Social Anxiety Disorder

What is social anxiety disorder?

Social anxiety disorder is a condition in which you avoid social situations that you fear will make you uncomfortable. It is also called social phobia or sometimes called SAD. You may fear that people are observing or judging you or that they have negative feelings about you. This fear may be real or imagined and can get in the way of work, school, or other daily activities. With proper treatment and medicine, you may be able to perform most of your daily activities.

What causes social anxiety disorder?

Experts do not exactly know what causes social anxiety disorder which they think may begin between the ages of 14 and 16 years. The signs and symptoms of social anxiety disorder can be caused by events that occur during these teenage years. Any of the following may make it more likely for you to have social anxiety disorder:

• A problem with chemicals in your body, such as serotonin or dopamine.
  
  
• Behavior copied from parents or other people, such as parents showing fear in social situations.
  
  
• Peer group pressure.

What are the signs and symptoms of social anxiety disorder?

You may have any of the following:

• Extreme fear and anxiety in places where you have to meet new people. You may fear that others are judging you.
  
  
• Choosing to avoid social situations due to fear of meeting people.
  
  
• Blushing, sweating, shaking, trembling, muscle tenseness, shaky voice, dry mouth, or pounding heart.

How is social anxiety disorder diagnosed?

• Psychiatric assessment: Caregivers will ask if you have a history of psychological trauma, such as physical, sexual, or mental abuse. They will ask if you were given the care that you needed. Caregivers will ask you if you have been a victim of a crime or natural disaster, or if you have a serious injury or disease. They will ask you if you have seen other people being harmed, such as in combat. You will be asked if you drink alcohol or use drugs at present or in the past. Caregivers will ask you if you want to hurt or kill yourself or others. How you answer these questions can help caregivers decide on treatment. To help during treatment, caregivers will ask you about such things as how you feel about it and your hobbies and goals. Caregivers will also ask you about the people in your life who support you.
  
  
• Signs and symptoms: Social anxiety disorder may be diagnosed by your signs and symptoms. Any of the following may help caregivers diagnose social anxiety disorder:
  
  
  • You may have extreme fear of one or more situations that involve meeting people or performing for people.
    
    
  • You may have extreme fear that you may be embarrassed or shamed by others.
    
    
  • You may have an anxiety or panic attack when you are about to be in a feared social situation.
    
    
  • Your fear is extreme and to others, may seem like over-reacting.
    
    
  • You may choose to stay away from feared social situations. You may also bear with the situation even though you are very anxious.
    
    
  • Your daily activities are changed because of fears and anxieties.
    
    
  • Social anxiety disorder is not caused by another mental disorder or by substance abuse.

What are the types of social anxiety disorder?

There are two types of social anxiety disorder:

• Non-generalized social anxiety disorder: This is fear limited to one or two situations, such as public speaking. You may also fear performing in front of people.
  
  
• Generalized social anxiety disorder: This type of fear is present in almost all situations where you may have contact with people. The fear may be present days or weeks before the situation occurs. Simply thinking about a coming event may cause anxiety symptoms.

How is social anxiety disorder treated?

You may have one or more of the following:

• Psychosocial therapy:
  
  
  • Cognitive behavioral therapy: With a therapist, you will learn to face the feared object or situation slowly and carefully. You will also learn to control the mental and physical reactions of fear.
    
    
  • Psychotherapy: This is also called talk therapy and may include any of the following:
    
    
    • Assertiveness training: This training teaches you to stand up for yourself. It teaches you how to ask for what you need, how to set limits, and how to say no.
      
      
    • Family meetings: Your caregivers will meet with you and your family. You will talk about how to cope with your illness.
      
      
    • Group therapy: This is a series of meetings that you attend with other patients and staff. During these meetings, patients and staff talk together about ways to cope with illness.
      
      
    • Individual therapy: A time for you to meet alone with your therapist. During this time you and your therapist may talk about how to cope with your illness.
      
      
    • Social skills training: This teaches and trains you how to get along with other people.
  
  
• Medicine: You may have one or more of the following:
  
  
  • Antianxiety medicine: This medicine may be given to decrease anxiety and help you feel calm and relaxed.
    
    
  • Anti-depressants: These medicines are given to decrease or stop the symptoms of depression. Other behavior problems may also be treated with anti-depressants.
    
    
  • Beta-blockers: You may be given these medicines to treat or prevent "performance anxiety".
    
    
  • Tranquilizers: These are also called sedatives and may be given to help you stay calm and relaxed.

Where can I find support and more information?

Having social anxiety disorder is a life-changing condition for you and your family. Accepting that you have social anxiety disorder is hard. You and those close to you may feel angry, sad, or confused. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group with other people who have social anxiety disorder. Ask your caregiver for contact information for support groups. Call or write one of the following organizations for more information:

• Anxiety Disorders Association of America (ADAA)
  8730 Georgia Avenue, Suite 600
  Silver Spring , MD 20910
  Phone: 1- 240 - 485-1001
  Web Address: http://www.adaa.org
  

• National Institute of Mental Health (NIMH), Public Information & Communication Branch
  6001 Executive Boulevard, Room 8184, MSC 9663
  Bethesda , MD 20892-9663
  Phone: 1- 301 - 443-4513
  Phone: 1- 866 - 615-6464
  Web Address: http://www.nimh.nih.gov/
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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