Social anxiety disorder often called social phobia

Social anxiety disorder vs. often called social phobia

Social anxiety disorder is also can be called as social phobia and it is known to all. It is a completely a matter of behaving in an embarrassing way whilst you talk or meet with other people, especially strangers. It can greatly affect your life. Treatment works well in many cases. Treatment options include cognitive behavioural therapy (CBT) and medication, usually with a selective serotonin reuptake inhibitor (SSRI) antidepressant.

What is social anxiety disorder?

Social anxiety disorder is sometimes called social phobia. Social anxiety disorder is not just shyness; it is more severe than this. With social anxiety disorder you get very anxious about what other people may think of you, or how they may judge you. As a result you have great difficulty in social situations, which can affect your day-to-day life.

Symptoms include:

• A marked fear or dread of social situations. You fear that you will act in an embarrassing or humiliating way and that other people will think you are stupid, inadequate, foolish, etc.
• In some cases the fear is only for certain situations where you will be looked at by others, even if they are known to you. For example, you become very anxious if you have to 'perform' in some way, such as giving a talk or presentation, taking part in a discussion at work or school, etc. But, you are OK in informal social gatherings
• In other cases the fear occurs for most social situations where you may meet strangers. This can even include eating in public places, as you fear you may act in an embarrassing way.
• You may have weeks of anxiety prior to a social event or an event where you have to 'perform'.
• You avoid such situations as much as possible.
• If you go to the feared situation:
  • You become very anxious and distressed.
  • You may develop some physical symptoms of anxiety. These may include a fast heart rate, palpitations, shaking (tremor), sweating, feeling sick, chest pain, headaches, stomach pains, a 'knot in the stomach', and fast breathing.
  • You may blush easily.
  • You may have an intense desire to get away from the situation.
  • You may even have a panic attack (see separate leaflet called Panic Attack and Panic Disorder)
  • However, you will usually know that your fear and anxiety are excessive and unreasonable.

Social anxiety disorder can greatly affect your life. You may not do as well at school or work as you might have done, as you tend to avoid any group work, discussions, etc. You may find it hard to get, or keep, a job. This may be because you feel unable to cope with the social aspects needed for many jobs, such as meeting with people. You may become socially isolated and find it difficult to make friends.

What causes social anxiety disorder?

The cause is probably a combination of your genetic 'makeup' which makes you more prone to this condition, and bad experiences as a child. In one study about half of affected people said their phobia began after one memorable embarrassing experience. The other half said it had been present 'as long as they could remember'.

How is it diagnosed?

You must have three features to be diagnosed with social anxiety disorder:

• Your symptoms must not be the result of some other mental health condition (for example, a delusion).
• You feel anxious entirely or mostly in social situations.
• One of your main symptoms will be the avoidance of social situations.

As well as discussing your problems your doctor or practice nurse may use a short questionnaire to get extra information on how severely you are affected.

Who has social anxiety disorder?

It is one of the most common mental health conditions. As many as 1 in 10 adults have social anxiety disorder to some degree. It usually develops in the teenage years and is usually a lifelong problem unless treated. Just over twice as many women as men are affected.

What are the treatment options for social anxiety disorder?

Cognitive and behavioral therapy

These, if available in your area, can work well for social anxiety disorder:

• Cognitive therapy is based on the idea that certain ways of thinking can trigger, or fuel, certain mental health problems such as anxiety and depression. The therapist helps you to understand your current thought patterns - in particular, to identify any harmful, unhelpful, and false ideas or thoughts which you have that can make you anxious (or depressed). The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful. Therapy is usually done in weekly sessions of about 50 minutes each, for several weeks. You have to take an active part, and are given homework between sessions. For example, you may be asked to keep a diary of your thoughts which occur when you become anxious or develop physical symptoms of anxiety.
• Behavioural therapy aims to change any behaviours which are harmful or not helpful. For example, with phobias your behaviour or response to the feared object is harmful, and the therapist aims to help you to change this. Various techniques are used, depending on the condition and circumstances. As with cognitive therapy, several sessions are needed for a course of therapy.
• Cognitive behavioural therapy (CBT) is a mixture of the two where you may benefit from changing both thoughts and behaviours. (Note: cognitive and behavioural therapies do not look into the events of the past. They deal with, and aim to change, your current thought processes and/or behaviours.) See separate leaflet calledCognitive Behavioural Therapy (CBT) for more details.