Social Anxiety Disorder

What is Social Anxiety Disorder

Social anxiety disorder, previously called social phobia, is a mental disorder. People with social anxiety disorder often feel nervous, afraid, or embarrassed when they are around other people in social situations.

They worry that other people are judging or criticizing them for how they look, what they say, or how they act.

Social anxiety disorder is more than just occasional shyness or self-consciousness. It can cause severe emotional distress. It can interfere with daily life activities. Social anxiety disorder also may lead to alcohol or drug use and even suicide.

Social anxiety disorder is a common mental disorder. It can develop at any time, but it usually starts in the teenage years.

What are the causes?

The cause of this condition is not known. It may involve genes that are passed through families. Stressful events may trigger anxiety.

What increases the risk?

This condition is more likely to develop in:

  • People who have a family history of anxiety disorders.
  • Women.
  • People who have a condition that makes them feel self-conscious or nervous, such as a stutter or a chronic disease.

What are the signs or symptoms?

The main symptom of this condition is fear of being criticized or judged in social situations. You may be afraid to:

  • Speak in public.
  • Go shopping.
  • Use a public bathroom.
  • Eat at a restaurant.
  • Go to work.
  • Interact with unfamiliar people.

Extreme fear and anxiety may cause physical symptoms, including:

  • Blushing.
  • Racing heart.
  • Sweating.
  • Shaky hands or voice.
  • Confusion.
  • Light-headedness.
  • Upset stomach, diarrhea, or vomiting.
  • Shortness of breath.

How is this diagnosed?

Your health care provider can diagnose this condition based on your history, symptoms, and behavior in social situations. Your health care provider may ask you about your use of alcohol or drugs, including prescription medicines. Your health care provider may refer you to a mental health specialist for further evaluation or treatment.

How is this treated?

Treatment for this condition may include:

  • Cognitive behavioral therapy. This type of talk therapy helps you learn to replace negative thoughts and behaviors with positive ones. This may include learning better coping skills and ways to control anxiety.
  • Exposure therapy. You will be exposed to social situations that cause fear. The treatment starts with situations that you can manage. Over time, you will learn to manage harder situations.
  • Antidepressant medicines. These medicines may be used for a short time along with other therapies.
  • Beta blockers. These medicines may help to control anxiety.
  • Biofeedback. This process trains you to manage your body’s response (physiological response) through breathing techniques and relaxation methods. You will work with a therapist while machines are used to monitor your physical symptoms.
  • Relaxation and coping techniques. These include deep breathing, self-talk, meditation, visual imagery, and yoga. Relaxation techniques help to keep you calm in social situations.

These treatments are often used in combination.

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Practice relaxation and coping strategies as taught by your health care provider.
  • Return to social activities as suggested by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your symptoms do not improve.
  • Your symptoms get worse.
  • You have signs of depression, such as:
    • A persistently sad, cranky, or irritable mood.
    • Loss of enjoyment in activities that used to bring you joy.
    • Change in weight or eating.
    • Changes in sleeping habits.
    • Avoiding friends or family members.
    • Loss of energy for normal tasks.
    • Feelings of guilt or worthlessness.
  • You become very isolated.
  • You find it very hard to speak or interact with others.
  • You are using drugs.
  • You are drinking more alcohol than normal.

Get help right away if:

  • You self-harm.
  • You have suicidal thoughts.

You can go to your nearest emergency department or call:

  • Your local emergency services (911 in the U.S.).
  • A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

  • Social anxiety disorder may cause you to feel nervous, afraid, or embarrassed when you are around other people in social situations.
  • Social anxiety disorder is a common mental disorder. It can develop at any time, but it usually starts in the teenage years.
  • Treatment includes talk therapy, exposure therapy, medicines, biofeedback, relaxation techniques, or a combination of two or more treatments.
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