Social phobia
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Social Anxiety Disorder, also called Social Phobia, is a kind of anxiety disorder. It is a psychiatric condition which refers to severe social anxiety, or anxious patterns of behavior in the face of social situations. Social Phobia may either be specific, as when only a particular set of situations is feared, or generalized, when all manner of social interactions bring about anxiety.

Social Phobia is considered the world's third largest psychological problem. Data provided by the National Institute of Mental Health shows that Social Phobia affects over 5 million Americans each year, with a higher ratio of females than males. At some point in their life, an approximate 13% of the U.S. population have had some form of Social Anxiety Disorder. In fact, for almost 13% of people suffering from this disorder, Social Phobia is a lifetime affliction.


Based on the definition by the Diagnostic and Statistical Manual of Mental Disorders, this phobia results in a constant fear or dread, self-consciousness, discomfort and even emotional distress when faced with certain situations where the person is subject to observation by others.

Some of these situations include being introduced to people, teasing and criticism, meeting people in authority, being laughed at, becoming the center of attention, the subject of scrutiny while doing something, public embarrassment, dating, chance encounters with strangers, having to make “small talk” at parties, and speaking in front of an audience or group of people.

People with Social Phobia may be able to interact with their family and close friends, however, their fears arise when faced with new situations or new people, such as speaking in public or in front of a group. They may be aware that this fear may seem exaggerated, unreasonable or excessive, but they are either unable to or have extreme difficulty overcoming this mental disorder.

Social phobia sufferers feel extreme shyness and self-consciousness. They have a great fear of embarrassment and humiliation, making a mistake, and dread negative judgment and evaluation from other people. These interfere with their day to day activities. Because of this fear, the afflicted person shies away from all social activities or any situation that involves interacting with other people. This may result in feelings of worthlessness or inadequacy, humiliation, embarrassment and depression.

Social phobics are also prone to set high standards for themselves, desiring to create a good impression but believing that they are unable to do so. When faced with a social situation, they constantly dwell on what might go wrong, and afterwards they review the event in their mind, dissecting it for any embarrassing or humiliating element and obsessing about it for weeks and even months at a time.

In adults, symptoms of Social Phobia include intense anxiety, frequent blushing, excessive sweating (Hyperhidrosis), trembling, a racing heartbeat, a dry mouth and throat, difficulty swallowing, stomachaches, nausea, involuntary muscle twitching, and stammering. In severe cases, being faced with social situations can bring bouts of panic attacks.

Children with Social Phobia frequently throw tantrums, “freeze up”, cling to parents or other family members, display separation anxiety, or refuse to talk (selective mutism) or interact with others.

Social Phobia commonly begins during early to middle teens. Sometimes it can stem from childhood shyness or social inhibition. Usually, this disorder may be the result of an experience which may have caused humiliation or extreme stress. On the other hand, it may have its beginnings from subtle or unseen factors.

Although mental health science has yet to isolate the exact cause of Social Anxiety Disorder, many studies point to a combination of genetics and environment that play a part in its occurrence. A shy and cautious temperament, together with what a person has been taught by parents or learned from role models, and negative life experiences such as childhood bullying, harassment or rejection can contribute to the development of a Social Anxiety Disorder.

Social Phobia can also stem from socio-cultural influences with regard to attitude and behavior towards shyness or cautiousness. For instance, children in the U.S. have been found to be more likely to develop Social Phobia if their parents or other persons in authority use shame as a means of discipline and place great importance on society's opinions on behavior. On the other hand, Chinese culture is more accepting of shy or inhibited children and tend to view these qualities as ideal for leadership and competence.

Social Phobia can result in children choosing extreme social isolation that may lead to eventual depression. In adults, this disorder may affect both school and work performance and cause them to have great difficulty in forming relationships with other people. Underachieving and low self-esteem is a common complication, as well as lack of social skills and visible physical manifestations of anxiety, such as stuttering, cold clammy hands and tremors. Social Phobics are also less likely to get married, and are prone to drop out of school, live with their parents or immediate family even after reaching adulthood and be unable to get gainful employment. They are also more vulnerable to substance abuse such as sedatives, alcohol or narcotics.


A diagnosis for Social Phobia can be made based on the patient's symptoms and history. A mental health professional can also ask the patient to fill out a questionnaire in order to establish the presence of the phobia and rule out other possible mental disorders. Children's diagnosis can be made based on interviews with parents, teachers, and other family members who have been closely exposed to the child's behavior.


A psychiatrist or psychologist may prescribe antidepressants like serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), Benzodiazepines, Buspirone, Gabapentin, Propanol, and Monoamine oxidase inhibitors (MAOIs). Over 50% of patients who have been diagnosed with Social Anxiety Disorder have been successfully treated with these type of medications. The doctor may also recommend psychotherapy, such as cognitive-behavioral therapy or group therapy. In most cases, both medication and psychotherapy are combined for a more effective treatment.

In 2002, behavioral specialists developed a preventive measure for Social Anxiety Disorder through early detection in childhood in order to develop methods of assisting patients with their social development. Overcoming Social Phobia is not easy. It will take patience, willingness to face fears, and the determination to try new things little by little until the person develops adequate confidence in facing social situations.


There exists a good prognosis, around 80%, for recovery from Social Phobia, provided it is detected early and given appropriate treatments of psychotherapy or medication, or both. The prognosis for untreated Social Anxiety Disorder complicated by substance abuse is poor, however, and these patients are often serial underachievers who have a history of depression or suicide.

Stanford University is currently holding a number of research studies under its Clinically Applied Affective Neuroscience (CAAN) Project. These studies are geared at clinical interventions for adults afflicted with Social Phobia, parental interventions for children with the disorder, psychopathology, and vulnerability/resilience research that will examine the genetic and environmental influences that shape the development of Social Anxiety Disorder.
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