Social Anxiety Disorder (also called Social Phobia) ...

"If I have to speak in front of people I get so anxious I can't stand it. I won't sign up for a class if an oral presentation is involved. It's just not worth it."

Social Phobia (also called Social Anxiety) is often viewed as an extreme form of Shyness. People who suffer with Social Phobia are extremely anxious around others, and often "clam up" or don't speak when in a crowd. Many times parties are avoided, job performance suffers, or school is skipped. Places with large crowds (e.g. shopping malls, grocery stores) are avoided. There is an extreme fear that others are watching you, or are evaluating everything you say or do. People with Social Phobia are overwhelmed when with others, but tend to be very personable and comfortable when one-on-one. Specifically, Social Phobia involves:

A marked fear of social or performance situations in which the person is exposed to unfamiliar people or to the possible scrutiny by others.

The individual fears that he will act in a way that will be humiliating or embarrassing.

Exposure to the feared social situation almost always provokes anxiety, which may even become a Panic Attack.

The person recognizes that the fear is excessive or unreasonable.

The feared social or performance situations are avoided or are endured with intense anxiety or distress.

The avoidance, anxious anticipation, or distress in the feared social situation interferes with the person’s normal routine, job (or school) functioning, social activities and relationships, or there is a marked distress about having the phobia.

Cognitive-behavioral model of social anxiety disorder:

Physiological symptoms of anxiety in social or performance situations (such as panic attacks, sweating, trembling, blushing), combined with negative or fearful thoughts about how others perceive or judge you, can lead to increased anxiety, decreased performance, avoidance of feared situations, negative beliefs about yourself and others, and anticipatory anxiety about future situations. People with social anxiety may adopt safety behaviors that help them feel safe in social situations, such as speaking softly or avoiding eye contact; however, these behaviors often cause them to appear awkward or aloof and can evoke the very negative reactions from others that they fear. The result of all these elements working together is a negative cycle of anxiety, negative self-evaluation, fearful anticipation, and avoidance behaviors that prevent people from overcoming their anxiety in social situations.

Cognitive-behavior therapy for social anxiety disorder:

Cognitive-behavior therapy for social anxiety involves several types of interventions, including:

• Education and monitoring: Learn about the specific cognitive, behavioral, and physiological components that contribute to your social anxiety.

• Cognitive: Identify and test the negative thoughts that contribute to your social anxiety, and develop more realistic and helpful beliefs.

• Behavioral: To overcome social anxiety, it is important to test your beliefs about social situations by exposing yourself to situations that trigger your fears. Your therapist will help you gradually expose yourself to feared social situations (starting with easy ones and working up to harder ones), both in imagination and in real life and set realistic goals for your performance in those situations. Your therapist will help you identify and drop safety behaviors that actually contribute to the problem. You and your therapist may also work on increasing your social skills so that you can feel more confident and be more effective in social situations.