We all know what it feels like to be nervous or uncomfortable in social situations. Maybe you’re reticent when meeting new people, or your palms get sweaty before a big presentation. Public speaking or walking into a room full of strangers isn’t exciting for everyone, but most people can get through it. If you suffer from social phobia (also known as social anxiety disorder), these situations may be too stressful for you to cope with. For example, you might avoid all social contact because things that others consider “normal”—like small talk and eye contact—make you feel uncomfortable. Every aspect of your life, not just social interactions, may begin to fall apart. Social anxiety disorder affects approximately 5.3 million people in the United States. The average age it starts is between 11 and 19 years old - the teenage years. It’s one of the most common mental disorders, and here’s how to know if your social reticence has gone beyond shyness to the point where you need to see a doctor. ##When does it happen? In some people with social anxiety disorder, the fear is limited to one or two specific situations, such as speaking in public or initiating conversations. Others are extremely anxious and fear any social situation. Anyone with social anxiety disorder can experience it in different ways. Here are some common situations where you tend to get into trouble: - Talking to strangers - Public speaking - Going on a date - Making eye contact - Entering a room - Using a public restroom - Attending a party - Eating in front of others - Going to school or work - Initiating a conversation Some of these The situation may not cause you problems. For example, giving a speech may be easy, but attending a party can be a nightmare. Or you might be good at one-on-one conversations, but not so good at walking into a crowded classroom. All socially anxious people have different reasons to fear certain situations. But overall it’s an overwhelming fear of: - being judged or looked at by others in social situations - feeling embarrassed or humiliated - and showing it by blushing, sweating or shaking - accidentally offending people - being noticed Focus **Test to see if you suffer from social phobia? ** ##How do you feel? Again, everyone’s experience may be different, but if you have social anxiety and are in a stressful situation, you may feel: - Extremely self-conscious in social situations - A persistent, intense, and chronic fear of being judged by others - When being looked at Shy and uncomfortable (giving presentations, talking in groups) - Hesitant to talk to others - Need to avoid eye contact You may also have physical symptoms, such as: - Rapid heartbeat - Muscle tension - Feeling lightheaded - Blushing - Crying - Sweating - Stomach problems and diarrhea - Inability to breathe - An “out-of-body” feeling You may have symptoms and become anxious immediately before something happens, or you may worry about it for weeks. Afterwards, you may spend a lot of time and energy worrying about how you behaved. ##What is the cause? There is no one thing that causes social anxiety disorder. Genes may have something to do with it: If social phobia runs in your family, you’re more likely to develop it, too. It may also be related to overactivity in the amygdala, the part of the brain that controls fear responses. Social anxiety disorder usually occurs around age 13. It may be related to a history of abuse, bullying or teasing. Shy children are also more likely to become socially anxious adults, as are children with overbearing or controlling parents. If you have a medical condition that draws attention to how you look or sound, that can also trigger social anxiety. ##How does it affect your life? Social anxiety disorder makes it impossible for you to live a normal life. You’ll avoid situations that most people consider “normal.” You may even have a hard time understanding how others deal with these issues so easily. When you avoid all or most social situations, it affects your relationships. It can also lead to: - Low self-esteem - Negative thinking - Depression - Sensitivity to criticism - Poor social skills that do not improve ##How to deal with social anxiety disorder? If your social anxiety prevents you from doing the things you want or need to do, or making friends, you may need therapy. Talk to a doctor or therapist experienced in treating social anxiety disorder about your fears and concerns. They will be able to tell if you have normal social anxiety or if you need treatment. ##How to treat social anxiety disorder? Prescription medications and behavioral therapy are two effective treatments for social anxiety disorder. You can receive both treatments at the same time. Here are some details about each: Medication: For some people, taking prescription medications can be a simple and effective way to treat social anxiety disorder. These medications work by reducing uncomfortable and often embarrassing symptoms. Sometimes medications can significantly reduce your symptoms or even eliminate them. Some people may not respond to specific medications, and some may not help at all. It is impossible to predict whether a drug will help you. Sometimes, you have to try many things to find something that works. The U.S. Food and Drug Administration (FDA) has approved four drugs to treat social anxiety disorder: Paxil, Zoloft, Luvox, and Effexor. Although these are the only medications approved specifically to treat this condition, other medications can be used successfully. The advantage of medications is that they are very effective and only need to be taken once a day. But there are some disadvantages. First, medications can only treat symptoms. If you stop taking it, your symptoms may return. Second, some people have side effects from anxiety medications. They may include headaches, stomach aches, nausea, and trouble sleeping. Additionally, like all medications also used to treat depression, FDA-approved drugs for social anxiety disorder come with FDA warnings. The FDA said the drugs may cause or worsen suicidal thoughts or behavior in young people under 24 years old. Therefore, adolescents taking these medications should be closely monitored for changes in suicidal thoughts. For many people, the benefits of medications outweigh the disadvantages. You and your doctor must weigh your options. If you take medications for social anxiety disorder, contact your doctor immediately if you experience any side effects, including moodiness and depression. Never stop taking any anti-anxiety medication without talking to your doctor first. Stopping anti-anxiety medications suddenly can cause serious side effects. Behavioral Therapy: Behavioral therapy with a trained therapist can help you identify and change the thoughts that make you anxious in social situations. A type of behavioral therapy called exposure therapy is often used for social anxiety disorder. Exposure therapy works by gradually exposing you to uncomfortable social situations and then waiting until you feel comfortable. In the process, your brain will learn that the social situation you fear isn’t actually that bad. Most therapists who practice exposure therapy start with small exposures to uncomfortable situations and then move on to more difficult exposures as you feel comfortable. The advantage of this therapy is that you are treating the underlying problem, not just the symptoms of social anxiety disorder. Therefore, if you stop behavioral therapy, your symptoms will be less likely to return. There are other therapies you can try to treat social anxiety disorder. They include: Relaxation Therapy: With this treatment method, you learn relaxation techniques such as breathing exercises and meditation. While relaxation therapy may help with some specific forms of social phobia, it is not considered an effective treatment for anxiety disorders in general. Beta Blockers: These drugs were originally used to treat high blood pressure or other heart problems. However, beta blockers are also effective in treating some people with a specific type of social phobia called expressive social anxiety disorder. This is when you’re afraid of performing, such as giving a public speech. Beta-blockers are not effective in treating general social anxiety disorder. However, they may be helpful if you’re concerned that specific situations that occur at specific, predictable times (such as giving a speech in class) are your problem. ##When should I talk to my doctor about social anxiety? First, it’s important to know that if you have social anxiety disorder, you are not abnormal. Many people have it. If you have unusually high anxiety and fear of social situations, openly discuss treatment options with your doctor. If left untreated, social anxiety disorder can lead to depression, drug or alcohol problems, school or work problems, and reduced quality of life.
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