Social phobia, also called social anxiety disorder, is an anxiety disorder in which a person has an excessive and unreasonable fear of social situations. Anxiety and self-consciousness arise from a fear of being closely watched, judged, and criticized by others.
A person with social anxiety disorder is afraid that he or she will make mistakes, look bad, and be embarrassed or humiliated in front of others. The fear may be made worse by a lack of social skills or experience in social situations. The anxiety can build into a panic attack. As a result of the fear, the person endures certain social situations in extreme distress or may avoid them altogether. In addition, people with social anxiety disorder often suffer the fear of a situation before it even happens. In many cases, the person is aware that the fear is unreasonable, yet is unable to overcome it.
People with social anxiety disorder suffer from distorted thinking, including false beliefs about social situations and the negative opinions of others. Without treatment, social anxiety disorder can negatively interfere with the person’s normal daily routine, including school, work, social activities, and relationships.
People with social anxiety disorder may be afraid of a specific situation, such as speaking in public. However, most people with social anxiety disorder fear more than one social situation. Other situations that commonly provoke anxiety include:
- Eating or drinking in front of others.
- Writing or working in front of others.
- Being the center of attention.
- Interacting with people, including dating or going to parties.
- Asking questions or giving reports in groups.
- Using public toilets.
- Talking on the telephone.
Social anxiety disorder may be linked to other mental illnesses, such as panic disorder, obsessive compulsive disorder, and depression.
Many people with social anxiety disorder feel that there is something wrong, but don’t recognize their feeling as a sign of illness. Symptoms of social anxiety disorder can include:
Intense anxiety in social situations.
Avoidance of social situations.
Physical symptoms of anxiety, including confusion, pounding heart, sweating, shaking, blushing, muscle tension, upset stomach, and diarrhea.
Children with this disorder may express their anxiety by crying, clinging to a parent, or throwing a tantrum.
There is no single known cause of social anxiety disorder, but research suggests that biological, psychological, and environmental factors may play a role in its development.
Biological: Social anxiety disorder is currently thought to be related to abnormal functioning of brain circuits that regulate emotion and the fight or flight response center in the brain.
Psychological: The development of social anxiety disorder may stem from embarrassing or humiliating social experiences in the past, such as being bullied or neglected by peers.
Environmental: People with social anxiety disorder may develop their fear from observing the behavior of others or seeing what happened to someone else as the result of their behavior. Further, children who are overprotected by their parents may not learn good social skills as part of their normal development.
For social anxiety disorder, the most effective treatment currently available is cognitive behavioral therapy (CBT). Medication may also be used to help ease the symptoms of social anxiety disorder so that CBT is more effective.
The outlook for those with social anxiety disorder is generally good with treatment. Many people improve and enjoy more productive lives. Unfortunately, social anxiety disorder cannot be prevented, but seeking help as soon as symptoms surface can help make treatment more effective.