February 19, 2008
Social Phobia: When Social Interaction Causes
Dr. David Prescott – Acadia Hospital
Social Phobia is a type of Anxiety Disorder: Phobias are intense, excessive fears about certain objects or situations. While most people experience heightened anxiety in some situations, people with phobias find their fears to be debilitating. One common type of phobia is termed social phobia, or social anxiety. It impacts about 15 million Americans, and it causes everyday social situations to become fraught with anxiety and embarrassment. Social Phobia is one type of anxiety disorder along with problems like panic disorder or obsessive-compulsive disorder. Together, anxiety disorders impact nearly one in every five people.
Defining Social Phobia: Social Phobia was long associated with being shy or timid, and its impact on people’s lives was minimized. However, in the early 1980’s, psychologists and other researchers began to focus on how social anxiety could be debilitating for some people. The essence of Social Phobia is:
Overwhelming anxiety and self-consciousness when a person interacts with others.
Intense, chronic fear of being watched and judged by others.
Extreme fear of doing things that will cause embarrassment during a social interaction.
Intense physical and subjective anxiety in most social situations; for example, feeling sick to your stomach, sweating, or racing heart.
When Does Shyness Cross the Line to Become Social Phobia? Like most psychological problems, the distinction between clinical and non-clinical problems is blurry at the boundary. In general, the greater the distress caused by anxiety, and the greater the anxiety disorder disrupts a person’s life, the more likely it is to require professional treatment. For Social Phobia, the more a person begins to rearrange their life to avoid social interactions, the more severe the problem.
“Caught Between a Rock and a Hard Place:” Getting a Person with Social Phobia to Seek Help. The struggle to seek help with a psychological problem is especially difficult for people with Social Phobia. Like all social interactions, the thought of meeting with a counselor is likely to cause intense anxiety and fear of embarrassment. Family members and friends can help by providing extra support, perhaps by accompanying the person to their first visit.
Treatment for Social Phobia: All anxiety disorders, including Social Phobia, have an excellent change of improving with treatment. The types of treatment that are effective include:
Cognitive Behavioral Therapy: Cognitive Behavioral Therapy involves identifying and changing thinking patterns which cause and perpetuate anxiety. These thinking patterns, and the behavior that follows, can be changed to break the cycle of escalating anxiety and avoidance of social interaction.
Medications: The most commonly used medications for social phobia are anti-anxiety medications, such as Klonopin, or a class of antidepressant medications called SSRIs (selective serotonin reuptake inhibitors) often help make anxiety more manageable. Medications are often a helpful adjunct to “talk” therapies.
Behavior Therapy: Behavior Therapy, like systematic relaxation training, can be used to teach specific skills to reduce anxiety.