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Social Anxiety Disorder: Do you have social phobia?

What is social anxiety disorder?

Anxieties are normal, but if they interfere with daily activities of an individual, one may be suffering from an anxiety disorder. Social anxiety disorder also known as social phobia, is the fear of social circumstances involving interaction with other people. Individuals suffering from social anxiety disorder, have anxiety, self-consciousness and embarrassment and fear of being judged or negatively assessed by others which result in interference with routine activities, deterioration in occupational, school and personal life. Social anxiety disorder is chronic in nature, and symptoms of this disorder generally start by the age of 13 years.

Social anxiety disorder is the 3rd largest, most common psychiatric disorder worldwide. Millions of individuals suffer from this serious traumatic and devastating condition every day.

With medication, psychological counselling and adapting coping skills, one can improve their ability to interact with others and gain confidence.

Social anxiety disorder arises owing to various interactions of the biological, environmental and genetic factors.

Causes and risk factors

Causes

Social anxiety disorders can result from:

  • Genetics: Some anxiety disorders occur in some families. How exactly the genetics and the learned behaviour play a role is not clear.
  • Brain structure: Amygdala in the brain has been linked to controlling fear response. Individuals with amygdala which is overactive may have amplified fear responses, leading to more anxiety in social scenarios.
  • Environment: Social anxiety disorder could be a learned behaviour. One may pick up this condition after observing the anxious behaviour of other individuals. There could be some association between the overprotective parents and social anxiety disorder. Negative experiences like bullying and family conflict also can contribute to Social anxiety disorder.

Symptoms and signs

Behavioural and emotional symptoms of social anxiety disorder include persistent:

  • Fear of circumstances where one might be judged
  • Concerns of offending others
  • Intense fear of talking or interacting with strangers
  • Worries about humiliation and embarrassment
  • Avoiding situations where one will be the centre of attention
  • Excessive blushing, trembling, stammering  and sweating
  • Panic attacks
  • Avoiding people due to embarrassment fear
  • Brooding over social interactions
  • Assuming the worst possible consequences from negative experiences in the past

Physical symptoms and signs can include an upset stomach, fast heartbeat, confusion, shaking and panic attacks. The symptoms of social anxiety disorder may change over time.

In children, symptoms include crying, refusal in having a social conversation with peers, temper tantrums and clinging to parents.

Diagnosis

Physical examination is done by the doctor to see if any physical causes are triggering the symptoms. Your mental health care provider may question you about the occurrence frequency and ask you to describe such situations. The mental health care provider may provide you or the child with a psychological questionnaire to diagnose social anxiety disorder.

Treatment and prevention

Treatment

Treatment for social anxiety disorder includes medication and psychotherapy. Both of them may be used in unison:

Medicine: Antidepressants -Selective serotonin reuptake inhibitors (SSRIs) are prescribed for treating social anxiety disorder. Tricyclic antidepressants are also prescribed.

Psychotherapy: Here one learns ways to handle social interactions and gain confidence in such situations. These may include role-plays and developing social skills.

Prevention

It can’t be predicted as to who will suffer from social anxiety disorder, so prevention is not possible. Steps to lessen the symptoms include:

  • Seek help: Early treatment can help than waiting for long.
  • Keep records: Keeping a record of daily events can help your doctor in identifying triggers.
  • Avoiding substance abuse and prioritising things in life can help in managing one’s time and energy.

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Complications

Social anxiety disorder can interfere with one’s school, work, relationships and other aspects of life.  It may lead to:

  • Hypersensitivity
  • Low self-esteem
  • Isolation
  • Low grades or poor job performance
  • Substance abuse
  • Suicidal ideation

Next steps

Visit your doctor if you panic, worry or feel embarrassed during normal social interactions.

Red Flags

Visit your psychiatrist if you or your near one are:

  • Avoiding social interaction with people
  • Remaining depressed for most of the day
  • Not eating properly
  • Worried about people’s opinion of his/herself
  • Showing signs of panic attacks before talking to anyone

Consult a top Psychiatrist

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References

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1. Anxiety Disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/social-phobia-social-anxiety-disorder/index.shtml

2. Social Anxiety Disorder. Anxiety Disorders Association of America. Accessed 28 Mar. 16. http://www.adaa.org/sites/default/files/July%2015%20Social%20Anxiety_adaa.pdf

3. Social Anxiety Fact Sheet. Social Anxiety Association. Accessed 28 Mar. 16. http://socialphobia.org/social-anxiety-disorder-definition-symptoms-treatment-therapy-medications-insight-prognosis

4. What is Social Anxiety? Social Anxiety Institute. Accessed 28 Mar. 16. https://socialanxietyinstitute.org/what-is-social-anxiety

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