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Social Anxiety Disorder

(Social Phobia)

Definition

Social anxiety disorder is the intense fear of social situations. People with social anxiety disorder:

Avoid interactions with other people
Are extremely afraid of being judged negatively by others
Feel humiliated, embarrassed, and inadequate more easily than others

Social anxiety may be:

Generalized to all social interactions
Specific to certain social situations, such as public speaking

Social anxiety disorder is much more severe than shyness. It can interfere with work, school, or other situations, as well as cause physical symptoms.

Physical Reactions of Anxiety

Causes

The exact cause is unknown. Possible causes include:

Genetic factors
Problems with the regulation of chemicals in the brain
Past emotional trauma in social situations

Risk Factors

Factors that increase your chance for social anxiety disorder include:

Age: adolescence and early adulthood
Other psychiatric disorders (such as anxiety disorder, bipolar disorder, depression, or drug abuse)

Symptoms

Symptoms during social interactions may include:

Blushing
Excessive sweating
Trembling
Dry throat and mouth
Muscle twitches
Intense anxiety
Rapid heart beat
Lightheadness (feeling like you are going to faint)

Symptoms may begin in any public situation such as:

Being teased or criticized
Being the center of attention
Meeting new people
Interacting with authority figures
Interacting with members of the opposite sex
Eating, writing, or speaking in public
Using public toilets

Diagnosis

Your doctor will ask about your fears and symptoms. A physical exam may be done. You may be referred to a mental health therapist. The therapist may do a psychiatric evaluation.

Treatment

Treatments include:

Cognitive-Behavioral Therapy

During cognitive-behavioral therapy, the therapist may:

Help you change your negative thought patterns and behaviors
Teach you techniques to help you control anxiety symptoms (eg, deep breathing, visualization, meditation)
Suggest changes to your social environment to minimize stress
Gradually expose you to feared situations in a controlled environment

A support group may also be part of your treatment.

Medication

Your doctor may recommend:

Selective serotonin reuptake inhibitors (SSRIs) or other antidepressants—to help relieve symptoms of anxiety and depression
Beta-blockers—to stop the physical symptoms of panic and anxiety (has been used to relieve the performance anxiety that often occurs with social anxiety disorder)

Your doctor may try using other medicines to help control your symptoms. Examples include:

Benzodiazepines
Anticonvulsants

Prevention

There are no guidelines for preventing social anxiety disorder. But early diagnosis and treatment can prevent complications, such as:

Drug abuse
Depression
Difficulties at school, work, or in your personal life

RESOURCES

Anxiety Disorders Association of America http://www.adaa.org/

Social Phobia/Social Anxiety Association http://www.socialphobia.org/

CANADIAN RESOURCES

Canadian Psychiatric Association http://www.cpa-apc.org/

Canadian Psychological Association http://www.cpa.ca/

References

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273 . Published May 22, 2009. Accessed August 27, 2012.

National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ . Accessed October 12, 2005.

National Mental Health Association website. Available at: http://www.nmha.org/ . Accessed October 12, 2005.

Revision Information

Reviewer: Brian Randall, MD
Review Date: 09/2012 -
Update Date: 00/91/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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