People with social phobia become very anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary
activities, and can make it hard to make and keep friends, let alone have a romantic relationship.
Social phobia is different from shyness. Shy people are able to participate in social functions. Social phobia affects the ability to function in work and relationships. Some of the most common fears of people with social phobia include:
- Attending parties and other social occasions
- Eating, drinking, and writing in public
- Meeting new people
- Speaking in
- Using public restrooms
Although many people with social phobia realize that their fears about being with people are excessive or unreasonable, they are unable to overcome them on their own. Social phobia can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others). Or, it may be so broad (such as in generalized social phobia) that the person experiences anxiety around almost everyone other than family members. Physical symptoms that often occur with social phobia include:
- Difficulty talking
- Profuse sweating
The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of the phobia. Anti-anxiety and antidepressant medications are
sometimes used to help relieve the symptoms of phobias. Cognitive-Behavioral treatment and experiential learning appear to have long-lasting benefits.
- Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts.
- Systematic desensitization or exposure therapy may be used to treat phobias. You are asked to
relax, then imagine the things that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears.
- Social skills training may involve social contact in a group therapy situation to practice social
skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation.
Lifestyle changes and self care may help reduce how often the attacks occur.
- Get regular exercise, enough sleep, and regularly scheduled meals.
- Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other
- Relaxation, meditation, deep-breathing, and mindfulness training can also help
- Increasing self esteem can also help a great deal
The outcome is generally good with treatment, and antidepressant medications have been shown to be very effective.
- 001953/Stein MB, Stein DJ. Social anxiety
CT, Pollack MH, LeBeau RT, Simon NM. Anxiety disorders: Panic,
social anxiety, and generalized anxiety. In: Stern TA, Rosenbaum
JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital
Comprehensive Clinical Psychiatry. 1st ed. Philadelphia,
Pa: Mosby Elsevier; 2008:chap 32.