Do you experience Social Anxiety? How intense are these feelings for you? Do your feelings prevent you from socializing? How do you manage your feelings of anxiety? If you live with social anxiety too you know how awkward it can be some days but there are things we can do to help ourselves...and the first thing is understanding why we feel what we're feeling...when we know more about what we're going through and why...we're better able to prepare for and manage these situations in our lives...we can learn to take control...and our anxieties have less impact when we do.
The following information regarding Social Anxiety Disorder is for your personal information and entertainment only. Do no use this information to self-diagnose or to change your medications. Please do use this information to open the lines of communication with your doctor and/or treatment team and with your support system as well. Let them know what makes you anxious and let them know too what you need to help bring you through it. The more they know...the more they can help.
Social Anxiety Disorder - Topic Overview
People with social anxiety disorder (or social phobia) are extremely anxious about what they will say or do in front of other people. This includes public speaking and day-to-day social situations. But it is more than just being shy or nervous before public speaking. The fear can begin weeks or months before an event. It can cause a fast heartbeat and make it hard to focus.
Doctors don't know what causes social anxiety disorder. They think it may run in families. But they are not sure if it's because of genetics or a response to a traumatic situation.
Social anxiety disorder causes both emotional and physical symptoms.
- It can make you nervous, sad, or easily upset before or during a social event. You may worry a lot or be afraid that something bad will happen.
- The anxiety can cause you to blush, sweat, and feel shaky. Your heart may beat faster than normal, and you may have a hard time focusing.
To diagnose social anxiety disorder, your doctor will examine you and ask about your symptoms. He or she may ask other questions to see how you are doing emotionally. This is called a mental health assessment.
Your doctor may also do blood or urine tests to rule out other conditions, such as thyroid problems that can cause similar symptoms.
Treatment of social anxiety disorder includes counseling and sometimes medicine, such as antidepressants. Whether you need medicine depends on how much the problem affects your daily life. If you already feel anxious around other people, it may be hard to ask for help. But treatment for social anxiety disorder works for many people.
Some people with social anxiety disorder turn to alcohol or drugs to help them relax. This can lead to addiction problems. They may also have depression. It is important to treat these issues too.
Social Anxiety Disorder - Symptoms
Social anxiety disorder causes unreasonable, debilitating fear of being judged or publicly humiliated. You may avoid or severely limit encounters with other people—which can keep you from daily activities. You may develop physical symptoms such as a rapid heartbeat, shortness of breath, or tightness in your chest when faced with a feared social situation.
When you have social anxiety disorder, common social situations—such as eating in public, writing in front of other people, using a public restroom, or speaking in front of others—can cause overwhelming fear and anxiety.
You may be more afraid of people noticing your anxiety than of the actual feared situation. A vicious cycle can emerge of avoiding or worrying about the social event (such as speaking in public) because you are afraid others will see you as weak, anxious, or foolish—this, in turn, leads to more anxiety. This may lead to avoiding or limiting contact with other people.
Symptoms of social anxiety disorder may differ in adults and children. Adults and teenagers with social anxiety disorder usually recognize their fears of being publicly humiliated are unreasonable or excessive. But children who have this disorder may not.
People with social anxiety disorder often underachieve at work or at school to avoid the attention of a promotion or to avoid being forced to participate in a group. They tend to have few friendships and have trouble dating or developing relationships. In prolonged or severe cases, many people develop other psychological conditions (such as depression or substance abuse).
Social anxiety disorder is among several types of phobias that many people experience, such as agoraphobia or a specific phobia (fearing an object, like a spider, or a frightening situation, such as being stuck in an elevator).
Social Anxiety Disorder - Exams and Tests
Social anxiety disorder is diagnosed based on your medical history, physical exam, and sometimes a mental health assessment, which is an evaluation of psychological symptoms.
Blood or urine tests may also be done to rule out other medical conditions that can cause similar symptoms (such as hyperthyroidism).
Social Anxiety Disorder - Treatment Overview
Treatment for social anxiety disorder involves psychological counseling and sometimes medicines (such as antidepressants) to reduce related anxiety and depression.
A combination of medicines and professional counseling may be effective for long-term treatment for people who have generalized anxiety and fear over many social situations. For those who fear only one or a few social situations (such as public speaking or eating in front of others), professional counseling to overcome the fear may be all that is needed.
Unfortunately, many people don't seek treatment for anxiety disorders. You may not seek treatment because you think the symptoms are not bad enough or that you can work things out on your own. But getting treatment is important.
How do I know if I have an anxiety disorder that needs treatment?
If you need help deciding whether to see your doctor, see some reasons why people don't get help and read about how to overcome them.
Initial and ongoing treatment Initial treatment of social anxiety disorder is based on how bad your emotional and physical symptoms are and how able you are to function in daily activities. People who have social anxiety disorder often have depression also. They may also have alcohol or substance abuse problems. Your doctor may ask you certain questions to see whether you might be drinking too much or abusing drugs.
Social anxiety disorder often goes undetected for years before treatment is sought. By that time, you may have developed behaviors that accommodate the fears. These habits or behaviors must be overcome to successfully manage social anxiety disorder.
First, your doctor must determine whether you are generally anxious about all social encounters or whether a specific situation triggers anxiety.
Treatment with a combination of medicines and professional counseling is often effective for generalized social anxiety disorder (fear of most public interaction). Some people need treatment throughout their lives, while others may recover completely after a period of treatment with counseling and medicines
Counseling It is possible to overcome the fears linked with social anxiety disorder. Working through fears with a specific type of therapy—cognitive-behavioral therapy that includes exposure therapy—may be the best approach for treating your anxiety. It is important to continue professional counseling even if you are taking medicines to reduce anxiety.
