Social Phobia/Social Anxiety Disorder
Social Phobia or Social Anxiety Disorder is often a life-long issue, even though it usually waxes and wanes according to what is happening in a person’s life. Estimates say approximately 2-13 percent of the general population struggles with Social Phobia.
Generalized Social Phobia is not the same as a limited fear of public speaking or other limited anxieties. It can be a little tricky to tease out if there are other mental/emotional issues in play, and the main point of doing that is for diagnostic purposes, as many anxieties or phobias related to interacting with others are treated in similar ways. In other words, some of the diagnostic criteria are more academic than necessarily helpful to the sufferer.
That being said, the official diagnostic criteria (edited for space) from the DSM-IV-TR is as follows (sans criteria specifically for children):
A. A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.
B. Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack.
C. The person recognizes that the fear is excessive or unreasonable.
D. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupation (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
F. In individuals under age 18 years, the duration is at least 6 months.
G. The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder.
H. If a general medical condition or another medical disorder is present, the fear in Criterion A is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson’s disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa.
Mayo Clinic has a simpler list of signs and symptoms of the anxiety disorder:
- Intense fear of being in situations in which you don’t know people
- Fear of situations in which you may be judged
- Worrying about embarrassing or humiliating yourself
- Fear that others will notice that you look anxious
- Anxiety that disrupts your daily routine, work, school or other activities
- Avoiding doing things or speaking to people out of fear of embarrassment
- Avoiding situations where you might be the center of attention
So what can you do about all this freaking out? There are medications, mostly SSRIs and anxiolytics/sedatives, as well as a few herbal remedies, Valerian and Kava in particular. The gold standard treatment, at least in the US, is medication along with Cognitive Behavioral Therapy.
Extremely simplified, CBT teaches you how to deal with the fear and cope with the symptoms. It doesn’t say you don’t have them; it doesn’t necessarily try to tease out the origins or blame your mother. CBT says, “Okay. When you do this, that happens. So when that happens, try this.” It is a more practical behavioral approach rather than years lying on a couch looking for clues.
I’m not dissing psychoanalysis at all. It can really help people. I’m merely describing CBT, which is a faster, more concrete behavioral approach to getting yourself under control. It is pretty successful in helping people deal with their fears and feel some ability to cope with them, even if the fears refuse to disappear.
I plan to address anxiety, panic disorders, and go more in-depth into medication for anxiety in upcoming posts.
Sources:
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, American Psychiatric Association
MayoClinic.com, Social Anxiety Disorder (Social Phobia)
