What is Social Anxiety Disorder?

Social anxiety disorder is part of a group of psychiatric conditions that involve excessive anxiety. This group is otherwise known as anxiety disorders. Anxiety in adequate amounts, such as in examination, can be considered helpful as it pushes the person to do better. However, pathologic anxiety that is excessive can oftentimes be disabling and prevent the person from fully functioning even with day-to-day activities and may disrupt occupational performance or from establishing new relationships.

In social anxiety disorder, the intense anxiety often arises when the person thinks and believes that he is being constantly judged, scrutinized or humiliated by others. This often occurs in social situations wherein the person is surrounded by a lot of people such as in a classroom or in a public setting. The person, more often than not, is acutely aware of the physical signs and symptoms of his anxiety. However, he is often powerless against this anxiety due to his fear that these symptoms will cause others to notice or judge them. Thus, this self-awareness exacerbates the feeling of anxiety even more. In extreme instances, this intense feeling of anxiety can develop into a full-blown panic attack.

Social anxiety disorder often starts during teenage years with the typical age of onset of 13 years old but people with this disorder often seek treatment years later. Studies have shown that around 19 million Americans have this disorder.

Common Causes of Social Anxiety Disorder

Until now, studies have not pinpointed a single cause for social anxiety disorder. However, it is postulated that genetic and environmental factors play a role. The following are common causes of social anxiety disorder:

  • Genetics – there is a greater risk of developing the disorder if a first degree relative is affected
  • Chemical imbalances in the brain such as overactive sympathetic nervous system or fight or flight response
  • Major life stressor such as a death in the family can result into an elevated level of cortisol, or hypercortisolemia, that has deleterious effects on the brain and body
  • Personality factors such as low self esteem and poor coping skills

Common Anxiety Provoking Situations for Social Anxiety Disorder

People with social anxiety disorder are generally functional except when faced with social situations. The following are some of the common anxiety provoking situations:

  • Attending and participating in class
  • Meeting new people
  • Public speaking
  • Conversing with people in authority
  • Shopping
  • Eating or drinking in public
  • Making a phone call or answering the phone call
  • Interviewing people
  • Dating and developing close relationships

Signs and Symptoms of Social Anxiety Disorder

Signs and symptoms of social anxiety disorder are usually multi systemic and are not specific for the condition. The following are common signs and symptoms:

Difficulty breathing, chest palpitations

Difficulty breathing, chest palpitations and hyperventilation are some of the symptoms of social anxiety disorder

  • Chest palpitations
  • Difficulty in breathing
  • Hyperventilation
  • Trembling or twitching
  • Profuse sweating
  • Headache
  • Difficulty in swallowing and talking
  • Abdominal pain
  • Dizziness
  • Irritable
  • Decreased concentration

Treatment of Social Anxiety Disorder

Treatment of social anxiety disorder involves a combination of behavioral therapy and pharmacologic therapy.

  • Cognitive behavioral therapy is found to be the most effective treatment for this disorder more than pharmacologic therapy. The main goal of cognitive behavior therapy is to help patients overcome their excessive and irrational fear or anxiety in order to reduce the occurrence of symptoms.
  • Pharmacologic therapy includes the use of the following medications:
    • Antidepressants
    • Benzodiazepine
    • Beta blockers

Social anxiety disorder, also known as social phobia, is a mental disorder that is characterized by an intense fear of social situations.

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