Stress Management

Facts about Social Phobia

What Is Social Phobia?

Social phobia, also called social anxiety, is a disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and of being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work or school - and other ordinary activities. While many people with social phobia recognize that their fear of being around people may be excessive or unreasonable, they are unable to overcome it. They often worry for days or weeks in advance of a dreaded situation.

Social phobia can be limited to only one type of situation - such as a fear of speaking in formal or informal situations, or eating or drinking in front of others - or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people. Social phobia can be very debilitating - it may even keep people from going to work or school on some days. Many people with this illness have a hard time making and keeping friends.

Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, trembling, and other symptoms of anxiety, including difficulty talking and nausea or other stomach discomfort. These visible symptoms heighten the fear of disapproval and the symptoms themselves can become an additional focus of fear. Fear of symptoms can create a vicious cycle: as people with social phobia worry about experiencing the symptoms, the greater their chances of developing the symptoms.. Social phobia often runs in families and may be accompanied by depression or alcohol dependence.

Medications include 

Some people with a form of social phobia called performance phobia have been helped by beta-blockers, which are more commonly used to control high blood pressure.

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Cognitive-behavior therapy is also very useful in treating social phobia. The central component of this treatment is exposure therapy, which involves helping patients gradually become more comfortable with situations that frighten them. 

The exposure process often involves three stages. 

1. Introducing people to the feared situation. 
2. Increase the risk for disapproval in that situation so people build confidence that they can handle rejection or criticism. 
3. Teaching people techniques to cope with disapproval. In this stage, people imagine their worst fear and are encouraged to develop constructive responses to their fear and perceived disapproval.

Cognitive-behavior therapy for social phobia also includes anxiety management training - for example, teaching people techniques such as deep breathing to control their levels of anxiety. Another important aspect of treatment is called cognitive restructuring, which involves helping individuals identify their misjudgments and develop more realistic expectations of the likelihood of danger in social situations.

Supportive therapy such as group therapy, or couples or family therapy to educate significant others about the disorder, is also helpful. Sometimes people with social phobia also benefit from social skills training.

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 What Other Illnesses Co-Occur With Social Phobia?

Social phobia can cause lowered self-esteem and depression. To try to reduce their anxiety and alleviate depression, people with social phobia may use alcohol or other drugs, which can lead to addiction. Some people with social phobia may also have other anxiety disorders, such as panic disorder and obsessive-compulsive disorder.

Source: NIMH