Exposure to social situations can produce physical symptoms, such as sweating, blushing, muscle tension, pounding heart, dry mouth, shaky voice or trembling. These symptoms can become a source of added concernÐworry that they will result in unwanted and embarrassing attention. People with social phobia either avoid social or performance situations, or endure them with intense anxiety or stress.
It is difficult to say how many people suffer from the disorder. Scholarly studies have used a variety of definitions for social phobia, but such reports put the incidence in the United States at anywhere from five to 13 percent of the population experiencing it during their lifetime. Interestingly, research in Korea has put the incidence much lower, at just one half of one percent of the Korean population.
US surveys have indicated that women and girls outnumber men and boys three to two among those with symptoms of social phobia. Men, however, have been more likely to seek treatment. A variety of studies have demonstrated that social phobia is most likely to develop in the teenage years, though it can start earlier or later. Mental health professionals report that many people suffer quietly for years, looking for help only when their fears have precipitated a major life crisis.
While definitive data are still to be collected, social phobia is considered to be a chronic condition that requires ongoing treatment. About half of the people with social phobia are thought to experience other psychiatric problems at the same time. These typically have included panic disorder, substance abuse and depression.
Types of Social Phobia
For some people, almost any social circumstance is a cause for fear and anxiety. These individuals are said to have generalized social phobia. People for whom just one or two situations produce anxiety are considered to have the nongeneralized form of the disorder.
A number of researchers have suggested that another way to group people with social phobia is based on the kind of situation that evokes dread. Two primary categories or groups are performance and interactional.
The performance grouping includes people who have strong anxiety at the idea of doing something in front of, or in the presence of, other people. Such situations include dining out, working, giving a speech or using a public restroom.
The interactional grouping includes people whose fears center on circumstances where they have to converse or otherwise engage with others, such as meeting new people.
Mental health professionals also have recognized that some people develop symptoms of social phobia as an outgrowth of other medical or physical problems. Individuals with Parkinson’s disease, obesity, disfigurement or other conditions sometimes can have severe anxiety that their physical appearance or actions will attract attention and disdain. While sharing similar symptoms, the Diagnostic and Statistical Manual for Mental Disorders specifically excludes a diagnosis of social phobia if the fears exhibited can be tied to these medical or physical conditions.