Social Anxiety is a potentially debilitating fear of social ssituations. It is generally considered to be the most common psychological problem, and encompasses a wide range of phobias and anxieties having to do with social situations. Social Anxiety Disorder (SAD), if left untreated, can degenerate into worse psychological issues, like agoraphobia or substance abuse, as people try to deal with their issues through avoiding them.

What is it?

Many people get nervous or uncomfortable before a date or a party or any gathering that makes them a public display, but not everyone finds that discomfort so overpowering that they are unable to go out and socialize in public. People with Social Anxiety can find their fear so overwhelming that they just cannot force themselves into a situation where they may be called on for some social function. These people can have difficulty attending work-related meetings, attending classes, speaking in public, or even going out to a party. Even though they may see that their condition is irrational, they can find themselves unable to overcome it, especially if their fear is reinforced by some traumatic or humiliating event. According to the National Institute of Mental Health (NIMH), some 5.3 Americans alone are affected to such a degree that they may intentionally limit themselves by avoiding things like promotions, or parties, even cutting classes in school. It is when an anxiety or phobia about social situations reaches this level that it becomes serious enough to require seeking treatment, as it is affecting the afflicted quality of life.

Treatment for SAD

The first step in treatment for Social Anxiety Disorder, as with any psychological condition, is an evaluation by a qualified mental health professional. Courses of treatment can include various medicines, like strong benzodiazepines like Valium, which are usually only prescribed for short periods of time because patient systems can quickly develop a tolerance for them, or selective serotonin reuptake inhibitor (SSRI) type drugs like Paxil, the most commonly-known drug for SAD, citalopram, and fluvoxamine. SSRI type drugs have become the predominant medication, as they are generally regarded as having fewer side-effects than older antidepressants.

Other methods of treatment can include aggressive cognitive-behavioral therapy (CBT). The main goal of CBT is to change a patient's thinking patterns from unhealthy, phobic ones, where they believe everyone is watching and judging their every action, to healthy, non-phobic ones, where they can rationally understand that they are under only the pressure they subject themselves to. This is accomplished primarily through exposing the person with Social Anxiety Disorder to that which is causing their phobia, in a controlled and understanding environment, and only when a patient has progressed far enough in his or her course of therapy to be able to handle and give permission for it.

Types

Psychiatrists have designated two general types of SAD. The first type is generalized Social Anxiety Disorder, whose sufferers have issues with any and all social situations. The second type covers those with specific social phobias. People with specific social phobias generally experience their anxiety and phobic reactions in only a few types of social situations. Glossophobia is by far the most common type of specific social phobia; it is the fear of speaking or performing in public, otherwise known as stage-fright. Paruresis, or shy bladder syndrome, is another highly common form of specific social phobia, where a person is physically unable to urinate in the presence of others (i.e. a public restroom urinal), and due to their psychological issues with it. A less-common form of SAD is scriptophobia, the fear of writing in public.

Causes and Physical Symptoms

Psychologists have not pinned down a specific root cause for Social Anxiety. It tends to run in families, and some types are more prevalent in one sex than another, but there is not any conclusive evidence to support any single theory. Some scientists see SAD as linked to an imbalance of serotonin, a brain chemical also linked to depression and bipolar disorder. Physical symptoms often accompany Social Anxiety, and may include simple blushing and accelerated heart rate, or nausea, uncontrolled weeping, hyperventilation and difficulty speaking. SAD, in either the general, or in a specific social phobia, can significantly and adversely affect a person's life, which is why it should be treated with the help of a qualified mental health professional as soon as it is discovered.

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