Social Phobia--A Common Cause of Anxiety

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Social anxiety disorder or social phobia is a very common mental health disorder but is rarely discussed. Social phobia affects more than 10 million North Americans and is ranked just behind depression and substance abuse in terms of how common it is. (1) The exact number of people affected with this disorder is not known as thousands more do not seek help or have not been diagnosed.

The basic essence of social phobia is intense anxiety and self-consciousness when one is in a public situation. The symptoms of social phobia are very similar to what is seen during a panic attack. These individuals often develop extreme anxiety when speaking in public, using public bathrooms, going to the swimming pool, attending parties, eating in public places or any activity that requires socialization.

Social phobia is not a trivial disorder. It can cause tremendous fear of being humiliated, disgraced or embarrassed in social environments or when trying to speak. The individual may develop sweating, palpitations, become dizzy, extremely thirsty and have a sensation of impending doom. These symptoms are often reinforced by anything that causes anxiety.

The symptoms of social phobia are often abrupt and tend to last anywhere from 15-45 minutes. Why people develop social phobia is a mystery. Some mental health experts believe that perhaps a stressing event or a humiliating event during childhood may be the precipitating factor. Many people have mild social phobia but this is not considered a mental health disorder until it is severe enough to adversely affect one’s life style, work or interpersonal relationships. People with social phobia will go at great lengths to avoid social situations that will adversely affect their mind. The fear can be so great that most people live a solitary life and become withdrawn. Even though social phobia is common and widely recognized, most people tend to have a delayed diagnosis. In most cases, the disorder is misdiagnosed as simply anxiety. The delay may vary from one month to as much as several decades. (2)

Social phobia is not only limited to adults but is also seen in children and teenagers. Social phobia first manifests itself during the teenage years and progresses. Teenagers affected with this disorder often avoid age-appropriate social activities like attending parties, dating or eating out. (3)

Women tend to be slightly more afflicted with this disorder than men. Overall, social phobia is most common in Caucasian females who are well educated. Social phobia is common in all cultures and ethnic groups.  People who have social phobia also tend to have other co-existing psychiatric disorders like depression, attention deficit disorder, separation anxiety disorder and OCD tendencies. (4)

In some cases, social phobia is the cause of suicidal symptoms and depression. In children, social phobia can often lead to discriminating mutism or be a precursor to depression. (5) Evidence has indicated that untreated social phobia increases the lifetime risk of depression and can even lead to substance or alcohol abuse. Most people are aware that they have this disorder but for some unknown reason are often afraid to seek help. (6)

Sources

1. Benjamen M. 2005. Social Phobia. http://psychcentral.com/disorders/anxiety/social_phobia.html

2. Wiltink J, Haselbacher A, Knebel A, Tschan R, Zwerenz R, Michal M, et al. Social Phobia - An Anxiety Disorder Underdiagnosed in Outpatient and Consultation-Liaison Service?. Psychother Psychosom Med Psychol. May 18 2009 http://www.ncbi.nlm.nih.gov/pubmed/19452420

3. Fichter MM, Kohlboeck G, Quadflieg N, Wyschkon A, Esser G. From childhood to adult age: 18-year longitudinal results and prediction of the course of mental disorders in the community. Soc Psychiatry Psychiatr Epidemiol. Sep 2009;44(9):792-803
http://www.ncbi.nlm.nih.gov/pubmed/19212695

4. Weinstock LS. Gender differences in the presentation and management of social anxiety disorder. J Clin Psychiatry. 1999;60 Suppl 9:9-13
http://www.ncbi.nlm.nih.gov/pubmed/10335674

5 Stein MB. Neurobiological perspectives on social phobia: from affiliation to zoology. Biol Psychiatry. Dec 15 1998;44(12):1277-85.
http://www.ncbi.nlm.nih.gov/pubmed/9861470

6. Beidel DC. Social anxiety disorder: etiology and early clinical presentation. J Clin Psychiatry. 1998;59 Suppl 17:27-32.
http://www.ncbi.nlm.nih.gov/pubmed/9811427

Reviewed Jun 17, 2011
Edited by Alison Stanton

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