Social Anxiety Fact Sheet


Social Anxiety Disorder (social phobia) is the third largest mental health care problem in the world.

Latest government epidemiological data show social anxiety affects over 7% of the population at any given time. The lifetime prevalence rate (i.e., the chances of developing social anxiety disorder at any time during the lifespan) stands at above 13%.

Definition: Social anxiety is the fear of social situations that involve interaction with other people. Put another way, social anxiety is the fear and anxiety of being judged and evaluated by other people. If a person usually becomes anxious in social situations, but seems fine when they are alone, then "social anxiety" may be the problem.

Perceptions: People with social anxiety are many times seen by others as being shy, quiet, backward, withdrawn, inhibited, unfriendly, nervous, aloof, and disinterested. People with social anxiety want to be "normal" socially, they want to make friends and they want to be involved and engaged in social interactions.

Having social anxiety prevents people from being able to do the things they want to do. People with social anxiety want to be friendly, open, and sociable. It is fear (anxiety) that holds them back from participating.

Social anxiety is a fully treatable condition and can be overcome.

Triggering Symptoms: People with social anxiety usually experience significant distress in the following situations:

Being introduced to other people

Being teased or criticized

Being the center of attention

Being watched or observed while doing something

Having to say something in a formal, public situation

Meeting people in authority ("important people/authority figures")

Feeling insecure and out of place in social situations ("I don’t know what to say.")

Embarrassing easily (e.g., blushing, shaking)

Meeting other peoples’ eyes

Swallowing, writing, talking, making phone calls if in public



This list is not a complete list of symptoms -- other symptoms may be associated with social anxiety as well.

Emotional Symptoms: The feelings that accompany social anxiety include anxiety, intense fear, nervousness, automatic negative thinking cycles, racing heart, blushing, excessive sweating, dry throat and mouth, trembling, and muscle twitches.

Constant, intense anxiety (fear) is the most common feature.

Insight: People with social anxiety know that their anxiety is irrational and does not make logical sense. Nevertheless, thoughts and feelings of anxiety persist and show no signs of going away, without appropriate treatment.

Therapy: Cognitive-behavioral therapy for social anxiety has been markedly successful. Thousands of research studies now indicate that, after CBT, people with social anxiety disorder report a changed life -- one that is no longer controlled by fear and anxiety. Appropriate therapy is markedly successful in changing people's thoughts, beliefs, feelings, and behavior.

National Institutes of Mental Health-funded studies report a very high success rate using cognitive therapy with a behavioral therapy group. Both are essential to alleviating anxiety symptoms associated with social anxiety disorder.

Medication: Social anxiety medication is useful for many, but not all, people with social anxiety disorder. Psychologists and therapists should work with the persons’ medical doctor and/or psychiatrist if at all possible. For cases of generalized social anxiety, research indicates use of the anti-anxiety agents, and certain antidepressants in conjunction with CBT has proven most beneficial. As to antidepressants, the MAOIs have the highest success rate when combined with CBT. Medication without the use of cognitive-behavioral therapy has proven to be only temporarily helpful.

In particular, antidepressant treatment using SSRIs has been shown to be useless.

Prognosis: Markedly good. People completing CBT training report a high success ratio. In the NIMH longitudinal studies, people continued to report progress after the CBT behavioral group therapy was over. We have found that repetition is the key to overcoming social anxiety disorder. Therapy is not difficult. What matters is a person's continuing commitment to getting better.

Treatment Specialties: Social anxiety, as well as the other anxiety disorders, can be successfully treated today. In seeking help for this problem, we recommend searching for a specialist -- someone who understands this problem well and knows how to treat it.

Social anxiety treatment must include an active behavioral therapy group, where members can work on their "fear" hierarchies in the group, and later, in real-life situations.

Differential Diagnosis and Comorbidity: Social anxiety disorder is one of the five major anxiety disorders as listed in the DSM-IV.

