Social Anxiety Disorder (Social Phobia)

Introduction:

When it comes to mental health, most people do not realize that they are the victim of a mental health condition until they or their dear ones see their lives fall apart. Social anxiety disorder or social phobia is one such mental disorder. It is like an iceberg in the ocean. Just as only the tip of the iceberg is visible, and a massive part of it goes unnoticed under the waterline, the signs of social phobia are overlooked both by the individual and people surrounding them, eventually impacting their physical, mental, and social life negatively.

What Is Social Phobia?

Social situations like talking to new people, delivering a speech, or a stage performance might give slight nervousness or shyness in some people and is completely normal. But if this nervousness transforms into fear and dwells permanently (at least for six months) in a person necessitating the individual to avoid such incidents, thereby affecting their personal or professional life, it is known as a social anxiety disorder (SAD) or social phobia.

People often confuse the real signs of social phobia with the temporary shyness that most people experience during social interactions. As a result, the gravity of this disorder goes neglected, and such people hesitate to reach out to seek help thinking it to be a part of their personality.

How Do People With Social Anxiety Disorder Feel Like?

Though this disorder is expected to be more common, the varied intensity of signs one experiences and the type of social scenario puts some people’s lives at risk. People with social anxiety disorder are timid, afraid of being judged, and worried about getting rejected or humiliated by others in a social setup. They are constantly worried about facing the event or being in a scenario well before, during, and after the situation and for an extended period.

While under social situations or about to perform in a gathering, despite having the potential, they tend to,

• Get anxious and nervous.

• Feel nauseous and awkward.

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• Feel embarrassed.

• Sweat a lot, and their body feels hot.

• Make no or little eye contact.

• Go blank in their mind with a rapid heartbeat.

• Breath rapidly and shallowly.

• Experience tremors.

• Speak with a soft and shaky voice.

• Blush.

• Stammer.

• Become self-conscious about how they walk, talk, or look.

• Feel dizzy.

• Get scared of conversations with new people and hence avoid it.

• Have panic attacks.

In the act of over-preparing for the complications that might never occur, they avoid being in such social conditions like a meeting, dating, presentation, stage talks, discussion, hanging out with friends, etc. This might significantly impact their work and relationships.

What Causes Social Anxiety Disorder?

It is unclear what exactly causes social anxiety disorder, but a combination of factors listed below are considered to cause it.

• Genetics - It is thought that to some extent, social anxiety disorders can be heritable.

• Parenting Types - Overprotective parenting can provoke this disorder in their children.

• Childhood Trauma - Children facing adverse life events like their parent’s death, abuse, family conflict, etc., can also develop this disorder.

• Bullying - Children getting bullied at their schools and facing humiliations or rejections from their parents or caretakers also grow with social phobia.

• Brain Structure - People with an overactive amygdala, the brain structure related to fear response, develop an increased fear response.

What Situations Trigger Social Phobia?

Not all people with social anxiety disorder tend to experience phobia with all the below-listed scenarios while encountering them. It depends. The kind of social situation that triggers the phobia differs in each individual. They are,

• Going to the grocery store.
• Talking to the cashier.
• Entering a hall with many people already seated.
• Going to school or work.
• Dating.
• Taking part in official meetings.
• Going on a trip with friends and well-wishers.
• Attending birthday parties, weddings, and other social gatherings.
• Having a meal with people.
• Meeting unfamiliar people.
• Initiating conversations.
• Shopping.
• Attending phone calls.
• Attending an interview.

Which Group of People Are Affected By Social Phobia?

Social phobia is more common among teenagers. While some overcome and get rid of this as they grow, some find it challenging to come out of this disorder carrying it to their adulthood. Social anxiety disorder can also occur in children. They exhibit their social phobia in the following ways:

• When in school, they do not ask for even simple help like borrowing books or stationery from their classmates or friends.
• They do not reach out to their educator or friends when they have problems understanding the topic.
• Children avoid communication with everyone at school.
• They do not go out to play and mingle with their groups and isolate themselves.
• They fear going to school or taking part in any co-curricular activities.
• Children with this disorder cry and get angry a lot over simple things.

What Complications Can Social Phobia Cause?

In order to calm themselves before any social event or activity, individuals with social anxiety disorder tend to drink alcohol, believing that it might help cope with their symptoms of social phobia, gradually paving the way for alcohol addictions. In the long run, they also engage in substance abuse.

• Social phobia can adversely affect their work life. They will not be able to achieve their work goals and targets due to a lack of sociability. Their productivity gets affected, and they cannot take in healthy criticisms. Most of them are forced to leave their jobs due to such conditions.

• Relationships also do not work. Neither they approach any friend or family member, nor do they talk even if someone comes to them. Ultimately, they end up fighting their loneliness. Their quality of life gets affected.

• In school, the child’s academic performance declines.

• In extreme conditions, helpless adults with social phobia develop major depressive disorders, low self-esteem, and attempt or think of suicide.

How to Get Rid of Social Phobia?

Both pharmacological and non-pharmacological management methods are available. The treating physician will decide whether any one or combination of both methods of management is necessary.

Non-Pharmacological Treatment-

• Behavioral Therapy: A psychotherapist will conduct multiple talk therapy sessions to develop positive thoughts and eliminate existing negative thoughts. Through the sessions, they also make one aware that it is not others’ thoughts and actions, but it is one’s own that matters and affects how they behave or react.

• Exposure and Group Therapy: In this method, the affected person is forced to gradually face the social situations and participate in social skills with similar groups. This makes it more comfortable for them to overcome their difficulties without any fear of being judged.
• Anxiety-Free Lifestyle: Avoid caffeinated beverages, quit smoking and alcoholism, practice mindfulness (breathing exercises, meditation, mindful yoga, and guided imagery), eat nutritious, stay physically active, and sleep well. These measures help reduce anxiety.

Pharmacological Treatment-

• Antidepressants: Paroxetine, Venlafaxine, and Sertraline are drugs approved by the Food and Drug Administration to treat social phobia.

• Beta-Blockers: Drugs of this group are usually prescribed for instant use, such as taking the drug right before a presentation, interview, or speech. Also, they help in decreasing symptoms like tremors and rapid heartbeat.

• Anti-Anxiety Drugs: Benzodiazepines like Alprazolam belong to this group. As their name suggests, they reduce anxiety levels. They cause drug dependence and hence are prescribed for short-term use only.

Avoid depending on alcohol and other illegal drugs to soothe yourself temporarily. These do not offer a permanent solution for your problems. Instead, they worsen your condition additionally causing alcohol and drug abuse.

Conclusion:

If you yourself have symptoms of social anxiety disorder or know anyone fighting with it, just learn and convey the same that these disorders are treatable with a combination of the above management strategies. Persistent or worsening social phobia is more than just shyness and nervousness. Reach out to a psychiatrist or psychologist for help.