Social Anxiety Disorder.

Do you feel nervous when meeting new people, speaking in front of crowds, or hanging out in group settings? It’s normal for people to experience some degree of discomfort or shyness in social situations and it’s also normal for there to be a variation in those levels of discomfort, as is the case of extroverts, introverts, and those who fall somewhere in between. However, there’s a point where the butterflies associated with social interaction are more than just passing feelings and actually a full-on phobia. This is known as social anxiety disorder and can be a debilitating condition that can significantly impact one’s overall quality of life. 

What Is Social Anxiety Disorder?

Social anxiety is a specific type of anxiety disorder and falls under the subcategory of phobia-related disorders (which includes things like the fear of spiders, heights, or needles). According to the DSM-5, the definition/diagnosis of social anxiety order is determined by meeting the following diagnostic criteria:

  • The person feels extreme fear or anxiety at the thought of interacting, performing, or being observed by others.
  • Social situations almost always provoke fear or anxiety.
  • This fear or anxiety is disproportionate to the situation.
  • Social situations are avoided or endured but cause intense fear or anxiety.
  • The distress felt towards the social situation significantly interferes with professional, social, and other important activities.
  • The fear, anxiety, or avoidance persists for 6 months or more.
  • These feelings are not caused by the physiological effects of a substance or other medical condition.
  • Nor are these feelings the result of another mental disorder such as panic disorder, body dysmorphic disorder, or autism.

In short, social anxiety disorder is characterized by a persistent and overwhelming feeling of fear or anxiety towards certain (or several) types of social interactions, particularly due to a fear of being watched and judged by others. These feelings result in immense stress which affects their ability to live a normal life and prevents them from attending school, work, or social functions. Social anxiety disorder is considered performance-only if this fear is strictly limited to the fear of public speaking or performing. 

Social Anxiety Disorder Symptoms

Symptoms of social anxiety disorder can be physical, behavioral, and emotional. Most take place during social situations, but some might occur simply in anticipation of an upcoming event. These can include:

  • Avoidant behavior of people or places
  • Blushing
  • Difficulty speaking
  • Difficulty making eye contact
  • Increased heart rate
  • Low self-esteem
  • Mind going blank
  • Nausea
  • Negative self-talk
  • Panic attacks
  • Rigid body or posture
  • Soft voice
  • Sweating
  • Trembling 

In children the symptoms of social anxiety disorder might display slightly differently and include:

  • Crying
  • Clingy behavior
  • Freezing
  • Refusal to speak
  • Tantrums

Social Anxiety Disorder Causes

Social anxiety disorder affects about 7% of all Americans–about 15 million people–which includes both children and adults. Females tend to be afflicted with this condition far more than men, a trend that persists across all age groups. The exact causes of social anxiety disorder aren’t fully understood. Unlike depression or schizophrenia, this condition cannot be attributed to any particular neurotransmitter. Genetic factors (anxiety runs in families) and environmental factors (i.e. the death of a loved one, bullying, childhood abuse) can increase the risk, but still, cannot be traced to a specific neurological pathway. 

Social Anxiety Disorder Treatment

If left untreated, social anxiety disorder can get worse and last a lifetime. Fortunately, there are several treatment options that have been found to be effective for helping individuals manage their symptoms and gain control over their anxiety in general. Cognitive-behavioral therapy (CBT) and exposure therapy can help make individuals more aware of their triggers and provide practical means for dealing with social situations. 

There are also a number of medications that can be helpful in managing social anxiety disorder symptoms. Many of the same general anxiety medications can lessen the particular manifestations of social phobia, though only as acute-short-term solutions. Benzos like Xanax and Klonopin are effective but have significant addiction potential and should be used sparingly. Antidepressants can provide longer-term relief for symptoms but may take months to take effect. Beta-blockers are an effective off-label medication that can minimize the physical effects of anxiety, such as a racing heartbeat or profuse sweating.




How To Manage Living With Social Anxiety Disorder

Like any other type of mental health discussion, social anxiety can range from mild to severe. The triggers and manifestations of this disorder can vary immensely from person to person. There is no “cure” but the combination of therapy and medication can make it a much more bearable condition. Visit a mental health rehab near you to find a professional that can help you find the best route of action.

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