Social anxiety is many times mixed up with panic disorder. People with social anxiety do not experience panic attacks, in which the principal fear is of having a medical problem (e.g., heart attack). People with social anxiety realize that it is anxiety and fear that they are experiencing. They may say things like "It was awful and I panicked!", but, when questioned, they are talking about feeling highly anxious. They are not talking about the fear of having a medical problem. People with social anxiety tend not to go to hospital emergency rooms after an anxiety problem. People with panic disorder many times go to hospital emergency rooms, because they feel there is something medically and physically wrong with them.

High rates of alcoholism and other substance abuse, family difficulties and problems, lack of personal relationships, and difficulty in obtaining and continuing with employment are among the everyday problems experienced by many people with social anxiety disorder.

Lack of professional and knowledgeable therapists is the biggest and most relevant problem to overcoming social anxiety. While we know it can be done, and a vast amount of clinical and research evidence supports this, overcoming social anxiety is difficult because of the scarcity of treatment options for people with this persistent anxiety disorder.

Copyright © 1997, 2000, 2009, The Social Phobia/Social Anxiety Association.

So this weekend has been absolutely terrible for me :( I feel like balling my eyes out right now. In fact I might go do that....

I don't know why my anxieties are getting worse! I've felt anxious and nervous all weekend and have barely eaten a thing, except for a spurt last night where I felt calm. I went to the grocery store today and totally freaked out, felt light headed, uneasy, nauseous, tense muscles, dry mouth. I made it through, but it was hell.

Other than work I haven't really left my house for a week, I think keeping yourself housebound makes things worse. two weeks ago I had no problems at all going shopping, now I do all of a sudden.

I feel terrible I keep ditching my friends!

I used to be SO happy, always on the go, never had any problems. Now my mind has taken over my life in the matter of a few weeks. I hope it's not forever.

Maybe i should up my dose? I'm only on 20mg of Celexa (been 3 weeks) and I'm running out of Lorazepam :( so I need more of that too...is it possible that anxieties sometimes get worse on this drug before they get better? I really just want my life back....maybe I need to expose myself more to the outside world instead of hiding in my house in my PJ's all the time just waiting to get better...

Hi Jerrica

I am sorry that you are strugling right now. Yes there are start up side effects to the meds, they can take up to 8 weeks to work into your system properly. So how you are feeling may pass. If you are really concerned, you can go back to your doc. Have a look in the Celexa Room here for others start up experiences.

Trace

Thanks, I saw my doc today. She wouldn't up my dose yet...she says I have to give it more time. She did give me more Lorazepam to take as needed. I think I know why I'm freaking out so bad now though. My major support person, whom is my best friend and has been getting me through this, god bless him, is going on vacation for a week on wednesday and I don't know what I'm going to do for a whole week without him :( and I think it's causing all sorts of anxieties and anticipation as to how I will cope when he's gone.

I've been living at his place lately, because I feel safe there. Home is not a good place for me (my mom is very unsupportive, brother disrespectful, they just don't understand and make it 10x worse). He did say he would leave me a key to stay there while he's gone but I'm uneasy about being alone right now....

It really sucks when you hate being home and feel like you have nowhere else to go :( BUT it's only a week.....I can do it!

Jerrica

Yes, it is only a week and you can do it. You also have us too. I hope the week goes fast for you.

Trace

I'm 19 and have had problems socializing with people ever since I was little. I can't even stand being around my family for more than 5 minutes, they don't even bother looking at me as I leave the room anymore during a movie or TV show. When I was in school I always got bad grades and constantly stuttered having panic attacks just simply reading something aloud. I didn't get help until about 3 years ago but nothing has helped until recently when i started taking Effexor EX along with Deplin, so far I've noticed improvement but I still can't stand being with people for to long.

Hi Masquerette,

What a difficult position to be in. What thoughts go through your head when you're with people?

xx

HI Sashapoo

It is a very difficult thing to cope with. It mst be tough having a job that deals with the public when you feel like this. Are you in therapy at all?

PRT xx

Anyone found a AD that helps there anxiety ?
I have depression as well but i think anxiety is the main problem
Been on cymbalta now for a bit over a week
no relief yet :(