(Source: The National Institute of Mental Health)
"In any social situation, I felt fear. I would be anxious before I even left the house, and it would escalate as I got closer to a college class, a party, or whatever. I would feel sick at my stomach—it almost felt like I had the flu. My heart would pound, my palms would get sweaty, and I would get this feeling of being removed from myself and from everybody else.
"When I would walk into a room full of people, I'd turn red and it would feel like everybody's eyes were on me. I was embarrassed to stand off in a corner by myself, but I couldn't think of anything to say to anybody. It was humiliating. I felt so clumsy, I couldn't wait to get out.
"I couldn't go on dates, and for a while I couldn't even go to class. My sophomore year of college I had to come home for a semester. I felt like such a failure."
Social Phobia, also called Social Anxiety Disorder, involves 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 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, drinking, or writing 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, nausea, and difficulty talking. If you suffer from social phobia, you may be painfully embarrassed by these symptoms and feel as though all eyes are focused on you. You may be afraid of being with people other than your family.
People with social phobia are aware that their feelings are irrational. Even if they manage to confront what they fear, they usually feel very anxious beforehand and are intensely uncomfortable throughout. Afterward, the unpleasant feelings may linger, as they worry about how they may have been judged or what others may have thought or observed about them.
Social phobia affects about 5.3 million adult Americans. Women and men are equally likely to develop social phobia. The disorder usually begins in childhood or early adolescence, and there is some evidence that genetic factors are involved. Social phobia often co-occurs with other anxiety disorders or depression. Substance abuse or dependence may develop in individuals who attempt to "self-medicate" their social phobia by drinking or using drugs. Social phobia can be treated successfully with carefully targeted psychotherapy or medications.
Social phobia can severely disrupt normal life, interfering with school, work, or social relationships. The dread of a feared event can begin weeks in advance and be quite debilitating.
Social phobia is a strong fear of being judged by others and of being embarrassed. This fear can be so strong that it gets in the way of going to work or school or doing other everyday things.
People with social phobia are afraid of doing common things in front of other people; for example, they might be afraid to sign a check in front of a cashier at the grocery store, or they might be afraid to eat or drink in front of other people. All of us have been a little bit nervous, at one time or another, about things like meeting new people or giving a speech. But people with social phobia worry about these and other things for weeks before they happen.
Most of the people who have social phobia know that they shouldn't be as afraid as they are, but they can't control their fear. Sometimes, they end up staying away from places or events where they think they might have to do something that will embarrass them. That can keep them from doing the everyday tasks of living and from enjoying times with family and friends.
Common Symptoms of Social Phobia:
- Anxious about being with other people
- Self-conscious in front of other people (worried about how they themselves will act)
- Afraid of being embarrassed in front of other people
- Fear that other people will judge them
- Excessive worry (for days or weeks) before an event where other people will be
- Avoids places where there are other people
- Difficult time making and/or keeping friends.
- Exhibits body symptoms around other people, such as:
- Heavy Sweating
- Difficulty Speaking
When Does Social Phobia Start?
Social phobia usually starts during the child or teen years, usually at about age 13. A doctor can tell that a person has social phobia if the person has had symptoms for at least six months. Without treatment, social phobia can last for many years or a lifetime.
Is There Help?
There is help for people with social phobia. The first step is to go to a doctor or health clinic to talk about symptoms. People who think they have social phobia may want to bring this booklet to the doctor to help them talk about the symptoms in it. The doctor will do an exam to make sure that another physical problem isn't causing the symptoms. The doctor may make a referral to a mental health specialist.
Doctors may prescribe medication to help relieve social phobia. It's important to know that some of these medicines may take a few weeks to start working. In most states only a medical doctor (a family doctor or psychiatrist) can prescribe medications.
The kinds of medicines used to treat social phobia are listed below. Some of these medicines are used to treat other problems, such as depression, but also are helpful for social phobia:
- Anti-Anxiety Medicines
- Beta Blockers
Doctors also may ask people with social phobia to go to therapy with a licensed counselor, social worker, psychologist, or psychiatrist. This treatment can help people with social phobia feel less anxious and fearful.
Why Do People Get Social Phobia?
Social phobia sometimes runs in families, but no one knows for sure why some people have it, while others don't. When chemicals in the brain are not at a certain level it can cause a person to have social phobia. That is why medications often help with the symptoms because they help the brain chemicals stay at the correct levels.
To improve treatment, scientists are studying how well different medicines and therapies work. In one kind of research, people with social phobia choose to take part in a clinical trial to help doctors find out what treatments work best for most people, or what works best for different symptoms. Usually, the treatment is free. Scientists are learning more about how the brain works, so that they can discover new treatments.
1Narrow WE, Rae DS, Regier DA. NIMH epidemiology note: prevalence of anxiety disorders. One-year prevalence best estimates calculated from ECA and NCS data. Population estimates based on U.S. Census estimated residential population age 18 to 54 on July 1, 1998. Unpublished.
2Robins LN, Regier DA, eds. Psychiatric disorders in America: the Epidemiologic Catchment Area Study. New York: The Free Press, 1991.
4Regier DA, Rae DS, Narrow WE, et al. Prevalence of anxiety disorders and their comorbidity with mood and addictive disorders. British Journal of Psychiatry Supplement, 1998; (34): 24-8.
5Kushner MG, Sher KJ, Beitman BD. The relation between alcohol problems and the anxiety disorders. American Journal of Psychiatry, 1990; 147(6): 685-95.
10Bourdon KH, Boyd JH, Rae DS, et al. Gender differences in phobias: results of the ECA community survey. Journal of Anxiety Disorders, 1988; 2: 227-41.
11Kendler KS, Walters EE, Truett KR, et al. A twin-family study of self-report symptoms of panic-phobia and somatization. Behavior Genetics, 1995; 25(6): 499-515.
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