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OVERVIEW

What is social phobia?

Social phobia, also called social anxiety disorder, is a fear of being judged by others during social situations. This includes, work, parties, family gatherings, etc. Most people feel nervous in certain social situations, such as at a job interview or when giving a speech. Most of us worry about what we’re going to say, do, or wear during events like these. These situations often become easier with some experience. However, for people who have social phobia these situations can be frightening and unbearable.

There are different levels of social phobia. For instance, some people may only have symptoms in one specific situation, such as performing on stage or speaking to a crowd. Others may have it any time they are out in public or around people.

SYMPTOMS

People who have social phobia can experience internal and external symptoms.

Internal (emotional) symptoms include:

• Fear of being judged, embarrassed, or rejected
• Feeling that everyone is watching them
• Belief that anxiety is a sign of weakness
• Belief that they are stupid, and other people are smarter and more confident than them

External (physical) symptoms include:

• Withdrawal or avoidance
• Blushing
• Sweating
• Nausea or vomiting
• Trembling or shaking
• Trouble talking or making eye contact
• Increased heart rate

People who have social phobia often realize their fears are not completely rational or warranted. However, they may still dread social situations. They may go out of their way to avoid going to some events. If they do go to an event, they usually feel very nervous before the event and very uncomfortable during it.  Afterward, the unpleasant symptoms and feelings may linger as they worry about what people thought of them.

CAUSES

What causes social phobia?

Social phobia is about twice as common in women as it is in men. Most people notice it as children or teens. The condition can be genetic and run in families. Other potential factors include hormones and environment. For example, race, culture, economic status, and neglect can increase a person’s risk. Social phobia also can be related to other conditions, including depression, other anxiety disorders, or addiction.

DIAGNOSIS

How is social phobia diagnosed?

Talk to your healthcare provider if you have symptoms of social phobia. They will want to know about your symptoms, health history, and family history. When diagnosing the condition, the healthcare provider will look for:

• Frequency of symptoms
• Presence of ongoing symptoms of 6 months or more
• Side effects of symptoms (for instance, do your symptoms affect your daily work, school, or social life?)
• Certain environments when the phobia occurs

They may refer you to a specialist, such as a psychologist.

PREVENTION

Can social phobia be prevented or avoided?

There is little you can do to prevent social phobia. You can get treatment to help manage, reduce, or relieve symptoms. You can learn to adjust in social situations you must participate in, such as work. Also, you can learn to adapt, such as attending a party for a shorter time.

TREATMENT

What helps people with social phobia?

Social phobia is an ongoing disorder that usually needs to be treated with medical care. It’s not just shyness and usually does not go away on its own. Your healthcare provider can help you find ways to Manage your symptoms:

Cognitive behavioral therapy (CBT) This helps people think about social situations differently.  The goal of therapy is to remove the thoughts and actions that are driving anxiety. CBT teaches you how to address fear, cope with stress, and improve social skills. Your healthcare provider may suggest group or family therapy in addition to CBT.

Social skills training. This can teach a person some strategies for handling certain types of social situations.

Prescription medicines. Your healthcare provider may recommend prescription medicine. Antidepressants and anti-anxiety medication are most common. Beta-blockers may help people who have a certain form of social phobia called “performance anxiety.” You can take them before a performance to help ease anxiety. Medicines may take a while to begin working. Do not stop taking anxiety medicine without talking to your healthcare provider first.

Living with social phobia

Social phobia can make it hard to go to work, school, or take part in daily activities. It can affect your ability to make and keep friends. It is not a condition that you should have to deal with alone. Talk to loved ones and your healthcare provider to begin treatment. It is common to choose a combination of therapy and medicine. Your healthcare provider should monitor your treatment and progress.

People who have social anxiety may try to self-medicate by experimenting with and becoming dependent on the use of alcohol or illegal drugs to manage a situation. This puts them at higher risk of substance abuse.

Diet and exercise also are important in managing the symptoms of social anxiety. This includes regular exercise, a nutritious diet, and avoiding stimulants, such as caffeine and over-the-counter cold medicines.

FOR MORE INFORMATION

The Centre for Addiction and Mental Health

https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/social-anxiety-disorder