Social Anxiety Disorder
Do you ever get overly anxious in the company of people
that you don't know well enough or met for the first time? Do you try
everything you can to avoid giving a presentation or speaking in
front of people? Do you often find yourself thinking about what others
might be thinking about you? Most of us find social
gatherings with unfamiliar people and public speaking anxiety
provoking, and at times most of us will try to guess what others
think of us. Yet for some people the anxiety is so unbearable that it
might compromise day-to-day functioning. In this case people may
develop social anxiety.
What is Social
Anxiety?
In short, social anxiety is
the fear of real or imagined social situations and the fear of negative
evaluations by others. Social anxiety may be generalised or specific.
Specific (or non-generalised) social phobia is associated with performance
anxiety, such as speaking or eating in front of other people. Generalised
social anxiety occurs in most social situations and it includes
difficulties with initiating or maintaining conversations, meeting people,
attending work functions and so on.
The most common form of
social anxiety is the generalised type. Since it is associated with most
social situations, people who suffer from a generalised social anxiety
often find it difficult to function well at work, they have
difficulty dating or making friends and eventually may also develop
depression.
Social anxiety can develop slowly over the course of
years, or it may develop abruptly, following a humiliating or
difficult incident (e.g., experiencing a panic attack during a board
meeting).
Social Anxiety and
Alcohol
Many people who suffer from social anxiety also
suffer from alcohol and substance abuse. The link between social anxiety
and alcohol/drug use is well established. Most socially
anxious individuals want to feel comfortable with others and
want to enjoy socialising, but unable due to their anxiety. Alcohol and
drugs can reduce inhibitions and may create the illusion of social
confidence and competence. Yet the combination of social anxiety and
alcohol use is very dangerous and people may find that the only way they
can interact with others is "after a few drinks". This pattern actually
increases the severity of social anxiety and makes it more difficult to
treat.
Symptoms of Social Anxiety
 |
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Notable and persistent fear about one or more
social and performance situations where one is exposed to
unfamiliar people or scrutiny by others.
-
Fear of acting or behaving in a way that will be
embarrassing or humiliating.
-
When exposed to the feared social situation, it
automatically provokes anxiety (could also elicit a panic
attack).
-
Recognition that the fear is excessive or
unrealistic.
-
The feared situations are avoided or endured with
intense anxiety.
-
The avoidance or the anxiety interferes with
normal functioning, including occupational, relationship and
social functioning. |
Treatment of Social Anxiety
The first step
in the treatment of social anxiety is the exploration of situations in
which anxiety occurs and the safety mechanisms that people apply (e.g.,
avoidance of public speaking). Second, we need to identify and set goals
for the treatment. These goals must remain realistic. The goal of
treatment is not a 180 degree shift in social functioning, but a
structured approach to improve our clients' quality of life.
When
clear goals are established, we can begin working on anxiety management.
Techniques and strategies involve education about anxiety, how it impacts
on our clients' lives, relaxation and awareness training, and finally
exposure to anxiety provoking situations while using the learned
techniques. True, real life exposure can take some time and also depends
on the availability of anxiety provoking situations. We often set
tasks together with our clients and at times we may accompany
them locally as a form of observation and support.
As
part of our treatment, we also focus on maintenance. We aim to
achieve long term changes that will ensure that our clients retain their
newly developed skills and able to enjoy a different life.
