What is Social Anxiety (Social Phobia)?

Social anxiety is a disorder that causes people to have an intense fear of social situations in which they may be scrutinized by other people. Typically, the fear is about being evaluated negatively by others. Often, there is a concern that they might be judged as weak, anxious, incapable, dirty, unlikeable, or boring. A person with social anxiety may fear that they will act in a way that will make others see them negatively like blushing, trembling, sweating, etc. Some people fear offending others and some fear urinating in public places where others might be present. The fear of judgement by others is out of proportion to the actual threat of being judged.

Prevalence

The prevalence of social anxiety is around 7% and decreases with age. For older adults specifically, the prevalence rate ranges from 2%-5%. Higher rates of social anxiety are found in females than in males.

Signs and Symptoms

On many occasions people with social anxiety will experience anticipatory anxiety if a social situation is approaching. However, the anxiety can also occur far in advance of the social situation. Individuals will often avoid these kind of situations or they will endure them but experience intense fear or anxiety throughout. Some will avoid situations extensively (not attending social events like parties, or not going to school). Others will over prepare, divert attention to others, or limit eye contact. The cultural background of the person is important to consider, given that there are social norms in some cultures that would explain a fear of judgement.

Treatment

The treatment for this disorder is with psychotherapy and medication if the severity is high. Psychotherapy can improve symptoms in most people with social anxiety and involves recognizing and changing negative thoughts about the self and developing skills to gain confidence in social situations. A combination of cognitive-behaviour therapy (CBT) and exposure typically has the best outcomes. Skills training and role-playing can be incorporated into the therapy. Medications like SSRIs are typically prescribed however, other antidepressants or anti-anxiety medications can also be helpful.

Sources:

The DSM-5 Diagnostic and Statistical Manual of Mental Disorders 5

The Mayo Clinic: Mayoclinic.org

Video resource: https://www.youtube.com/watch?v=QLjPrNe63kk