic disorder are sometimes convinced that their fear comes from some dire physical cause, and would often go to the hospital or call for an ambulance during or after their attacks.

Social phobics may experience a panic attack when triggered, but they are aware that they are only experiencing extreme anxiety. The principal different between the two is that social phobia deals with anxiety in a social setting, while panic disorder is extreme anxiety for any situation, not necessarily one involving other people.

How many are affected with social phobia?

About 13.3 percent of the general population may meet criteria for social anxiety disorder at some point in their lifetime, with the male to female ratio being 1:1.5. These anxieties usually begins in childhood or early adolescence. There are also some evidences that genetic factors are involved.

Symptoms of social phobia

People with social phobias usually experience blushing, profuse sweating, trembling, palpitations, nausea, and stammering. Panic attacks may also occur under intense fear and discomfort. They may also feel as if all eyes are focused on them, or that people talk about them behind their backs. If not diagnosed early, social phobia may develop additional mental problems such as depression, as well as the use of alcohol or other drugs to reduce fears and inhibitions at social events.

Treatment of social phobia

A person with the disorder may be treated with psychotherapy, medication, or both. Research has shown that cognitive behavior therapy to be effective in treating social phobia. In this program, the patient tries to identify irrational thoughts, assumptions, and beliefs that are related to debilitating negative emotions, as well as identify how they are dysfunctional, inaccurate, or not helpful at all. This is done in an effort to reject distorted thinking and replace them with a more realistic and self-helping alternatives.

Prescribed medications such as "selective serotonin reuptake inhibirors" (SSRIs) and "serotonin-norepinephrine reuptake inhibitors" (SNRIs) can also be given to patients with social anxiety disorders. However, withdrawal symptoms can occur if medication is discontinued abruptly.