Most everyone panics a bit at the thought of speaking in front of a room full of people. In fact, reportedly that is the number one phobia! And we are all somewhat uncomfortable when meeting new people in social situations. But social anxiety disorder (or social phobia) is much more severe than the norm. It is a debilitating condition that can severely impair one's functioning.
- Do you go out of your way to avoid interacting with people?
- Do you often feel closely watched, judged and criticized by those around you?
- Do you worry about upcoming social events/situations for days or weeks in advance?
- Are you uncomfortable eating, drinking or working around other people?
- In social settings, do you experience physical symptoms such as sweating, shaking, pounding heart, blushing, upset stomach or muscle tension?
If you answered "yes" to two or more of the above, you may be experiencing symptoms of social anxiety disorder. (This quiz does not take the place of a thorough evaluation by your doctor and mental health professional.)
Levels of Symptomology
As with most psychiatric disorders, the symptomology is measured in degrees. To meet the criteria for the diagnosis, you must be experiencing distress at the level that it is interfering with your normal functioning. The mild anxiety of new social situations would not qualify. People with social anxiety disorder have a very difficult time negotiating their world. Imagine being anxious and upset about every social situation you are in; work settings, gatherings with co-workers or friends, dating, shopping or even talking on the phone!
The symptoms are accompanied by an irrational belief system characterized by thoughts, feelings and physical responses based on the assumption that everyone is watching, judging and critical of your actions. According to Mayo Clinic.com, as a result of the irrational beliefs, the following associated characteristics may occur:
Trouble being assertive
Hypersensitivity to criticism
Poor social skills
Screening and Diagnosis
Because there are often physical symptoms accompanying this diagnosis, it is important to see your primary care physician to first rule out underlying physical causes for your symptoms. A psychological evaluation should also be done by a licensed, trained mental health clinician. You will be asked to describe your symptoms and situations that often trigger your anxiety responses.
If you have social anxiety disorder, what are your treatment options? Cognitive behavioral therapy (CBT) has been shown to be an effective treatment. This type of therapy helps you examine your thought processes and help you to realize that it is not external things, people or places that cause your distress, but your own irrational thought patterns. Meditation and other relaxation techniques are often very helpful in reducing anxiety responses.
Medication is often indicated to reduce symptoms so that the patient can best utilize therapy. Anti-depressants and anti-anxiety medication are most used. Please check with your therapist and doctor about these options.
Traditional self-help, like support groups are not usually an option for patients with social anxiety disorder. The social nature of the group setting is too anxiety-producing. I have had much luck referring patients to support online. One cautionary note: But be aware that peer-led support is not a substitute for treatment from a professional. And in my experience not all online forums are healthy places to seek help. A trusted site like Anxiety Disorders Association of America would be a good place to start looking for online resources.
If you are looking for a therapist or just want more information, try your local library's Web site or call your local Mental Health Association. If using the phone causes anxiety, try asking a trusted family member or friend for help. But try not to rely too much on that resource. You want to take some of these steps towards getting better on your own!