Understanding What Causes Social Phobia,
Its Symptoms & How to Treat Social Anxiety Disorder
What is Social Anxiety Disorder?
Do you always feel that people around you are criticizing
you or judging you? Do you find it difficult to interact with new
people or to speak at a gathering or a party?
Social Anxiety Disorder (also known as Social Phobia)
is characterized by an excessive fear of scrutiny by other people,
or by a persistent fear of humiliation or embarrassment in social
or performance situations. Exposure to any kind of social or performance
situation almost immediately provokes an anxiety response.
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People with Social Phobia are well aware of the
irrationality of their feelings, but nevertheless feel great apprehension
when facing the feared situation and hence go up to any lengths
to avoid them. For example, turning down a promotion to avoid presentations.
Also, when confronted with these social situations, there is a nagging
worry at all times about what the people are thinking or talking
about them
One of the main characteristics of Social Phobia
is the intense anxiety you feel prior to the social situation, which
is referred to as “Anticipated Anxiety”. So when you
actually confront the particular situation you are so overwhelmed
with nervousness and fear about it, that your worst fears regarding
facing the situation come true. This leads to increased level of
“Anticipated Anxiety” before the next social situation,
and in the process you are drawn into a vicious, self-perpetuating
cycle.
Social Anxiety Disorder is a lot more common than
you may think. It's actually the third most common psychiatric disorder
in the United States-1 out of every 8 Americans suffer from Social
Anxiety Disorder. This disorder can start as early as childhood
and tends to affect men and women in equal numbers. However, anyone
can suffer from Social Anxiety Disorder at any age.
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Although no one has discovered a single cause for
Social Anxiety Disorder, studies suggest that various factors including
Brain Chemistry, Genetics, Environment may play a role in the development
of Social Anxiety Disorder.
Biochemistry
Individuals with Social Anxiety Disorder (and other
emotional disorders) probably have abnormalities in the functioning
of some parts of their Anxiety-Response System.
There are several key Neurotransmitters, namely
Serotonin, Norepinephrine and Gamma-aminobutyric Acid (GABA), which
are produced in the brain and directly affect the way we feel about
a given thought or situation. Scientists are studying how an imbalance
in these could impact the functioning of our anxiety-response system.
Other studies have also pointed out that people
who are very sociable tend to have increased levels of Dopamine,
and drugs that act on levels of Serotonin and Dopamine in the brain
generally help to improve and reduce the symptoms of Social Anxiety
Disorder.
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Brain Structure
The Amygdala is the part of the brain that controls
your fear response. Recent brain-imaging research has indicated
that people who frequently experience social anxiety have an overactive
Amygdala and an underactive Prefrontal Cortex.
Genetic Predisposition
Researchers have still not found conclusive proof
to emphatically state the role of genes in causing Social Anxiety
Disorder. Scientists are seeking out specific genes that play a
role in anxiety and fear.
Social Anxiety Disorder seems to run in families.
However, it’s not clear whether the hereditary link is owing
to genetics or it is learnt behavior which a child picks up while
growing up from his parent / parents.
Environmental Causes
Environmental causes, especially during childhood,
can be very important in the development of social phobias. At this
stage of life, parents have an essential role, and may even suffer
from social phobia themselves.
For example, parents who are too protective, parents
who worry too much about their children or are shy themselves and
try to avoid certain social situations could transmit to their children
certain feelings and convictions that could make the children social
phobics.
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Combination of Genetics and Environment
Another school of scientists feel that social phobia
appears to be a combination of Genetics and Environment.
Heredity may predispose a person to develop Social
Phobia but in most cases it requires a trigger from the environment
for full-blown development of the disorder. This is what is commonly
referred to as a "Diathesis-Stress" model. The Diathesis,
or weakness, would be seen as a genetic predisposition toward shyness,
behavioral inhibition and anxiety.
The stress, or external force that taxes the individual's
coping resources could be any one of a number of events. It could
be a difficult school experience (such as giving a speech in class),
shame about body development related to puberty or any number of
pivotal issues.
Emotional Trauma
Scientists are also trying to focus their attention
to the connection between early-life emotional trauma and the development
of Social Anxiety Disorder. If you have experienced some trauma
as a child then you might develop Social Anxiety Disorder later
in life.
A diagnosis of Social Anxiety Disorder can indicate
either a "Specific Disorder" or a "General Disorder".
A Specific Disorder is when only one particular
situation causes social anxiety like speaking in public.
A Generalized Social Anxiety Disorder typically
involves a persistent, intense, and chronic fear of being judged
by others and of potentially being embarrassed or humiliated by
their own actions. These fears can be triggered by perceived or
actual scrutiny by others.
Situations that commonly provoke Anxiety include:
Interacting with new people
Speaking in front of people
Asking questions or giving reports in a group
Eating or drinking in front of others
Writing or working in front of others
Using public toilets
Being the center of attention
Talking on the telephone
Meeting people in authority (bosses, HODs etc)
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The symptoms of a person suffering from Social
Anxiety Disorder can be categorized into three distinct categories:
physical, behavioral and cognitive.
Physical Symptoms
Blushing
Profuse sweating
Palpitations
Cold, clammy hands
Difficulty making eye contact
Dry mouth
Muscle tension
Trembling voice
Disorientation
Stomach upset
Nausea
Diarrhea
Behavioral Symptoms
Excessive fear of social interaction, esp. with people you don’t
know
Dreading situations where you feel people will judgmental
Constantly worried about unbecoming behavior on your part
Anxiety about people noticing your awkward behavior
Avoiding or being fearful of any kind of social contact or
situations
Constantly being a victim of an all-consuming
anxiety that interferes with you normal, daily routine / activities
Cognitive Symptoms
Excessive concern about negative evaluation by people around
Poor self esteem; feeling of inadequacy
A feeling of being isolated
Feeling that you are perceived as anxious, weak, mad or stupid
by others
Suffering from a ‘negative bias’:
tendency to disregard your own positive social interactions
and magnifying the social abilities of others
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It's important to know that the anxiety you may
feel in social situations is not necessarily "just the way
you are." No matter how long you've lived with it, Social Anxiety
doesn't have to be part of your personality or your life. Social
Anxiety Disorder can be treated, no matter how or why it develops.
Several therapies already exist to help people
suffering from Social Anxiety Disorder, and researchers are working
hard to find even more treatments.
Some people with Social Anxiety Disorder may use
alcohol or drugs as a way to self-medicate to help them get through
social situations. In fact, about one quarter of all people with
Social Anxiety Disorder abuse alcohol. Although alcohol or drugs
may seem to help initially, they eventually become another problem
in the life of the person with Social Anxiety Disorder.
The two most effective types of treatment for Social
Anxiety Disorder are Medications and a form of Psychotherapy called
Cognitive Behavior Therapy. For the greatest effectiveness, they're
often used in combination.
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Types of Counseling used to treat Social Anxiety
Disorder include:
Cognitive Behavioral Therapy
Exposure Therapy
Social Skills Training
Cognitive Restructuring
Symptom Management Skills
Medications used include:
Selective Serotonin Reuptake Inhibitors (SSRIs)
Benzodiazepines
Monoamine Oxidase Inhibitors (MAOIs)
Beta-blockers
Venlafaxine
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