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A Non-Profit
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A Non-Profit
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Social Anxiety Disorder (social phobia) is the third largest mental health care problem in the world today. The latest government epidemiological data show social anxiety affects over 7% of the population at any given time. The lifetime prevalence rate (i.e., the chances of developing social anxiety disorder at any time during the lifespan) stands slightly above 13%. Definition: Social anxiety is the fear of social situations that involve interaction with other people. Put another way, social anxiety is the fear and anxiety of being judged and evaluated by other people. Perceptions: People with social anxiety are many times seen by others as being shy, quiet, backward, withdrawn, inhibited, unfriendly, nervous, aloof, and disinterested. Paradoxically, people with social anxiety want to make friends, be included in groups, and be involved and engaged in social interactions. But having social anxiety prevents people from being able to do the things they want to do. Although people with social anxiety want to be friendly, open, and sociable, it is fear (anxiety) that holds them back. Triggering Symptoms: People with social anxiety usually experience significant distress in the following situations: Being introduced to other people Being teased or criticized Being the center of attention Being watched or observed while doing something Having to say something in a formal, public situation Meeting people in authority ("important people/authority figures") Feeling insecure and out of place in social situations ("I don’t know what to say.") Embarrassing easily (e.g., blushing, shaking) Meeting other peoples’ eyes Swallowing, writing, talking, making phone calls if in public This list is not a complete list of symptoms -- other symptoms may be associated with social anxiety as well. Emotional Symptoms: The feelings that accompany social anxiety include anxiety, high levels of fear, nervousness, automatic negative emotional cycles, racing heart, blushing, excessive sweating, dry throat and mouth, trembling, and muscle twitches. Constant, intense anxiety (fear) is the most common symptom. Insight: People with social anxiety know that their anxiety is irrational and does not make logical sense. Nevertheless, thoughts and feelings of anxiety persist and are chronic (i.e., show no signs of going away). Appropriate therapy is the only solution to this problem. Seeking Help: Social anxiety, as well as the other anxiety disorders, can be successfully treated today. In seeking help for this problem, we recommend searching for a specialist -- someone who understands this problem well and knows how to treat it. Social anxiety treatment must include an active behavioral therapy group, where members can work on their "anxiety" hierarchies in the group, and later, in real-life situations. Social anxiety is a fully treatable condition and can be overcome with work and patience. Therapy: Cognitive-behavioral therapy for social anxiety has been markedly successful. Thousands of research studies now indicate that, after the completion of social anxiety-specific CBT, people with social anxiety disorder report a changed life -- one that is no longer controlled by fear and anxiety. Appropriate therapy is markedly successful in changing people's thoughts, beliefs, feelings, and behavior. National Institutes of Mental Health-funded studies report a very high success rate using cognitive therapy with a behavioral therapy group. Both are essential to alleviating anxiety symptoms associated with social anxiety disorder. Medication: Social anxiety medication is useful for many, but not all, people with social anxiety disorder. For social anxiety, research indicates use of the anti-anxiety agents, and (perhaps) certain antidepressants in conjunction with CBT have proven most beneficial. Medication without the use of directed cognitive-behavioral therapy has proven to be temporarily helpful, but to bring about no lasting changes. Current research indicates many antidepressant medications for social anxiety disorder to be useless, even in the short-term. Compliance with Cognitive-Behavioral Therapy: Cognitive-behavioral (rational) therapy is not difficult to do, and has not been seen this way by respondents. The first factor in not complying with the therapy is that "I can't remember to do it every day" and "I have a hard time committing to something in which I don't see immediate results". Prognosis: Markedly good. People completing CBT training report a high success rate, compared to controls. In the National Institute of Mental Health longitudinal studies, people continued to report progress after CBT behavioral group therapy was over. Studies repeatedly indicate that treatment compatibility (i.e., did the person carry out the prescribed therapy?) is the key element in success. Using different terminology, the social anxiety people who understand and follow directions to be repetitive with the therapy report the most positive changes in lessening anxiety feelings and thoughts. Repetition and reinforcement of rational ideas, concepts, strategies, and methods is the key to alleviating social anxiety disorder on a long-term basis. Differential Diagnosis and Comorbidity: Social anxiety disorder is one of the five major anxiety disorders as listed in the DSM-IV. Social anxiety is many times mixed up with panic disorder. People with social anxiety do not experience panic attacks, in which the principal fear is of having a medical problem (e.g., heart attack). People with social anxiety realize that it is anxiety and fear that they are experiencing. They may say things like "It was awful and I panicked!", but, when questioned, they are talking about feeling highly anxious. They are not talking about the fear of having a medical problem. People with social anxiety tend not to go to hospital emergency rooms after an anxiety situation. People with panic disorder many times go to hospital emergency rooms, because they feel there is something physically wrong with them. High rates of alcoholism and other substance abuse, family difficulties and problems, lack of personal relationships, and difficulty in obtaining and continuing with employment are among the everyday problems experienced by many people with social anxiety disorder. Biggest Problem: Lack of professional and knowledgeable therapists is the biggest and most relevant problem to overcoming social anxiety. While it can be done, and a vast amount of clinical and research evidence supports this, overcoming social anxiety is difficult because of the scarcity of treatment options for people with this persistent anxiety disorder. Often, we are led to the conclusion that effective therapy comes only from people who have experienced this disorder themselves. --Thomas A. Richards, Ph.D.
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