Social phobia
Social phobia
Social phobia is a type of
anxiety disorder
. People who have social phobia experience extreme and persistent
anxiety
associated with social or performance situations. A person with social phobia experiences anxiety in situations where they are likely to be scrutinised and observed by others. They may have persistent fears about being judged, criticised, ridiculed or humiliated.
Most people feel shy or nervous in certain social situations. Public speaking or entering a roomful of strangers can cause anxiety in many people. However, this kind of common apprehension doesn’t indicate a social phobia. For people with social phobia, social situations provoke feelings that extend beyond simple anxiety or nervousness.
A social phobia occurs for a person when:
there is a persistent fear of one or more social or performance situations where they are exposed to unfamiliar people or to possible scrutiny by others. The person fears that they will act in a way that will be embarrassing and humiliating
feared situations are avoided or endured with intense anxiety and distress
a person realises that the social anxiety is excessive and unreasonable, but feels they are unable to change or control the feelings or behaviour
it interferes significantly with their daily life including work, education, family and social life
fear or avoidance isn’t due to a general medical condition or the physiological effects of a substance (such as
drugs
or
medications
).
It is estimated that around three per cent of the Australian population experience social phobia in any one year. Up to 13 per cent of the population may develop social phobia during their lifetime. Men and women are equally affected, though a higher number of men seek treatment.
In many cases, social phobia begins with shyness in childhood and progresses during adolescence. The onset of social phobia generally occurs around ages 11 to 15. Social phobia is also known as social anxiety disorder.
Symptoms of social phobia
When exposed to a feared social situation, a person with social phobia may experience symptoms of extreme anxiety, including:
blushing
trembling
feeling as if you have nothing to say
accelerated heart rate
shallow, fast breathing
sweaty palms
nausea
tense muscles
dry throat
stomach pain
feeling
faint
or light-headed
feelings of self-doubt and uncertainty
negative thoughts such as ‘I’m making a fool of myself’
difficulty concentrating on anything other than physical sensations of anxiety, negative feedback from others and negative thoughts
an overwhelming urge to flee the situation
the realisation that these feelings are irrational and out of proportion.
Social phobia – feared social situations
Some people with social phobia fear and avoid specific situations (such as public speaking), while others may feel generalised anxiety about several social situations (generalised social phobia). A person with social phobia can fear (and try to avoid) a range of situations, including:
crowds and parties
public speaking
starting or having a conversation
talking to a large group
voicing opinions
meeting someone new, shaking hands
dating
using public toilets
shopping
talking with someone who is in a position of seniority or authority
being watched while doing something, such as eating, signing papers or talking on the telephone
situations that put them in the spotlight, such as parties to celebrate their own birthday.
Social phobia – underlying fears
Some of the fears commonly aroused by social situations can include:
worry that others will notice their physical symptoms of anxiety, such as blushing, sweating, and stammering
fear of looking stupid, silly, or ridiculous
fear of appearing quiet, boring and uninteresting to others
fear of being judged as socially inadequate.
Social phobia can extend beyond the social event
A person with social phobia can feel anxious while simply anticipating an upcoming social event. After the event, the person may replay the conversations they had and rate their performance. Brooding on these feelings of social failure can make the person feel even worse, and reinforce the desire to avoid social situations in the future.
Common complications of social phobia
If left untreated, social phobia can severely affect quality of life. Some of the common complications may include:
using
alcohol
to cope with anxiety during social events
alcohol abuse
misuse of prescription and non-prescription drugs
difficulty forming and maintaining
relationships
curtailed education or employment opportunities
depression
suicidal thoughts
isolation from family, peers and community
reluctance to leave the house.
Treatment options for social phobia
Recovery from social phobia is possible with appropriate treatment. Depending on the individual, treatment options may include:
cognitive behaviour therapy (CBT)
anxiety management techniques
social skills training
medication
.
Cognitive behaviour therapy (CBT)
Cognitive behaviour therapy aims to help people change the way they think, feel and behave in social situations. These techniques may help people to confront their fears. In time, people come to realise that others are unlikely to judge them harshly – and even if it does happen, they realise it’s not a major tragedy. They will also learn that they can exert some control and choice over their thoughts and feelings.
Treatment using CBT may include:
education about the nature of social anxiety
challenging and changing false or distorted thoughts and beliefs
gradual exposure to feared situations
attention training.
Anxiety management techniques
Relaxation training and breathing techniques may help a person manage their anxiety symptoms. Some physical anxiety symptoms may be triggered by hyperventilation (overbreathing). Taking slow, deep breaths from the abdomen – rather than fast, shallow breaths from the chest – can reduce anxious feelings.
Relaxation techniques include:
progressive muscle relaxation
mindfulness
meditation
visualisation
isometric relaxation exercises.
Social skills training
Some people who have suffered with social phobia for many years may develop habits that make it difficult for them to take steps towards recovery. For example, they may:
find it difficult to make or maintain eye contact
use soft or hesitant speech
display closed body language
have rigid facial expressions
need a large personal space
have difficulty listening or keeping a conversation going.
Social skills training methods include modelling the appropriate behaviour, role-playing and then practising in real-life situations.
Medication
Some medications, such as selective serotonin re-uptake inhibitors (SSRIs), can help if the person is also suffering from depression. In the short term, drugs such as beta-blockers may be used to help manage some of the symptoms of anxiety.
Where to get help
Your
GP (doctor)
Psychologist
Anxiety Recovery Centre Victoria
Helpline
External Link
Tel.
(03) 9830 0533
or
1300 ANXIETY (269 438)
Australian Psychological Referral
Service
External Link
Tel.
(03) 8662 3300
or
1800 333 497