Identifying and Treating Social Phobia

Some people are extroverted; they have no problem being the center of attention in social situations. Others are introverted and shy; they prefer to interact with others one on one or in small groups. Still, others are beyond shy; they fear social situations. These individuals experience social phobia.

According to Wikipedia, approximately 13.3% of the general population in the United States meets the Diagnostic and Statistical Manual of Mental Disorders criteria for social phobia at some time in their lives.

Social phobia, which is also known as social anxiety disorder, typically sets in around mid-adolescence, but it can begin when a person is younger or older, too. Symptoms of social phobia include an intense fear of one or more social situations and fearing that you will embarrass or humiliate yourself in performance or social situations where you do not know the individuals there.

The Diagnostic and Statistical Manual of Mental Disorder, the book psychologists and psychiatrist utilize to diagnose mental illnesses, defines social phobia as a marked and persistent fear of one or more performance or social situations where an individual is exposed to possible scrutiny by others or to unfamiliar people. Additionally, the individual fears he or she may show anxiety symptoms or behave in a way to humiliate or embarrass him or herself. Upon being exposed to a feared situation, the individual experiences anxiety. The individual may also have panic attacks either before or during the feared social or performance situation. The person recognizes that the fear is unreasonable and excessive. Feared performance or social situations are either endured with a great deal of distress or avoided.

Fear or avoidance of social or performance situations must interfere with an individual's daily life occupationally, academically, or affect relationships or social life. Finally, the fear must not be due to a substance or a general medical condition in order for a psychologist or psychiatrist to diagnose someone with social phobia.

The Diagnostic and Statistical Manual of Mental Disorders also specifies two types of social phobia: generalized and specific. Specific social phobia is defined by being afraid of one or a few types of social situations, such as dating and initiating and maintaining conversations.

Generalized social phobia is diagnosed when an individual is afraid of most social and performance situations, such as public speaking, talking to authority figures, dating, talking on the phone, going to parties, being in small groups, and meeting new people.

Treatment options for social phobias include psychotherapy and medication. Medications typically used to treat social phobias include selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. SSRIs are typically the first choice drugs physicians and psychiatrists use for social phobia. The first drug to be approved for the treatment of social phobia was Paxil. SSRIs are effective in treating social anxiety disorder in many people.

Benzodiazepines are also utilized in the short-term for treating social anxiety. Ativan and Klonopin are often used for the treatment of social anxiety disorder that is disabling or very severe. However, these drugs tend to be very addictive, and thus, are not typically prescribed for long-term use.

Finally, a form of psychotherapy, cognitive-behavioral therapy, is effective for treating anxiety disorders, including social anxiety disorder. In cognitive-behavioral therapy, therapists teach clients to examine and challenge their thoughts and behaviors.

Social phobias make being in social situations difficult. With medication and/or therapy, however, individuals may successfully learn to cope with their fear of social and performance situations.

Sources:

Wikipedia: Social Phobia:
http://en.wikipedia.org/wiki/Social_phobia#Treatment

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. IV-TR. (2000). American Psychiatric Association: Washington DC.