Social Anxiety Disorder

(Social Phobia)

by Editorial Staff and Contributors

Definition

Social anxiety disorder is the intense fear of social situations. People with social anxiety disorder:

  • Avoid interactions with other people
  • Are extremely afraid of being judged negatively by others
  • Feel humiliated, embarrassed, and inadequate more easily than others

Social anxiety may be:

  • Generalized to all social interactions
  • Specific to certain social situations, such as public speaking

Social anxiety disorder is much more severe than shyness. It can interfere with work, school, or other situations, as well as cause physical symptoms.

Physical Reactions of Anxiety

Physical reaction anxiety
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Causes

The exact cause is unknown. Possible causes include:

  • Genetic factors
  • Problems with the regulation of chemicals in the brain
  • Past emotional trauma in social situations

Risk Factors    TOP

Factors that increase your chance for social anxiety disorder include:

Symptoms    TOP

Symptoms during social interactions may include:

  • Blushing
  • Excessive sweating
  • Trembling
  • Dry throat and mouth
  • Muscle twitches
  • Intense anxiety
  • Rapid heart beat
  • Lightheadness (feeling like you are going to faint)

Symptoms may begin in any public situation such as:

  • Being teased or criticized
  • Being the center of attention
  • Meeting new people
  • Interacting with authority figures
  • Interacting with members of the opposite sex
  • Eating, writing, or speaking in public
  • Using public toilets

Diagnosis    TOP

Your doctor will ask about your fears and symptoms. A physical exam may be done. You may be referred to a mental health therapist. The therapist may do a psychiatric evaluation.

Treatment    TOP

Treatments include:

Cognitive-Behavioral Therapy

During cognitive-behavioral therapy, the therapist may:

  • Help you change your negative thought patterns and behaviors
  • Teach you techniques to help you control anxiety symptoms (eg, deep breathing, visualization, meditation)
  • Suggest changes to your social environment to minimize stress
  • Gradually expose you to feared situations in a controlled environment

A support group may also be part of your treatment.

Medication

Your doctor may recommend:

  • Selective serotonin reuptake inhibitors (SSRIs) or other antidepressants—to help relieve symptoms of anxiety and depression
  • Beta-blockers—to stop the physical symptoms of panic and anxiety (has been used to relieve the performance anxiety that often occurs with social anxiety disorder)

Your doctor may try using other medicines to help control your symptoms. Examples include:

  • Benzodiazepines
  • Anticonvulsants

Prevention    TOP

There are no guidelines for preventing social anxiety disorder. But early diagnosis and treatment can prevent complications, such as:

  • Drug abuse
  • Depression
  • Difficulties at school, work, or in your personal life

RESOURCES:

Anxiety Disorders Association of America
http://www.adaa.org
Social Phobia/Social Anxiety Association
http://www.socialphobia.org/

CANADIAN RESOURCES:

Canadian Psychiatric Association
http://www.cpa-apc.org
Canadian Psychological Association
http://www.cpa.ca/

References:

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov... . Published May 22, 2009. Accessed August 27, 2012.
National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ . Accessed October 12, 2005.
National Mental Health Association website. Available at: http://www.nmha.org/ . Accessed October 12, 2005.
Last reviewed September 2012 by Brian Randall, MD
Last Updated: 09/10/2012
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