Social phobia, or social anxiety disorder, is an intense fear of being watched and judged by others. It is the third largest mental health issue in the world today. Those who experience this disorder feel self conscious in social situations and have an irrational fear of becoming humiliated in social situations, e.g., embarrassing yourself in front of other people. It can affect work, school, personal interactions, and other day-to-day activities. Approximately 7% of the population suffers from some form of social anxiety disorder, and it often begins around early adolescence or even younger.
If you suffer from social phobia, you tend to think that other people are very competent in public and that you are not. Small mistakes you make may seem to you much more exaggerated than they really are. You may avoid situations where you are the center of attention or not partake in activities for fear of embarrassment.
Sometimes social phobia involves a general fear of social situations such as parties. It can also be more specific, like fear of talking to your boss, giving a speech or even dating. In less common instances, it may involve a fear of eating out, having to make a phone call, or using a public restroom.
People with this disorder can be perceived as shy or even aloof. People who are shy may feel uncomfortable around others, but they are not extremely anxious prior to a social situation, and they don’t necessarily avoid circumstances that make them feel self-conscious.
Conversely, people with social phobia can be completely at ease with people most of the time, but particular situations, e.g., walking down an aisle in public or making a speech, can give them intense anxiety.
This pervasive and chronic (because it does not disappear on its own) disorder causes anxiety and fear in most all areas of a person’s life. It can interfere with everything from a person’s career to social relationships. If a person turns down a job because he can’t give public presentations, this is an indicator of social phobia. The dread of an upcoming social event can begin weeks in advance, and symptoms can be quite debilitating.
People with social phobia are aware that their anxiety is not rational. Still, they experience a great deal of dread before facing the feared situation, and they may go out of their way to avoid it.
Recommended treatments include social anxiety-specific cognitive behavioral therapy as well as anti-anxiety medication and certain selective serotonin reuptake inhibitors (SSRIs). The combination of cognitive and behavioral therapy changes the brain, enabling people to overcome their social anxiety. Medications can only temporarily change brain chemistry and can be useful in some cases, though research suggests that the use of anti-anxiety medications, such as benzodiazepines, and specific SSRIs used in conjunction with CBT have been most beneficial. Only cognitive behavioral therapy can permanently change the neural pathway associations in the brain; thus, there are no long term benefits to using only medication to relieve social phobia.
National Institutes of Mental Health-funded studies report a very high success rate using cognitive therapy with a behavioral therapy group. Both are essential to alleviating anxiety symptoms associated with social anxiety disorder.
It is important to note that each person reacts differently to different treatments, and there is no general rule that works concerning social anxiety and medications.
National Institute of Mental Health. (2018). Social Anxiety Disorder: More Than Just Shyness. Retrieved from https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/index.shtml on April 24, 2018.
Social Anxiety Association. (2018). Social Anxiety Fact Sheet: What is Social Anxiety Disorder? Symptoms, Treatment, Prevalence, Medications, Insight, Prognosis Retrieved from http://socialphobia.org/social-anxiety-disorder-definition-symptoms-treatment-therapy-medications-insight-prognosis on April 27, 2018.
PSYCOM. (2018). Social Anxiety Disorder: Test, Symptoms, Causes and Treatment. Retrieved from https://www.psycom.net/social-anxiety-disorder-overview on April 27, 2018.
Carmosino, A. (2020). Social Phobia. Psych Central. Retrieved on August 6, 2020, from https://psychcentral.com/lib/social-phobia/