Social Phobia

What is Social Anxiety Disorder?

Imagine going through your whole life constantly fearing others opinions of you, saying things just seek the approval of your peers and being scared to go out in public for fear people are scrutinising your every move.

“I thought that was life. It was for me for years, but luckily now I know better,” says Sarah who suffers from social phobia.

Do you worry about making a fool of yourself in front of other people, feel anxious before going into any social situation and avoid parties like the plague? If so then you may well be suffering from social anxiety disorder.

The World Psychiatric Association estimates as little as three but possibly up to 15% of the population suffers from what’s known as social phobia or social anxiety disorder. Of those who suffer only 25% seek help.

Social phobia is the inability to face social situations due to extreme fear of being watched, scrutinised or judged by others. Both men and women are as equally susceptible and the disorder is not discriminated by culture. The disorder is believed to develop during adolescence with approximately 40% of social phobias occurring before the age of ten and 95% before the age of 20.

Social phobias can be inherited or learned. Clinical psychologist and social phobia specialist, Catherine Madigan says, “Hereditary or genetic influenced can account for 30% of the chance of developing social phobia with environmental factors accounting for the remaining 70%”. Environmental factors can include “traumatic experiences of humiliation, upbringing by parents, observing and learning from the social behaviour of parents, class mates, etc”, says Catherine.

People who suffer from social anxiety disorder encounter difficulties when speaking in public, eating and drinking in public, writing in front of others, meeting new people, being the centre of attention, being watched doing something, using the telephone or even when having to speak to authority figures.

Many of you at this moment can probably empathise with several of these scenarios, however be careful not to confuse social anxiety disorder with shyness. To differentiate the two, Catherine says, “People with social phobia experience impairment in their social or occupational functioning. Shyness tends to be generalised whereas social phobia tends to be fears of specific activities such as far of public speaking, talking on the phone or dating”.

Social phobias go way beyond a person’s inability to talk in public or ask someone on a date, when someone experiences a threatening situation they may experience physiological symptoms such as a rapid heartbeat, sweating, blushing or a feeling of panic. Sufferers usually realise their fears are irrational, excessive or unreasonable yet are unable to control their feelings.1

Many sufferers are afraid to admit they have social anxiety disorder. For fear they’ve failed. If you can identify with any of the above mentioned scenarios then you may well be suffering from social phobia. Further if you are a family member of friend who knows someone with social phobia then you must attempt to help this person.

To identify if someone close to you have a social phobia, Catherine says, ” Firstly you need to ask them questions- the person may be depressed and/or have panic disorder rather than social anxiety. You would ask someone whether they feared e.g.: being introduced, dealing with authority figures, speaking on the phone, being watched doing something, eating in front of people, writing in front of others or public speaking.

You would then ask the person if they experienced physical symptoms of anxiety such as blushing, sweating, tense muscles or headaches when exposed to feared social situations.” However, note that not al individuals report the above symptoms but might simply feel very self conscious, fearful and apprehensive.

Given people with social anxiety disorder fear being negatively judged, if you were to raise the issue with them it is highly probably that they would become distressed. Hence the importance of ensuring the issue is raised in a tactful and empathetic way. Catherine suggests,” it may be helpful to disclose some of your own social fears or uncomfortable social experiences, so the sufferer will feel less threatened. If perhaps you think your partner is refusing to go to a party because of social phobia say, ” Sometimes I feel like the odd one out at parties. Do you ever feel that that?” This way you are making the person feel comfortable in that they are not alone in how they feel.”

Another alternative Catherine suggests is to steer the conversation around to someone famous who has divulged they have social anxiety using celebrities such as Susie O’Neill (swimmer) or Gary Mc Donald( actor) as starting points. The person says to the suspected sufferer have you ever felt like Gary or Susie?” Again this helps the person to identify with someone else and not feel so isolated in their feelings.

If you suspect an individual may be suffering from the disorder but they deny it and refuse to seek help Catherine says, “You can still help them by providing them with literature, books and newspaper articles. You can give them to the person directly or be more subtle by leaving them on the coffee table’.”

Social Anxiety Treatment

Social anxiety disorder is treatable and there are various methods by which social phobia can be managed. Once the disorder is under control, if the learned practices are not continually implemented the problem can resurface with just as much vengeance.

The most common and readily accepted method of treating social phobia is via psychological treatment (One of )the methods psychologists use is called cognitive behaviour therapy(CBT). This therapy is not solely use for people suffering from social phobia but can also be used to treat many other conditions. Administration of CBT encompasses both relaxation training and exposure therapy.

“In CBT the psychologist asks the sufferer questions to determine which social situations are feared and how the sufferer acts and thinks in these social situations. The psychologist helps the sufferer identify the problematic behaviours and thoughts and helps them develop more effective coping strategies,” says Catherine. CBT can be performed in a group or individual setting. It has been shown with effective implementation of CBT people have been able to remarkably improve the severity of the condition in as little as 12 sessions.

Exercise also has a place in treating social phobia because it is an effective means of releasing tension, stress and anxiety. Exercise also triggers feelings of calmness and happiness. Further, regular exercise boosts physical fitness and helps control weight, which in turn positively effects self esteem.2

Using natural products and methods such as those used by naturopaths is an alternative method to controlling social phobia. Natural methods include administering mixtures of aromatic herbs and flower essences to help calm down the body’s nervous system. The most popular remedy at present is called Bach Flower Rescue Remedy. This particular remedy involves combining cherry, plum, clematis, impatiens, rock rose and Star of Bethlehem. This remedy has been used to alleviate the physiological symptoms of social phobia, by alleviating the anxiety experienced by sufferers. The Bach flower rescue remedy, can help deal with any emergency or stressful event, such as taking a driving test, exam nerves or speaking in public.

Medication can also be prescribed by doctors and psychiatrists to deal with the disorder, but again tend to deal only with alleviating the physiological aspects of the problem rather than eliminating the cause. Medications such as beta blockers which aim to lower the heart rate may be administered. Anti-depressants can help to stop the anxiety and panics, although they take a few weeks to kick in and can have some undesirable side effects. Tranquillisers such as Valium were used in the past to treat all sorts of anxiety but are addictive and not as effective in the long run3.

If social phobia is left untreated Catherine says,” The sufferer may end up single, less educated, financially dependent or less well off. They may also go on to develop additional psychiatric disorders such as alcoholism, drug abuse and be socially isolated. The very worst case scenario is they may commit suicide”.

The good news though is help is readily available. If you suspect you re suffering or someone close to you is suffering from social phobia, do yourself and/or them a favour and seek help. There are a number of psychologists, psychiatrists ,general practitioners, support groups, workshops, courses and community groups who are available to help so there is no need to feel segregated and alone.

Catherine Madigan is a psychologist who specialises in the treatment of social anxiety disorder. She offers both individual and group therapy.


1. Social Phobias involve more than shyness.

2. Social Phobias Help is at Hand — The Royal College of Psycholgists

This article published on Nov 10, 2012. View related Articles

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