Social phobia is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as parties and other social events.
People with social phobias fear and avoid situations in which they may be subject to the scrutiny of others. It may begin in adolescence and may be associated with overprotective parents or limited social opportunities. Males and females are affected equally with this disorder.
People with social phobia are at high risk for alcohol or other drug dependence, because they may come to rely on drinks or drugs to relax in social situations.
People with social phobia become overwhelmingly anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.
Although many people with social phobia realize that their fears about being with people are excessive or unreasonable, they are unable to overcome them on their own.
Social phobia can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others). Or, it may be so broad (such as in generalized social phobia) that the person experiences anxiety around almost everyone other than family members.
Physical symptoms that often occur with social phobia include:
Social phobia is different from shyness. Shy people are able to participate in social functions. People with social phobia are constrained by their condition to the point that it affects their ability to function in work and relationships.
Some of the most common fears of people with social phobia include:
The health care provider will look at your history of phobia, and will get a description of the behavior from you, your family, and friends.
Signs include:
The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of the phobia.
Anti-anxiety and antidepressant medications are sometimes used to help relieve the symptoms associated with phobias. See Panic Disorder for more information about medications.
Behavioral treatment appears to have long-lasting benefits.
Lifestyle changes may help reduce how often the attacks occur.
The outcome is generally good with treatment, and antidepressant medications have been shown to be very effective.
Call your health care provider or mental health professional if fear is affecting your work and relationships with others.
Taking measures to improve your self-esteem and getting training in social skills may be helpful.
Phobia - social; Social anxiety disorder
Stein MB, Stein DJ. Social anxiety disorder. Lancet. 2008;371:1115-1125.
Taylor CT, Pollack MH, LeBeau RT, Simon NM. Anxiety disorders: Panic, social anxiety, and generalized anxiety. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 32.
Reviewed by: Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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