Social Phobias: An Insight

Social Phobias

Social phobia, is also known as social anxiety disorder and those with this diagnosis will suffer with a persistent, intense and recurring fear of being judged and/or watched by those around them. They fear doing something that may cause them embarrassment and can undergo extreme stress and anxiety for several weeks prior to attending a social activity.

Causes Of Social Phobias

Certain circumstances may trigger the onset of a social phobia and there are characteristics and/or personalities that may increase a person's vulnerability:

  • Hereditary: someone who has a parent with social phobia, may inherit the disorder due to genetic factors. For example, a study by Hettema et al that appeared in The American Journal of Psychiatry showed that a person with a first degree relative with an anxiety disorder is ten times more likely to develop an anxiety disorder themselves. There have been numerous other studies that have demonstrated high heritability rates.
  • Environmental causes: children are vulnerable to their environment, it is the arena in which they acquire behaviors, values and beliefs. Should a child be in a family situation where a family member avoids social activities or the child is prohibited from engaging in social functions, they may adopt some of the symptoms of social phobias. This may result in extreme shyness which may gradually result in social phobia.
  • Neurological causes: concrete causes for the disorder have yet to be identified, however, chemical imbalances in the brain may be a cause of social phobias. The amygdala is a part of the brain responsible for the regulation of fear, and when overactive can lead to a serotonin imbalance. Serotonin is a neurotransmitter in the brain that helps to regulate emotions and moods and so an imbalance could bring about social phobia symptoms.

Signs & Symptoms of Social Phobia

The symptoms of social phobia may change with time and it may be possible for some people to experience symptoms that are different from another with the same diagnosis.

Emotional and behavioral symptoms may include:

  • A fear of situations where you may be judged by others
  • Avoiding any situation in which you may be the center of attention
  • Bouts of anxiety so intense that it interferes with daily routines such as school, work or usual activities
  • Avoiding talking to people or doing things because of a fear of embarrassment
  • Overwhelming and intense fear of possible situations where you do not know the other people
  • Fear of others noticing your anxiousness
  • Excess fear and/or worry about humiliating or embarrassing yourself

Physical symptoms include:

  • Heart palpitations
  • Diarrhea
  • Upset stomach
  • Nausea
  • Excessive blushing
  • Sweating profusely
  • Difficulty talking
  • Muscle tensions
  • Trembling
  • Confusion
  • Difficulties in making eye contact
  • Shaky voice
  • Clammy and cold hands

Treatment For Social Phobias

Treatment for social phobia typically consists of both therapy and medications.

Cognitive behavioral therapy is the principle therapeutic approach. During therapy the person is taught to recognize his/her negative thoughts and to replace them with positive ones. They may also be exposed to situations they fear and taught through a gradual process a number of techniques to help decrease the fear and reduce the anxiety.

Social phobia prescription medications are used to treat the symptoms of the phobia and not the phobia itself. Medications are more beneficial when used in combination with therapy. Medications include:

  • SSRI’s such as Prozac, Zoloft or Paxil
  • Anti-anxiety medications such as Ativan or Klonopin

References

National Institute of Mental Health: Social Phobia (Social Anxiety Disorder) https://www.nimh.nih.gov/health/topics/social-phobia-social-anxiety-disorder/index.shtml

Mayo Clinic: Social Anxiety Disorder ( Social Phobia) https://www.mayoclinic.com/health/social-anxiety-disorder/DS00595/DSECTION=causes

Social Anxiety Institute (SAI) https://www.socialanxietyinstitute.org/

Social Anxiety Institute: Richards, Thomas A. PhD., What is Social Anxiety? https://www.socialanxietyinstitute.org/define.html