You probably know someone with social anxiety. Imagine that it's worse than simple anxiety and is a full-blown phobia. Social phobia, also known as Social Anxiety Disorder, is an Axis I clinical disorder listed in the Diagnostic and Statistical Manual of Mental Disorders. Social phobia is characterized by ''clinically significant anxiety that's provoked by exposure to social or performance scenarios,'' and this anxiety leads to avoidance behaviors. For example, a student with social anxiety disorder may completely avoid eating in the school cafeteria with other students because he or she experiences a great deal of fear and anxiety when engaging with other students in this manner, and the only way to reduce or remove the anxiety is to avoid the cafeteria entirely.
The essential features of social phobia are persistent fear of social or performance situations in which the person feels that embarrassment may occur. The person fears that when he is exposed to unfamiliar people, some possible scrutiny by others could occur and he will act in a way that could be embarrassing.
As soon as the exposure to the social situation occurs, anxiety is almost immediate. The most common scenario is that the social situation is avoided, but when it is not, it is endured with dread and fear. Social phobia is said to be generalized when the anxiety and fear tends to include most social situations and not just one or two specific scenarios.
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The person with social phobia could also experience a panic attack, but it is not required for diagnosis. A panic attack is a period of intense fear or discomfort in which the person experiences numerous symptoms within about a ten minute time period. Some of those symptoms include sweating, shaking, racing heart, shortness of breath, chest pain, dizziness and fear of losing control, to name a few.
The fear and anxiety that are present with social phobia need to be significant enough that it interferes with the person's daily life, and his or her social and occupational functioning. The person must also be significantly distressed about having the phobia.
The onset of social phobia tends to be in the mid-teens. In individuals who are younger than 18 years old, the fear and anxious symptoms must be present for at least six months before a diagnosis can be rendered. Adolescents and adults may recognize that the fear is both unreasonable and excessive, but young children may not.
The duration of social phobia tends to be persistent and lifelong. The severity of the symptoms and impairment could also fluctuate in response to life events and stressors. For example, if a person with social phobia earns a promotion that requires more public speaking, he or she may see an increase in symptoms.
Treatment for social phobia most often involves a combination of medication and psychotherapy. Cognitive Behavioral Therapy (CBT) techniques are most often applied including exposure therapy and cognitive restructuring, and these techniques have been shown to be very effective. The medication that is most often prescribed is called a selective serotonin reuptake inhibitor (SSRI). Common SSRIs include Paxil (paroxetine), Zoloft (sertraline), Prozac (fluoxetine), and Luvox (fluvoxamine). With therapy and medication management, an individual with social phobia can potentially begin living a relatively normal life.
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