What Is Social Phobia?

Social phobia is a sort of catch-all diagnosis that may include several more specific fears. The phobia can be divided into two main types: specific, in which one or more situations are feared, and generalized, which encompasses multiple situations. Although social phobia is popularly considered a fear of other people, it is actually a fear of acting in an embarrassing way.

For example, you may be afraid of speaking in front of others, performing in front of others, or simply being around other people. Whatever specific situations you fear, all forms of social phobia share several common characteristics.

Symptoms of Social Phobia

Each person's symptoms are a little bit different. The exact symptoms that you experience depend on many factors, including the severity of your social phobia. Common symptoms of social phobia include, but are not limited to:

• Fear: You may feel a sense of dread or doom beginning in the days leading up to a scheduled social event. During the event, your dread may become overwhelming.

• Physical Symptoms: You may have a physical reaction similar to a panic attack. Intense blushing, shaking, palpitations, and stomach distress are particularly common.

• Self-Judgment: Many people with social phobia feel that they are being intensely scrutinized by those around them. You may become hyperaware of the way you walk, talk, chew, and perform other everyday actions. Becoming very critical of yourself is also common.

Diagnosing Social Phobia

Like any phobia or other mental health disorder, social phobia can be diagnosed only by a trained professional. Specific criteria for diagnosing this phobia can be found in the Diagnostic and Statistical Manual (4th ed., DSM-IV).

One of the most critical elements of diagnosing any phobia is the fact that it must significantly impact the sufferer's life. If you have a fear of public speaking, for example, but have created a life that does not require this skill, then you may not have a phobia. Someone who makes his living as a lawyer, however, could be severely disabled by the same fear.

Progression of Social Phobia

Each case of social phobia is different, so your particular phobia may not follow a "typical" pattern. In general, however, it appears that untreated social phobia tends to worsen over time. Social phobia often progresses from fear of a single social situation to multiple situations or even an overall fear of people. In extreme cases, untreated social phobia can lead to isolation, depression, other anxiety disorders, or even agoraphobia.

Treating Social Phobia

Social phobia can be treated in any of three ways: medication, therapy, or alternative methods. Many practitioners choose to use a combination of treatments.

Medication Options

The medications used in treating social phobia fall into four main categories:

• SSRIs: Selective serotonin reuptake inhibitors, or SSRIs, work by affecting the level of serotonin in the brain. They are popularly prescribed for depression, but research has shown them to be effective in treating anxiety disorders, including phobias, as well.

• MAOIs: MAOIs, or monoamine oxidase inhibitors, block an enzyme that breaks down certain neurotransmitters in the brain. Popularly prescribed for depression, these medications have an impact on anxiety as well.

• Benzodiazepines: Benzodiazepines are mild sedatives commonly used to treat anxiety. They can ease phobias by addressing the associated anxiety.

• Beta Blockers: Most popularly prescribed for high blood pressure and certain heart conditions, beta blockers work by suppressing the effects of epinephrine (adrenaline) in the body. Some studies have shown that beta blockers can be particularly effective in relieving some aspects of social phobia.

Therapy

Numerous types of talk therapy may be effective in treating social phobia. Psychoanalysis, intensive group seminars, and behavioral techniques have all been found to be effective in some cases. For a variety of reasons, however, cognitive-behavioral therapy remains one of the most popular forms of treatment for phobias.

Alternative Treatments

Many people find relief from social phobia in a wide range of alternative treatments. Hypnotherapy, aromatherapy, guided imagery, and homeopathy are among the most popular. However, not all of these remedies have been rigorously tested under clinical conditions. If you choose to pursue alternative treatments for your social phobia, it is highly recommended that you do so only under the guidance of both a licensed mental health professional and an expert in the chosen remedy.

Living With Social Phobia

In many ways, those suffering from social phobia face the same challenges to daily living as those with any other phobia. Depending on the severity of your social phobia, it may be a manageable annoyance or a devastating condition. Since social phobia involves a fear of being around other people, it can also present unique challenges, particularly in situations such as dating.

Traveling with social phobia can present unique challenges. Flying involves close contact with strangers, and enhanced airport security measures can trigger an intense reaction. Road trips may be a bit more manageable, but only if you are extremely comfortable with your traveling companions.

Social phobia can seem worse during the winter holidays. Shopping malls are packed to overflowing with hurried strangers. You may be expected to make the rounds of holiday parties hosted by people you barely know. Even if you generally love the holiday season, you may find even the most mundane tasks more difficult to accomplish.

Because social phobia can cause so much difficulty in daily life, it is important to seek professional help as soon as possible. Social phobia is extremely treatable, but left untreated, it can be extremely disabling. Contact your mental health provider to develop an individualized treatment plan that is right for you.

_Source:

_{American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th Ed.). Washington, DC: Author.}