Social Anxiety Disorder
(social phobia) is the third largest mental health care
problem in the world.
epidemiological data show social phobia 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 at above 13%.
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. If a person
usually becomes anxious in social situations, but seems fine
when they are alone, then "social anxiety" may be the problem.
People with social anxiety are many times seen by others
as being shy, quiet, backward, withdrawn, inhibited, unfriendly,
nervous, aloof, and disinterested. People with social anxiety
want to be "normal" socially, they want to make
friends and they want to be involved and engaged in
Having social anxiety prevents
people from being able to do the things they want, however.
Symptoms: People with social anxiety usually experience
significant distress in the following situations:
introduced to other people
Being teased or
center of attention
situations where the person exhibits excessive
or observed while doing something
Having to say
something in a formal, public situation
in authority ("important people/authority figures")
insecure and out of place in social situations ("I don't know
what to say.")
easily (e.g., blushing)
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.
The feelings that accompany social anxiety include
anxiety, intense fear, nervousness, automatic negative thinking
cycles, racing heart, blushing, excessive sweating, dry throat
and mouth, trembling, and muscle twitches.
Constant, intense anxiety is
the most common feature.
People with social anxiety know that their anxiety is
irrational and does not make logical sense. Nevertheless,
thoughts and feelings of anxiety persist and show no signs of
going away, without appropriate treatment.
Cognitive-behavioral therapy for social anxiety has been
markedly successful. Thousands of research studies now indicate
that, after CBT, people with social anxiety disorder report a
changed life -- one that is no longer controlled by fear and
National Institutes of Mental
Health-funded studies report a very high success rate using
cognitive therapy and a behavioral therapy group. Both are
essential to alleviating anxiety symptoms associated with social
Social anxiety medication is useful for many people, and
psychologists and therapists should work with the persons
medical doctor and/or psychiatrist if at all possible. For cases
of generalized social anxiety, research indicates use of the
anti-anxiety agents, and certain antidepressants in conjunction
with CBT has proven most beneficial. As to antidepressants, the
MAOIs have the highest success rate when combined with CBT.
Medication without CBT has proven to be only temporarily
Markedly good. People completing CBT training report a high
success ratio. In the NIMH longitudinal studies, people
continued to report progress after the CBT behavioral group
therapy was over.
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 "fear" hierarchies in
the group, and later, in real-life situations.