What is Social Anxiety Disorder?

Social anxiety disorder (social phobia)
Definition

It’s normal to feel nervous in some social situations. Going on a date or giving a presentation may give you that feeling of having butterflies in your stomach, for instance. This isn’t social anxiety disorder.

In social anxiety disorder, everyday interactions cause extreme fear and self-consciousness. It may become impossible for you to eat with acquaintances or write a check in public, let alone go to a party with lots of strangers. If your life is disrupted by this kind of fear, you may have social anxiety disorder.

If you or a loved one has social anxiety disorder, take heart. Effective treatment — often with cognitive behavioral therapy, medication and positive coping skills — can improve the symptoms of social anxiety disorder and open up new opportunities.
Symptoms

Social anxiety disorder is a chronic mental health condition that causes an irrational anxiety or fear of activities or situations in which you believe that others are watching you or judging you. You also fear that you’ll embarrass or humiliate yourself.

Social anxiety disorder can have emotional, behavioral and physical signs and symptoms.

Emotional and behavioral signs and symptoms of social anxiety disorder include:
Intense fear of being in situations in which you don’t know people
Fear of situations in which you may be judged
Worrying about embarrassing or humiliating yourself
Fear that others will notice that you look anxious
Anxiety that disrupts your daily routine, work, school or other activities
Avoiding doing things or speaking to people out of fear of embarrassment
Avoiding situations where you might be the center of attention

Physical signs and symptoms of social anxiety disorder include:
Blushing
Profuse sweating
Trembling or shaking
Nausea
Stomach upset
Difficulty talking
Shaky voice
Muscle tension
Confusion
Palpitations
Diarrhea
Cold, clammy hands
Difficulty making eye contact

You may also be affected by:
Low self-esteem
Trouble being assertive
Negative self-talk
Hypersensitivity to criticism
Poor social skills

Worrying about having symptoms
When you have social anxiety disorder, you realize that your anxiety or fear is out of proportion to the situation. Yet you’re so worried about developing social anxiety disorder symptoms that you avoid situations that may trigger them. And indeed, just worrying about having any symptoms can cause them or make them worse.

When to see a doctor
If your fears or anxieties don’t really bother you, you may not need treatment. For instance, you may not like making speeches but you do so anyway without being overwhelmed by anxiety.

What sets social anxiety disorder apart from everyday nervousness is that its symptoms are much more severe and last much longer. If social anxiety disorder disrupts your life, causes you distress and affects your daily activities, call your doctor.

Common, everyday experiences that may be difficult to endure when you have social anxiety disorder include:
Using a public restroom or telephone
Returning items to a store
Interacting with strangers
Writing in front of others
Making eye contact
Entering a room in which people are already seated
Ordering food in a restaurant
Being introduced to strangers
Initiating conversations

Social anxiety disorder symptoms can change over time. They may flare up if you’re facing a lot of stress or demands. Or if you completely avoid situations that would usually make you anxious, you may not have symptoms. Although avoidance may allow you to feel better in the short term, your anxiety is likely to persist over the long term if you don’t get treatment.
Causes

Like many other mental health conditions, social anxiety disorder likely arises from a complex interaction of environment and genes. Researchers continue to study possible causes, including:
Genes. Researchers are seeking specific genes that play a role in anxiety and fear. Social anxiety disorder seems to run in families. But evidence suggests that the hereditary component of this condition is due at least in part to anxious behavior learned from other family members.
Biochemistry. Researchers are exploring the idea that natural chemicals in your body may play a role in social anxiety disorder. For instance, an imbalance in the brain chemical serotonin (ser-oh-TOE-nin) could be a factor. Serotonin, a neurotransmitter, helps regulate mood and emotions, among other things. People with social anxiety disorder may be extra-sensitive to the effects of serotonin.
Fear responses. Some research suggests that a structure in the brain called the amygdala (uh-MIG-duh-luh) may play a role in controlling the fear response. People who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations.
Risk factors

Social anxiety disorder is one of the most common of all mental disorders. Between 3 and 13 percent of people in Western countries experience social anxiety disorder at some point in their lives. Social anxiety disorder usually begins in the early to midteens, although it can sometimes begin earlier in childhood or in adulthood.

A number of factors can increase the risk of developing social anxiety disorder, including:
Your sex. Women are more likely to have social anxiety disorder.
Family history. Some research indicates that you’re more likely to develop social anxiety disorder if your biological parents or siblings have the condition.
Environment. Some experts theorize that social anxiety disorder is a learned behavior. That is, you may develop the condition after witnessing the anxious behavior of others. In addition, there may be an association between social anxiety disorder and parents who are more controlling or protective of their children.
Negative experiences. Children who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to social anxiety disorder. In addition, other negative events in life, such as family conflict or sexual abuse, may be associated with social anxiety disorder.
Temperament. Children who are shy, timid, withdrawn or restrained when facing new situations or people may be at greater risk.
New social or work demands. Meeting new people, giving a speech in public or making an important work presentation may trigger social anxiety disorder symptoms for the first time. These symptoms usually have their roots in adolescence, however.
Complications

Left untreated, social anxiety disorder can be debilitating. Your anxieties may run your life. They can interfere with work, school, relationships or enjoyment of life. You may be considered an “underachiever,” when in reality it’s your fears holding you back from excelling. In severe cases, you may drop out of school, quit work or lose friendships.

Social anxiety disorder can also lead to other health problems, such as:
Substance abuse
Excessive drinking
Depression
Suicide
Source: http://www.mayoclinic.com/health/social-anxiety-disorder/DS00595

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