Social phobia

A person with social phobia experiences anxiety in situations where they are likely to be scrutinised and observed by others. They may have persistent fears about being judged, criticised, ridiculed or humiliated.

Most people feel shy or nervous in certain social situations. Public speaking or entering a roomful of strangers can cause anxiety in many people.

However, this kind of common apprehension doesn’t indicate a social phobia.

For people with social phobia, social situations provoke feelings that extend beyond simple anxiety or nervousness. A social phobia occurs for a person when: there is a persistent fear of one or more social or performance situations where they are exposed to unfamiliar people or to possible scrutiny by others.

The person fears that they will act in a way that will be embarrassing and humiliating a person realises that the social anxiety is excessive and unreasonable, but feels they are unable to change or control the feelings or behaviour fear or avoidance isn’t due to a general medical condition or the physiological effects of a substance (such as It is estimated that around three per cent of the American population experience social phobia in any one year.

Up to 13 per cent of the population may develop social phobia during their lifetime.

Men and women are equally affected, though a higher number of men seek treatment

In many cases, social phobia begins with shyness in childhood and progresses during adolescence.

The onset of social phobia generally occurs around ages 11 to 15. Social phobia is also known as social anxiety disorder.

When exposed to a feared social situation, a person with social phobia may experience symptoms of extreme anxiety, including: difficulty concentrating on anything other than physical sensations of anxiety, negative feedback from others and negative thoughts the realisation that these feelings are irrational and out of proportion.

Some people with social phobia fear and avoid specific situations (such as public speaking), while others may feel generalised anxiety about several social situations (generalised social phobia). A person with social phobia can fear (and try to avoid) a range of situations, including: situations that put them in the spotlight, such as parties to celebrate their own birthday.

Some of the fears commonly aroused by social situations can include:

• worry that others will notice their physical symptoms of anxiety
• such as blushing sweating
• stammering fear of being judged as socially inadequate

A person with social phobia can feel anxious while simply anticipating an upcoming social event.

After the event, the person may replay the conversations they had and rate their performance. Brooding on these feelings of social failure can make the person feel even worse, and reinforce the desire to avoid social situations in the future.

If left untreated, social phobia can severely affect quality of life. Some of the common complications may include: reluctance to leave the house.

Recovery from social phobia is possible with appropriate treatment

Depending on the individual, treatment options may include: Cognitive behaviour therapy aims to help people change the way they think, feel and behave in social situations.

These techniques may help people to confront their fears

In time, people come to realise that others are unlikely to judge them harshly – and even if it does happen, they realise it’s not a major tragedy.

They will also learn that they can exert some control and choice over their thoughts and feelings.

Treatment using CBT may include: attention training

Relaxation training and breathing techniques may help a person manage their anxiety symptoms. Some physical anxiety symptoms may be triggered by hyperventilation (overbreathing). Taking slow, deep breaths from the abdomen – rather than fast, shallow breaths from the chest – can reduce anxious feelings.

Relaxation techniques include: isometric relaxation exercises. Some people who have suffered with social phobia for many years may develop habits that make it difficult for them to take steps towards recovery.

For example, they may: have difficulty listening or keeping a conversation going.

Social skills training methods include modelling the appropriate behaviour, role-playing and then practising in real-life situations. Some medications, such as selective serotonin re-uptake inhibitors (SSRIs), can help if the person is also suffering from depression. In the short term, drugs such as beta-blockers may be used to help manage some of the symptoms of anxiety.

Social phobia is a type of anxiety disorder

People who have social phobia experience extreme and persistent anxiety feared situations are avoided or endured with intense anxiety and distress it interferes significantly with their daily life including work, education, family and social life drugs or medications Symptoms of social phobia blushing trembling feeling as if you have nothing to say accelerated heart rate shallow, fast breathing sweaty palms nausea tense muscles dry throat stomach pain feeling faint or light-headed feelings of self-doubt and uncertainty negative thoughts such as ‘I’m making a fool of myself’ an overwhelming urge to flee the situation Social phobia – feared social situations crowds and parties public speaking starting or having a conversation talking to a large group voicing opinions meeting someone new, shaking hands dating using public toilets shopping talking with someone who is in a position of seniority or authority being watched while doing something, such as eating, signing papers or talking on the telephone Social phobia – underlying fears fear of looking stupid, silly, or ridiculous fear of appearing quiet, boring and uninteresting to others Social phobia can extend beyond the social event Common complications of social phobia using alcohol to cope with anxiety during social events alcohol abuse misuse of prescription and non-prescription drugs difficulty forming and maintaining relationships curtailed education or employment opportunities depression suicidal thoughts isolation from family, peers and community Treatment options for social phobia cognitive behaviour therapy (CBT) anxiety management techniques social skills training medication Cognitive behaviour therapy (CBT) education about the nature of social anxiety challenging and changing false or distorted thoughts and beliefs gradual exposure to feared situations Anxiety management techniques progressive muscle relaxation mindfulness meditation visualisation Social skills training find it difficult to make or maintain eye contact use soft or hesitant speech display closed body language have rigid facial expressions need a large personal space Medication Where to get help Your GP (doctor) Psychologist Anxiety Recovery Centre Michigan Helpline (616) 555-0200 or 1300 ANXIETY (269 438) American Psychological Referral Service (616) 555-0200 or 1800 333 497.

Key Points

• Public speaking or entering a roomful of strangers can cause anxiety in many people
• However, this kind of common apprehension doesn’t indicate a social phobia
• Men and women are equally affected, though a higher number of men seek treatment
• Some of the common complications may include: reluctance to leave the house
• Recovery from social phobia is possible with appropriate treatment