Social anxiety is a serious condition that may touch every area of a person’s life, as it prohibits their ability to interact with the world at large. Social phobia is the clinical term used to describe intense fear of humiliation and embarrassment in either social or evaluative situations. Social situations can include dating, attending parties, meeting strangers and talking to authority figures. Evaluative or performance situations include public speaking, job interviews, eating, drinking or writing in public. Avoiding use of a public bathroom also falls under this category. The extreme unease in these situations may provoke a panic attack.
Individuals who are diagnosed with social phobias fear being exposed to scrutiny and being judged, fearing they might embarrass or humiliate themselves with awkward actions or speech. They may refuse to speak in public for fear of sounding inarticulate. Most people who experience social phobias fear several types of situations rather than just one.
While it is common for many individuals to feel uneasy before speaking in public or meeting people for the first time, those who are diagnosed with social phobia recognize that their reaction is extreme, excessive and often unwarranted. Social phobia can be a debilitating condition causing people to drop out of school, avoid dating, quit jobs or never seek employment.
Less Severe Anxiety
It is important to note that stage fright is a common, normal experience for most people, and does not fall under the category of social phobia. Anxiety in new situations and with new people is also common and does not point to a mental health issue, unless it is severe or extreme.
Individuals who have a low level of persistent anxiety in social situations may have a generalized anxiety disorder. With generalized anxiety disorder (GAD), individuals typically report constant and excessive worry for six months or more, but the worry is not exclusive to social or performance situations. Generalized anxiety disorder also includes physical symptoms of irritability, sleep disturbance, difficulty concentrating and muscle tension.
Social Anxiety in Children
For individuals under age 18, social anxiety is often displayed as a refusal to speak, refusal to attend school, separation anxiety and extreme shyness. However, these behaviors must be ongoing for at least six months before mental health professionals make a diagnosis of social phobias. If school age children have generalized anxiety (less severe) they may have fear and unease focused on school and sports, but they may also worry about natural disasters and war.
Questions to Ask
The following list includes some characteristics common if experiencing social anxiety. If these descriptions sound familiar, you may be experiencing a social phobia, but only a qualified mental health professional can make that determination.
Characteristics indicating social anxiety:
- Overwhelming and constant fear of being negatively judged by others
- Deep and continuing fear of embarrassing themselves
- Distinct and ongoing terror before speaking or performing in pubic, sometimes months or weeks before the event
- Uneasy meeting strangers, using public bathrooms, eating, drinking or writing in public
- Panic attacks sometime occur in these stressful situations
- Experiencing other physical symptoms including sweating, hoarseness and shaking
- Refraining from these situations or reluctantly engaging in them with dread and distress
- Extreme worry and nervousness about having anxiety
- Refraining from the activity that generates anxiety results in a major, negative impact on daily life
- Avoiding activities that involve work, school, or family
- Avoiding social interaction such as attending parties, dating, and generally socializing with others
- Recognition that the fear is unreasonable and unwarranted
Why Does It Occur?
Social anxiety occurs in approximately 10-15 percent of the adult population. It usually develops in the middle teenage years, often in individuals who were shy as children. It may also begin after a stressful, embarrassing event or may appear with no direct cause. In general, a social phobia is believed to be a learned behavior, either from a direct traumatic experience or through a vicarious trauma (seeing others traumatized, hearing stories or seeing photos of others’ trauma). However there is evidence that some individuals may be genetically predisposed to more fearful reactions in life.
Stressful life situations may make social anxiety more distressing or more prevalent, which can develop into a social phobia. These do not resolve itself with time and individuals do not generally “grow out of it.” Social phobias can also make a midlife appearance, if life and work require participation in performance and social events.
How Is It Treated?
Treatment for social anxiety is designed to help the individual reduce fear and develop social skills. Relaxation techniques such as deep breathing and visualization are frequently taught in individual or group therapy sessions, and the individual is expected to practice self-relaxation at home. Cognitive therapy is used to challenge people’s thoughts and improve their perception of themselves. Social skills training may include practice in maintaining eye contact, posture or tone of voice. Role playing may be used to practice skills, while other techniques involve using a video or voice recorder. Medications are not indicated to cure social phobias but may be used to alleviate symptoms.
Unfortunately, those with social phobias may be reluctant to seek treatment, but they should: Social anxiety is a treatable condition.