SOCIAL ANXIETY

Social anxiety belongs to the group of neurotic disorders and is the third most common mental disorder (after depression and alcohol addiction) in the general population. Despite how frequently it occurs, it often goes unrecognized. This is because it is confused with ordinary shyness; moreover, people with social phobia tend to live isolated lives, staying away from other people and therapists.

Social anxiety usually affects young people, beginning in adolescence, around ages 12-14. In the general population, it affects about 7% of people and occurs twice as often in women as in men. Like other types of phobia, social anxiety is a serious mental disorder and should be treated by a specialist.

Symptoms

Social phobia is characterized by fear of some or all social situations. The person is afraid of contact with other people, embarrassment in social situations, and being in the spotlight. This fear is excessive, unjustified, worsens normal professional and social functioning, and causes significant discomfort and suffering for the affected person. Exposure to anxiety-provoking situations leads to a number of physical symptoms, such as:

• rapid heartbeat,
• severe facial blushing,
• increased sweating,
• shortness of breath,
• trembling hands,
• dizziness,
• tinnitus,
• nausea,
• pressure on the bladder,
• a sudden urge to have a bowel movement,
• speech disorders.

Causes

The most common situations that lead to the onset of symptoms of social phobia are:

• public speaking,
• introducing oneself,
• calling someone on the phone,
• conversations with your supervisor,
• meetings with people regarded as authority figures,
• eating in the company of others,
• writing or doing other things while being watched,
• meetings with a person of the opposite sex, dating.

Diagnosis

According to the DSM classification, social phobia is diagnosed when:

• there are fears that words or actions may cause humiliation or embarrassment,
• exposure to or even thinking about social exposure causes anxiety and physical symptoms,
• the fear of humiliation or embarrassment is unjustified or excessive,
• there is avoidance of anxiety-provoking situations and severe stress during exposure to social situations,
• suffering caused by avoiding social situations is present,
• there are social and occupational problems.

Treatment and effects

Social phobia prevents normal functioning in society and affects the behavior of the affected person. Such a person avoids uncomfortable and unpleasant situations. Children with social phobia therefore try not to stand out in class, are reluctant to approach the board, do not speak in front of the class, and do not participate in discussions during lessons, which may affect how teachers assess them. When a person with social phobia has to be in a situation that causes anxiety, a kind of panic attack occurs. In such circumstances, all everyday activities become impossible for a person with social phobia to carry out.

People with social phobia often remain single and are less likely to marry; they find it more difficult to pursue an education despite having the relevant intellectual knowledge and abilities; therefore they do not take jobs or accept less responsible, and thus lower-paid, positions. Their family and social life also suffers as a result. They are often dismissed and/or go on disability benefits or public assistance.

Social phobia is often accompanied by other neurotic disorders. Studies conducted in the United States indicate the following co-occurrence rates: Studies conducted in the United States indicate the following co-occurrence rates:

• The most common co-occurring condition is agoraphobia—the fear of being in open spaces. It occurs in 45% of people suffering from social phobia.
• Because alcohol use temporarily reduces feelings of anxiety, people with social phobia are particularly vulnerable to addiction. 20% of people with social phobia suffer from alcoholism. Research indicates an increased risk of suicide among male alcoholics who also suffer from social phobia. Psychoactive substances may also give patients a temporary feeling of relaxation; their misuse was observed in 13% of those studied.
• Depression occurs in 20% of people with social phobia, with women being much more susceptible to it than men. Depression appears on average 12 years after the first symptoms of the phobia.
• Dysthymia occurs in 15% of people with social phobia.
• 12% of patients suffer from obsessive-compulsive disorder.
• 7% experience sudden panic attacks.

Other studies also indicate a higher occurrence of bipolar disorder, body dysmorphic disorder, eating disorders (anorexia, bulimia), and generalized anxiety disorder than in healthy people. It is also not uncommon for people affected by social phobia to be prone to procrastination. The presence of an avoidant personality is also associated with social phobia. There is also a higher risk of suicide among those affected.

Therefore, do not underestimate the symptoms of social phobia and seek help from a psychiatrist. Combination therapy is used to treat social phobia: psychotherapy and pharmacotherapy. Patients with social phobia need long-term therapy that lasts at least a year. It should be remembered that proper treatment makes a normal life possible.