Social Phobia: Crippling, but Treatable
Social anxiety disorder (SAD) is an extremely common condition that affects about seven percent of all Americans. The condition imposes an enormous burden on people who suffer from it, impacting their everyday social and occupational lives, to the extent that the mere anticipation of an event—such as eating or drinking in front of others, or speaking publicly—causes severe anxiety and may result in avoidance of such places or events. The person suffering from SAD has a fear of being scrutinized and judged, and then humiliated or rejected.
The condition frequently manifests in people who are very shy, though the condition is “beyond” shyness. Without treatment, the disorder can last for years and inhibit people from reaching their full potential.
What causes SAD? While the disorder can be heritable, it’s not clear why some members of a family have it and others don’t. One causes may involve parts of the brain involved in fear and anxiety (such as the amygdala), or misreading others’ behavior, such as thinking people are staring or looking disapprovingly at you, when they are not.
The amygdala, which governs social and threat-processing in the brain, may be hyper-responsive to faces with aversive or disapproving expressions in people who suffer from SAD. However, some of these studies are dated, and more studies are needed to establish direct cause and effect. (Biology of Psychiatry, 2006).
If you are concerned that you might have SAD, first consult your doctor to make sure a physical problem is not causing your distress. Your doctor may then refer you to a specialist trained in mental health issues.
How SAD Is Treated. SAD is usually treated with “talk” therapy, also known as psychotherapy, and/or medication. Psychotherapy may consist of cognitive behavioral therapy (CBT), which helps to change negative thinking and views into more positive ways of behaving and reacting to situations.
Support groups also may be helpful, in that you’ll be exposed to other people who suffer from your same condition, and see how they deal with feeling they’re being rejected or unable to deal with social situations. You will learn that your interpretation of how the world views you may not be correct.
If your caregiver thinks medication might help you overcome your phobia, there are three classes of medications that might be prescribed:
- Anti-anxiety medications begin working immediately, unlike
- Antidepressants, which may take several weeks to kick in and may have side effects, such as headaches or difficulty sleeping. Anti-anxiety medications generally are taken for a shorter time in order to avoid building up a tolerance or dependency on them.
- Beta-blockers are sometimes prescribed to alleviate physical symptoms of anxiety, such as sweating, tremors, or increased heart rate.
Don’t Forget Lifestyle Changes. While treating your SAD with medications or psychotherapy, you also can make some healthy lifestyle changes if you haven’t already done so. Eating a healthy diet, getting the right amount of “good” sleep, and exercising all go a long way toward helping to maintain a balanced life.
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