EXTREME SHYNESS

SOCIAL PHOBIA

Topics in Mental Health

By Shlomo Y. Radcliffe

People with social phobia don\'t enjoy parties or other situations in which they must spend time interacting with people they don\'t know. Although they may seem to be shy, they are actually suffering from a severe form of anxiety called Social Phobia. Social Phobia is a condition of intense anxiety about being judged negatively by others. The social phobic person imagines that he or she doesn’t look good enough, act the right way, say the right things or otherwise “pass the test” in the eyes of others. He or she feels painfully inadequate and consequently anticipates rejection from everyone except close friends and family members. People with social phobia may have a fear of blushing, appearing clumsy or appearing shameful or silly, and of having these “failings” observed by others. Some social phobics won’t eat or write in front of other people. Some can barely talk in public. Many avoid public situations as much as possible in order to avoid the stress of worrying, trying and failing. Social Phobia commonly appears during the middle teens, although some children have early symptoms in the form of very low self-esteem and extreme shyness in childhood.

In order to diagnose a person with Social Phobia the person must meet the following criteria:

• The person has intense fears of at least one social or performance situation that involves facing strangers or being watched by others. The person fears revealing his or her symptoms of anxiety (i.e. by trembling, blushing, stammering etc.) or behaving in any way that will be embarrassing or humiliating. Typical examples include fears of being at a party, answering questions in the classroom setting or eating in front of others.
• The person realizes that the fear is out of proportion or unreasonable.
• The feared person or social situation almost always causes anxiety or a panic attack- in much the same way that a dog phobia always leads to severe anxiety upon seeing a dog.
• People under the age of 18 must have had the symptoms for six or more months for a proper diagnosis.
• The person either avoids the situation or endures it only with severe anxiety or distress.
• Either there is significant distress about having the phobia (the person is very bothered by is or her social fears), or it markedly interferes with the person’s usual routines, occupation, social or personal functioning. For instance, the person avoids social situations, thereby leading an isolated life and/or functions in a very restricted way at school or work in order to limit anxiety-provoking situations.
• The symptoms are not directly caused by any general medical condition or by the use of substances (including medication).
• The symptoms are not better explained by a different mental disorder, including other anxiety disorders, any pervasive developmental disorder, Schizoid Personality Disorder, or Body Dysmorphic Disorder.
• If the person has any other mental disorder or any general medical condition, the phobia is not related to it. 

 
Treatment for Social Phobia

Psychotherapy and cognitive-behavioral therapy are common, effective treatments for Social Phobia. Treatment may be carried out with or without additional pharmaceutical treatment. Antidepressant medication and drugs such as imipramine and antianxiety drugs such as diazepam can be helpful during the course of therapy and to relieve symptoms of anxiety in social situations. Some people may find that alternative treatments for anxiety (such as herbal medicine, Bach Flower Therapy, Energy Psychology and others) may make behavior therapy less stressful and more effective. Personal preference and severity of symptoms will dictate the appropriate interventions for each individual.