Social phobia is a form of anxiety disorder that occurs in the presence of other people or in specific social situations. This disorder is quite common because it may affect up to several percent of the population. Symptoms of social phobia usually appear in childhood, and they can also have a negative impact on functioning in adulthood. Various tools are used to treat social anxiety disorder, including psychotherapy and medications.

Social phobia – what is it?

Social phobia, or too social anxiety disorderis one of the most common mental disorders in the general population – right behind depression and alcohol addiction. As a disease entity, social phobia began to be recognized only in the 80s.

The distinguishing feature of social phobia is the fear accompanying contact with other people, especially strangers. Often, anxiety symptoms appear already at the thought of specific situations, such as meeting in a group, speaking in front of people, eating in public or writing in the company of other people.

Social phobia occurs in women up to two times more often than in men.

People with social phobia recognize and avoid situations that trigger anxiety states (such as shaking hands, flushing, difficulty expressing themselves). It is not just about the fear associated with the perception of a stressful situation – in people with social phobia anxiety does not go away with the duration of the stress-inducing activity. This may have a negative impact on functioning in the school or professional environment, as well as on interpersonal relationships.

Anxiety in the context of social phobia

The main manifestation of social phobia is anxiety and the accompanying symptoms. Anxiety as such can be defined as a mental state in response to various stimuli, external or internal. She accompanies him a sense of danger and a number of somatic symptomsand therefore unpleasant reactions from various body systems. Although anxiety can be a reaction to a real threat or a new or disturbing situation, in the case of anxiety states in mental disorders, it is a response to imaginary danger.

Also read: Panic Attack – What is it?

In social phobia, anxiety is often irrational and disproportionate to the situation that gives rise to concern. The anxiety states of people with social anxiety disorder recur every time a situation arises that requires entering into social interactions that causes the person anxiety, fear and tension. Problematic situations may be different for different people – sometimes only some circumstances of contact with people are problematic, and sometimes almost all situations requiring interaction with people outside the circle of loved ones.

Attention

In the case of social phobia, anxiety arises both when thinking about the situation that is the source of the phobia and when actually experiencing it. The severity of symptoms can vary and, in extreme situations, lead to panic attacks.

Social phobia – symptoms

Symptoms of social anxiety disorder can occur in a variety of situations requiring different types of social interaction. Anxiety is often associated with exposure to unknown people, a feeling of being watched, and an unjustified or excessive fear of embarrassment. Patients with social phobia may experience in stressful situations:

  1. excessive sweating;
  2. pouring blush;
  3. hand tremors;
  4. voice tremors;
  5. difficulty speaking;
  6. stuttering;
  7. dry mouth;
  8. fear of vomiting or getting wet;
  9. palpitations.

Other conditions often coexist with social phobia, including specific phobias (e.g. agoraphobia), symptoms of depression, addiction (e.g. alcoholism). There is also a bigger one risk of developing depression in people with social anxiety disorder.

What are the causes of social anxiety disorder?

Social phobia most often manifests itself in children and adolescents, which can hinder overall social development and networking. If it is not treated, symptoms may continue into life and diminish the quality of life. As for the possible causes of social anxiety disorder, the following predispositions are taken into account:

  1. temperamental traits that predispose to the fear of being judged or criticized by other people;
  2. environmental factors, including childhood traumas;
  3. genetic factors.

The interpretation of the probable sources of social anxiety disorder may differ in each individual case. For a complete evaluation, please refer to the appropriate specialists to begin treatment and combat the disorder or at least alleviate its symptoms.

Check it out: Where do social phobias come from?

Do you have social anxiety disorder?

The diagnosis of social phobia is dealt with by specialists, using appropriate diagnostic criteria. An interview with a patient and obtaining a description of symptoms outlines the patient’s clinical picture, which allows for the diagnosis of social anxiety disorder or possibly other accompanying disorders.

Special tests are also used to assess the severity of symptoms of social phobia, e.g. Leibowitz Social Anxiety Scale (LSAS). Such a test consists in answering the questions asked, assessing the difficulty of the described situations on a numerical scale, and it can also be performed independently.

What is the treatment of social anxiety disorder?

Treatment of social phobia is a process that requires time and requires the selection of appropriate methods of working with the patient. The main directions of treatment are psychotherapy and the use of medications prescribed by a doctor. This means that you need the help of several specialists, i.e. a psychologist, psychotherapist and psychiatrist, who will select the treatment agents. If the patient is struggling with specific symptoms, supportive treatment may be indicated, e.g. speech therapy for stuttering. One should also remember about the treatment of diseases coexisting with social anxiety disorder.

