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What is social anxiety disorder?
Social anxiety disorder, also known as social phobia, is a recurrent disproportionate fear of social situations, where a person fears being judged, criticised or humiliated in front of other people.
Social anxiety disorder is not just being shy or nervous when in formal situations or when having to give a speech – situations where many people feel apprehensive. It happens in ordinary everyday situations, such as eating in public, meeting people, or being watched while doing something. A person may feel that they will humiliate or embarrass themselves.
The fear of embarrassment and of being judged causes people with social anxiety disorder to avoid or limit social situations, which may then impact their personal relationships, lead to loneliness, reduced success at school or work, depression and substance abuse.
What are the symptoms of social anxiety disorder?
Symptoms of social anxiety disorder are both physical and psychological and include:
- feeling anxious in social situations
- feeling self-conscious around other people
- increased heartbeat, sweating, dizziness, and trembling
- blushing or stammering when speaking
- upset stomach — diarrhoea or feeling sick
- replaying social situations repeatedly in your mind after they have occurred
The common physical symptoms of anxiety such as excessive sweating, a pounding rapid heartbeat, nausea, shaking, blushing and stammering can be particularly stressful for someone with social anxiety disorder since these symptoms can cause further embarrassment as the person worries that people may notice.
Symptoms of social anxiety disorder may be so intense that they affect your life and prevent you from participating in everyday social events in your personal or work life.
What causes social anxiety disorder?
A number of factors may contribute to a person developing social anxiety disorder. These include:
- genetic factors — social anxiety disorder can run in families
- temperament — shy or excessively timid children or adolescents are more at risk
- being bullied, embarrassed or poorly treated
Social anxiety disorder is common in Australia and often starts in childhood.
When should I see my doctor?
If you think you may have social anxiety disorder you should seek help from your general practitioner or a mental health professional. There are psychological treatments and coping strategies that can help, as well as medication.
If you find it difficult to interact with a medical professional, ask a friend or family member to help book an appointment for you. It may help if they go with you to the appointment.
If you can’t cope with seeking professional help yet, there are many online resources for coping with anxiety, including those for mindfulness and meditation, and peer support groups and helplines, where you can chat to other people who feel the same way.
How is social anxiety disorder diagnosed?
A person can be diagnosed as having social anxiety disorder if they have had typical symptoms that have caused significant distress for at least 6 months.
How is social anxiety disorder treated?
Social anxiety disorder can be treated with psychological therapies (talking therapies). These strategies can help to change your underlying thinking patterns, which helps to keep anxiety under control.
Cognitive behaviour therapy (CBT) is a type of psychological treatment which can be used to treat social anxiety disorder. In CBT, you work with a psychologist or doctor to identify unhelpful thinking patterns and reprogram them. It also helps with relaxation and breathing to manage anxiety. It usually takes between 8 and 12 sessions.
Many people with mild social anxiety disorder can be treated with psychological therapies only, but if the anxiety is moderate to severe, medications may be needed in conjunction with CBT. Children with social anxiety are usually treated with psychological therapies only.
The medications most often used to treat social anxiety disorder are antidepressants — specifically SSRIs (selective serotonin reuptake inhibitors).
How can social anxiety be prevented?
Social anxiety can be prevented by challenging negative thinking patterns and retraining yourself to avoid ‘safety behaviours’, which make you feel more comfortable in social situations, but are actually prolonging the social anxiety. Alcohol and drugs are an example of a safety behaviour.
CBT has been used widely to prevent social anxiety
What are the complications of social anxiety disorder?
It’s common among people with social anxiety disorder to suffer from depression, to have a problem with alcohol or drug use. People may use these substances to help with anxiety or to self-medicate anxiety, but then become reliant on them.
