For many people, an impending social engagement or performance situation brings fear that prompts avoidance or otherwise interferes with functioning.

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For many people, an impending social engagement or performance situation brings fear that prompts avoidance or otherwise interferes with functioning. Social anxiety disorder typically begins before adulthood and, while it often feels crippling, can be treated.

Definition

Social anxiety disorder, formerly referred to as social phobia, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social anxiety disorder have a persistent, intense, and chronic fear of being watched and judged by others and of being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work, school, or other activities. While many people with social anxiety disorder recognize that their fear of being around people may be excessive or unreasonable, they are unable to overcome it. They often worry for days or weeks in advance of a dreaded situation. In addition, they often experience low self-esteem and depression.

Social anxiety disorder can be limited to only one type of situation—such as a fear of speaking or performing in public—or a person can experience symptoms whenever they are around other people. If left untreated, social phobia can have severe consequences. For example, it may keep people from going to work or school on some days. Many with this illness are afraid of being with people other than family members. As a result, they may have a hard time making and keeping friends.

Physical symptoms, which often accompany the intense stress of social anxiety disorder, include blushing, profuse sweating, trembling, and other symptoms of anxiety, such as difficulty speaking and nausea or other stomach discomfort. Because these visible symptoms heighten the fear of disapproval, they themselves can become an additional focus of fear, creating a vicious cycle: As people with social anxiety disorder worry about experiencing these symptoms, the greater their chances are of developing them.

Social anxiety disorder often runs in families and may be accompanied by depression or other anxiety disorders, such as panic disorder or obsessive-compulsive disorder. Some people with social anxiety disorder self-medicate with alcohol or other drugs, which can lead to addiction.

Prevalence of Social Phobia

About seven percent of the U.S. population is estimated to have social anxiety disorder within a given 12-month period. Social anxiety disorder occurs twice as often in women as in men, although a higher proportion of men seek help for this condition. The disorder typically begins in childhood or early adolescence and rarely develops after age 25.

Treatments

Most anxiety disorders can be treated successfully by a trained mental health care professional.

Research has shown that there are two main forms of effective treatment for social anxiety disorder: psychotherapy and certain medications.

Cognitive-behavioral therapy (CBT) is a form of psychotherapy that is very effective in treating severe social anxiety. A major aim of CBT and behavioral therapy is to reduce anxiety by eliminating beliefs or behaviors that help to maintain the anxiety disorder. For example, avoidance of a feared object or situation prevents a person from learning that it is harmless. (Psychology Today)

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