Social Anxiety Disorder
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KEY POINTS
- Social anxiety disorder is a severe fear of being watched and judged by other people that stops you from doing things such as public speaking, going to a party, or using a public restroom.
- Treatment may include cognitive behavioral therapy, exposure and response prevention therapy, assertiveness training, or medicines.
- Learning ways to relax may help.
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What is social anxiety disorder?
Social anxiety disorder is a severe fear of being watched and judged by other people. Many people feel shy or nervous in social situations, but social anxiety disorder is a much more intense fear. If you have this disorder, you fear that if you do things when other people are around, you will look foolish and be embarrassed. The fear stops you from doing things such as public speaking, going to a party, shopping in stores, eating in front of others, or using a public restroom. You are always tense and on edge around other people. Social anxiety disorder is also called social phobia.
Without treatment, social anxiety disorder can last a lifetime. However, treatment is very successful.
What is the cause?
The exact cause of this disorder is not known.
- The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals. Some parts of the brain may be more active or less active than in other people.
- Social anxiety tends to run in families. It is not known if this is caused by genes passed from parent to child. It may also be that overprotective parents fear and avoid social events, and children learn this behavior from the parents.
- Social anxiety may start after a frightening or hurtful experience, such as being bullied or abused. Being very self-critical might also lead to social anxiety.
Social anxiety usually starts in the teen years, but may begin in childhood.
What are the symptoms?
Symptoms of social anxiety disorder may include trembling voice, fast or irregular heartbeat, hot and flushed skin, sweaty palms, nausea, headaches, stomachaches, or diarrhea. Feelings that you may have with social anxiety include:
- Anxiety when you are the focus of attention, even for a short time
- Fear of being judged and rejected
- Fear that you will offend someone
- Fear that other people will notice how nervous you are
- Fear of unfamiliar places
- Fear of being embarrassed that is so severe that you cannot work, go to school, or take part in social activities
- Knowing that your anxiety is not logical or reasonable
If you have this disorder you may panic when you think about being in a social situation, and worry about what people think of you for hours afterward. Social anxiety can lead to lack of self-confidence, lack of self-esteem, depression, alcohol and drug abuse, and suicide.
How is it diagnosed?
Your healthcare provider or therapist will ask about your symptoms. He will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms.
How is it treated?
Psychotherapy
Cognitive behavioral therapy (CBT) may help you learn to change your response to situations. Replacing negative thoughts with more positive ones can help you to control the fear. Group therapy with other people who have social anxiety is very helpful.
Exposure and response prevention therapy (ERPT) helps you face your fears. You learn ways to control your body's response to anxiety. Assertiveness training may help you feel less fearful and more self-confident.
Medicines
Several medicines can help treat social anxiety disorder. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.
Natural Remedies and Alternative Treatments
Claims have been made that certain herbal and dietary products help control anxiety symptoms. Supplements are not tested or standardized and may vary in strength and effects. They may have side effects and are not always safe. Talk with your provider before you try herbs or dietary supplements to treat your condition.
Learning ways to relax may help. Yoga, meditation, and deep breathing exercises may also be helpful. Hypnosis can also help. You may want to talk with your healthcare provider about using these methods along with medicines and psychotherapy.
How can I take care of myself?
- Get support. Consider joining a support group in your area. Go to an assertiveness training class in your local community.
- Learn to manage stress. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
- Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and don't skip meals. Low blood glucose can make you feel more nervous. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions. Regular exercise can help calm you and make it easier for you to deal with stress.
- Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.
- Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse. Sometimes this illness makes you afraid to see your provider or therapist. Watch for this and be honest with your provider or therapist about it.
Get emergency care if you or a loved one has serious thoughts of suicide or self-harm.
For more information, contact:
- National Alliance on Mental Illness (NAMI)
800-950-NAMI
http://www.nami.org - Mental Health America
800-969-6642
http://www.mentalhealthamerica.net/