Treatment of social phobia – psychotherapy

Participation in therapy is one of the most important steps in curing social anxiety disorder. Although there are several proven psychotherapeutic techniques used when working with anxiety problems, not everyone reports to a specialist. In the case of people with social phobia, about 20 percent. he is not looking for psychotherapeutic help. As for people using therapy, many come late, even 20 years after the onset of symptoms.

important

The decision to consult a psychotherapist is often dictated not by symptoms of social phobia, but rather by comorbid disorders, e.g. intensifying symptoms of depression.

In the treatment of social phobia, cognitive-behavioral psychotherapy (CBT) is primarily used. It is a method that focuses not on the causes of anxiety, but on techniques to deal with stressful situations. Here, attention is paid to negative thought patterns, and the patient works to change them. Such behavior is to help him manage his fear more effectively when confronted with other people.

Other forms of therapy that have also found application in the treatment of people with social anxiety disorder (their effectiveness has not been fully confirmed) include:

  1. Acceptance and Commitment Therapy (ACT) – it is a therapy derived from the mainstream of behavioral analysis; it uses techniques such as learning the patient’s acceptance of experiences, learning to stay in touch with the present moment, making thoughts neutral (separating), evaluating, and taking action.
  2. Cognitive therapy based on mindfulnessor Mindfulness-based cognitive therapy (MBCT) – a therapeutic program that includes meditation, reducing mental tension, breaking patterns and mechanisms of reacting to various situations.
  3. Mindfulness-based stress reduction, czyli Mindfulness Based Stress Reduction (MBSR) – this technique also uses meditation, focusing on the present moment, greater acceptance of one’s experiences, as well as educational and self-cognitive elements.

It is possible too Internet-based social phobia therapy. Such a solution for this disorder may help people who are considering treatment, but are afraid of the process. One of the options is online therapy via chat or e-mail, the other are platforms that facilitate independent use of therapeutic resources (also with the support of a therapist). In this form, e.g. online cognitive behavioral therapy (ICBT). This form of treatment allows, among others, on psychoeducation of the patient, cognitive restructuring, performing tasks set by the therapist or exposure to anxiety stimuli.

What medications are used to treat social anxiety disorder?

An important supplement to psychotherapeutic treatment in social phobia is pharmacotherapy. Drugs administered to patients with this disorder may be of use alleviating the symptoms of mental phobias, but also limiting physical symptoms. As part of the treatment of social phobia, MAO inhibitors (monoamine oxidase inhibitors) and SSRIs (selective serotonin reuptake inhibitors) are mainly used. It should be remembered that the effects of drugs are not visible immediately – a minimum of several weeks of therapy is needed.

As for MAO inhibitors, different generations of these drugs are available. In the case of combating the symptoms of social anxiety, irreversible, non-selective monoamine oxidase inhibitors (HAD) that block the metabolism of serotonin, dopamine and norepinephrine. Means from the MAOI group may interact strongly with other drugs and some dietary components, which is an unfavorable phenomenon. An alternative are reversible monoamine oxidase type A inhibitors (RHYME), moclobemide is particularly commonly administered. Research indicates that it is slightly less effective than MAOIs, but the drug is better tolerated by the body.

Another group of drugs prescribed for social anxiety disorder are SSRIs, which block serotonin reuptake. SSRI medicinal products are standard in the treatment of social anxiety disorder. Examples of this group of drugs are paroxetine, fluvoxamine, sertraline, and escitalopram. In the treatment of anxiety in social situations, selective serotonin and noradrenaline reuptake inhibitors are also used (SNRI) – venlafaxine and duloxetine.

The following are helpful in relieving anxiety symptoms associated with social phobia:

  1. beta-adrenergic drugs (e.g. atenolol) – relieve symptoms such as tachycardia and tremors;
  2. anticonvulsants (pregabalin, gabapentin) – their anxiolytic effect has been confirmed; pregabalin can also prevent phobias from returning;
  3. benzodiazepines – drugs from this group are highly addictive, so they can only be taken for a short time and are not the first choice in treating social phobia; examples of such drugs are clonazepam and alprazolam.

How long is social phobia treated?

Thanks to the implementation of treatment, it is possible to cure the symptoms of social phobia or to reduce them significantly. However, the effectiveness of therapy depends on many factors, including the severity of the condition, patient involvement, support, as well as systematic psychotherapy and medication use. If the selected treatment methods are effective for a given patient, it is possible to complete the treatment within a few to several months. However, it all depends on each individual case.

Read also:

  1. Anxiety neurosis, or generalized anxiety disorder – causes, symptoms, treatment
  2. Selective mutism – symptoms, causes, treatment
  3. Erythrophobia – fear of redness in company

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