Types of counseling most often used to treat social anxiety disorder include:
- Cognitive-behavioral therapy which helps you identify anxieties and the situations that provoke the anxiety. At first you may feel uncomfortable while addressing the feared situations, but it is an important part of your recovery. Several types of cognitive-behavioral therapy are used to treat social anxiety disorder, including:
- Exposure therapy. You will be guided by a professional counselor to imagine you are facing the feared situation until you no longer fear it, such as eating in public. Next, you may go with your counselor to a public place and eat until, eventually; you can eat by yourself in public without fear.
- Social skills training. This therapy helps you develop the skills you need in social situations through rehearsing and role-playing. Your anxiety is reduced as you become more comfortable with and prepared for the feared social situations.
- Cognitive restructuring. This therapy helps you learn to identify and improve fearful thinking to help you better handle social situations.
- Symptom management skills. This therapy teaches you how to reduce stress by controlling your breathing and other physical responses to anxiety.
Supportive Therapy - This can include:
- Education about the disorder.
- Family therapy, to support loved ones affected by your condition.
- Group therapy or support groups, to seek support from others also diagnosed with the disorder.
Medicines often used for chronic, severe, or generalized social anxiety disorder include:
- Selective serotonin reuptake inhibitors (SSRIs), to relieve anxiety. SSRIs are often the first type of medicine used to treat generalized social anxiety disorder.
- Venlafaxine, a serotonin norepinephrine reuptake inhibitor (SNRI), to help relieve anxiety and depression.
- Monoamine oxidase inhibitors (MAOIs), to relieve depression and anxiety. MAOIs have potentially serious side effects when they are taken with certain foods (such as some cheeses and red wine).
- Benzodiazepines, to relieve anxiety. They are fast-acting. But they may be habit-forming and are not generally used in those who have substance abuse problems.
- Beta-blockers, to reduce anxiety. Beta-blockers are sometimes used to treat physical symptoms of anxiety (such as tremors or rapid heart rate).
Ongoing treatment of social anxiety disorder usually includes continuing psychological counseling and regular checkups to monitor any medicines you may be taking. If professional counseling alone has not reduced your anxiety symptoms, medicines may be added to your treatment.
If your anxiety is triggered by many social situations (generalized), you may need continuous and prolonged treatment with a combination of counseling and medicines. During this time, your doctor will need to monitor your medicines. If one medicine doesn't work for you, you and your doctor may decide you should try another.
Treatment if the condition gets worse
With social anxiety disorder, it is possible to progress from debilitating fear of one social situation to having anxiety about all social encounters (generalized). If this occurs, additional treatment is needed that usually includes adding medicines and increasing the amount of professional counseling you receive.
You may also feel more anxious when you start professional counseling. This is because you are thinking about the situations that cause you fear and anxiety. After the situations have been identified, the fears can be addressed through counseling—especially cognitive-behavioral therapy which includes exposure therapy—gradually exposing you to your fear.
If you are taking medicines to treat social anxiety disorder, you will need regular checkups to monitor the medicines (such as selective serotonin re-uptake inhibitors) and their potential side effects. The medicines may cause bothersome side effects that may make your anxiety worse at first. These side effects may get better over time. But if they do not, you may need to take a different medicine.
If social anxiety disorder is left untreated or improperly treated, it can cause debilitating distress that interferes with daily activities. Physical symptoms such as rapid heart rate, blushing, shortness of breath, and dizziness can occur and need to be assessed.
While counseling and medicines are the most effective treatments for social anxiety disorder, you may wish to reduce your anxiety level at home by practicing a healthy lifestyle.
- Get regular exercise. Start slowly so that you don't overdo it. Build up your exercise program bit by bit, and aim for at least 2½ hours a week of moderate exercise. It's fine to be active in blocks of 10 minutes or more throughout your day and week.
- Get enough sleep by going to bed at nearly the same time every night. Also, keep your room quiet and dark. This may reduce distractions and may help you get a good night's rest.
- Eat a balanced diet by choosing foods low in fat and high in fiber.
- Avoid foods and beverages that contain caffeine, such as chocolate and coffee, since they may increase your anxiety.
- Try some relaxation exercises. Certain breathing exercises and muscle relaxation exercises help reduce anxiety.
- Change how you think. Positive thinking can change how you feel and can reduce your anxiety.
If you drink alcohol or use drugs in an attempt to gain confidence to face feared social situations, it is possible to develop substance abuse problems in addition to social anxiety disorder.
Other Resources for Help
Anxiety Disorders Association of America (ADAA)
8730 Georgia Avenue
Silver Spring, MD 20910
Phone: (240) 485-1001
Fax: (240) 485-1035
Web Address: www.adaa.org
The Anxiety Disorders Association of America (ADAA) works to improve the lives of people who have anxiety disorders. Members of the association are not only people who have or are interested in anxiety disorders but also health professionals who do research and treat people who have anxiety disorders.
KidsHealth for Parents, Children, and Teens
Nemours Home Office
10140 Centurion Parkway
Jacksonville, FL 32256
Phone: (904) 697-4100
Web Address: www.kidshealth.org
This website is sponsored by the Nemours Foundation. It has a wide range of information about children's health—from allergies and diseases to normal growth and development (birth to adolescence). This website offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly emails about your area of interest.
Mental Health America
Web Address: www.mentalhealthamerica.net
National Institute of Mental Health (NIMH)
Web Address: www.nimh.nih.gov
This information is produced and provided by the National CancerInstitute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.
WebMD Medical Reference from Healthwise
Last Updated: June 13, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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