Social Anxiety Disorder


Healthy Living - August 23, 2016
David Prescott, PhD, Acadia Hospital

Dreading Potential Embarrassment in Social Situations:  Many people look forward to “back to school season” as a chance to see old friends and meet new people.  However, you may be among those who find themselves dreading social interactions.  People with social anxiety disorder worry that others will negatively judge them or that they will do something embarrassing is social situations. 
Social Anxiety Disorder:  One common type of anxiety disorder is termed social anxiety disorder or social phobia.  Typically, symptoms of social phobia are first evident in the early teenage years
Social phobia impacts almost 7 percent of the American population, and it causes everyday social situations to become fraught with anxiety and embarrassment.  
Social Anxiety Disorder 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 Anxiety 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. 
Intervention Strategies
Don’t Calm Down – Get Excited!  Often, people with social anxiety attempt to cope with it by trying to calm down in social situations.  However, recent research suggests that the opposite strategy may be more helpful.  Relabeling your feelings as “Excitement” may help you get through difficult situations.  In one set of studies, people who were about to give a persuasive public speech, take a difficult math test, or do Karaoke, were taught to tell themselves that they were excited, rather than anxious, just before the event.  In each case, they performed better than a control group who focused on calming their anxiety.
Avoid The Avoidance Trap:  Many people attempt to cope with anxiety through avoidance.  People with social phobia, for example, may go to great lengths to avoid social interactions.  The difficulty with this approach is that the relief from anxiety is only temporary, and it often makes it more difficult for the person to engage in social interactions in the future.  While the saying “face your fears” borders on overused, the principle behind this is actually good psychology.
Treatment for Social Phobia:  All anxiety disorders, including Social Phobia, have an excellent change of improving with treatment.  People with social phobia often would like to be with other people more often, or would like to reach out to friends.  However, when the moment comes, they typically experience extremely high levels of anxiety and feel compelled to change their plans.
Treatment can help people with social phobia overcome this pattern of fear and avoidance.  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.
  • Behavior Therapy:  Behavior Therapy, like systematic relaxation training, can be used to teach specific skills to reduce anxiety.  It can also help people develop strategies other than avoidance for coping with anxiety.
  • Medications:  The most commonly used medications for social phobia are anti-anxiety medications, 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.
 For More Information: 
National Institute of Health      
American Psychological Association