Probably everyone has experienced shyness and some degree of social phobia at some point in their lives. This is particularly likely to have occurred when going into unfamiliar social contexts like a new school or workplace; and/or having to perform socially with new people or for people with perceived greater importance or social standing. For those with Social Anxiety Disorder they experience these feelings when trying to engage with everyday activities. This leads them to retreat from other people and avoid situations where any expectations can be placed on them to interact.
Social Anxiety Disorder can cause a range of physical symptoms that can include:
skin flushing or blushing
feeling short of breath
feeling sick (nausea)
churning feeling in stomach (butterflies)
fast thumping heartbeat
difficulty talking and shaky voice
trembling or shaking
Confusion or feeling 'out of body'
Emotional symptoms of social anxiety disorder include:
feeling intensely self-conscious and easily embarrassed
obsessively worrying about social events for days, weeks or months before they occur
fear that others are judging them - paranoia that everyone is talking negatively about them
fear of doing something wrong and being humilated - predicting the worst possible outcome from any social situation
fear that others are aware that they are feeling anxious and notice physical symptoms such as blushing or stress in the voice.
The extent to which each individual with Social Anxiety Disorder is able to cope with their condition determines the impact on their everyday functioning. Treatments focus on helping individuals with their symptoms and supporting them to overcome their anxieties. There are two approaches that have been found to effective for both adults and children:
Cognitive Behaviour Therapy. This approach involves attending sessions with a therapist who helps the patient replace negative cycles of thoughts and feelings with more positive interpretations of the situations that cause them distress.
Medication. Drugs are prescribed that work by reducing the excitability of the amygdala, part of the brain concerned with processing fear responses. The behaviours of Social Anxiety Disorder can be described as flight or freeze responses to stress and the amygdala is involved in this. Inhibiting these responses reduces the physical symptoms of anxiety enabling the individual to cope better when faced with difficult and stressful situations.