Social phobia is a fear of behaving in an embarrassing way whilst you talk or meet with other people, especially strangers. It can greatly affect your life. Treatment works well in many cases. Treatment options include cognitive behavioural therapy (CBT) and medication, usually with a selective serotonin reuptake inhibitor (SSRI) antidepressant.
Social phobia is sometimes called social anxiety disorder. Social phobia is not just shyness, it is more severe than this. With social phobia you get very anxious about what other people may think of you, or how they may judge you. As a result you have great difficulty in social situations, which can affect your day-to-day life.
Social phobia can greatly affect your life. You may not do as well at school or work as you might have done, as you tend to avoid any group work, discussions, etc. You may find it hard to get, or keep, a job as you may not be able to cope with the social aspects needed for many jobs, such as meeting with people. You may become socially isolated and find it difficult to make friends.
It is one of the most common mental health conditions. Up to 1 in 10 adults have social phobia to some degree. It usually develops in the teenage years and is usually a lifelong problem unless treated. Just over twice as many women are affected than men.
The cause is probably a combination of your genetic makeup which makes you more prone to this condition, and bad experiences as a child. In one study about half of affected people said their phobia began after one memorable embarrassing experience. The other half said it had been present 'as long as they could remember'.
You must have three features to be diagnosed with social phobia:
Some studies suggest that cognitive behavioural therapy (CBT) works well in up to 3 in 4 cases of social phobia. (However, it may not be available on the NHS in all areas.)
Cognitive therapy is based on the idea that certain ways of thinking can trigger, or fuel, certain mental health problems such as phobias. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful, and false ideas or thoughts which you have that can make you anxious. The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful. Therapy is usually done in weekly sessions of about 50 minutes each, for several weeks. You have to take an active part, and are given homework between sessions. For example, you may be asked to keep a diary of your thoughts which occur when you become anxious before a social event.
Behavioural therapy aims to change any behaviours which are harmful or not helpful. Various techniques are used. For social phobia the therapist will usually help you to face up to feared situations gradually, a little bit at a time. The therapist teaches you how to control anxiety when you face up to the feared situations. For example, by using deep breathing techniques. This type of behavioural therapy is called exposure therapy where you are exposed more and more to feared situations and learn how to cope. The therapist may also teach you certain social skills such as verbal and nonverbal skills to help you in social situations. For example, how to start and maintain a conversation, appropriate eye contact with other people, etc.
You can get leaflets, books, tapes, videos, etc, on how to relax and how to combat anxiety. They teach simple deep breathing techniques and other measures to relieve stress and anxiety. A longer leaflet in this series, called 'Shyness and Social Anxiety - a Self Help Guide'' is a good start.
Medication for social phobia
A combination of treatments such as CBT and an SSRI antidepressant may work better in some cases than either treatment alone.
Although alcohol may ease anxiety symptoms in the short-term, don't be fooled that drinking helps to cure anxiety. In the long run, it does not. Drinking alcohol to 'calm nerves' is often a slippery slope to heavier and problem drinking. See a doctor if you are drinking heavily (or taking street drugs) to ease anxiety symptoms.
Not much is known about the natural progress of the condition. However, with treatment there is a good chance that symptoms can be greatly improved. Without treatment, social phobia can be associated with depression in later life.
Zion Community Resource Centre, 339 Stretford Road, Hulme, Manchester, M15 4ZY
Tel: 08444 775 774 Web: www.anxietyuk.org.uk
A leading UK charity for anxiety disorders.
93 Brands Farm Way, Randlay, Telford, Shropshire TF3 2JQ
Helpline: 0808 808 0545 Web: www.nopanic.org.uk
For people with panic attacks, phobias, obsessive compulsive disorder, and related disorders.
Helpline: 0845 2967877 Web: www.anxietyalliance.org.uk
If you have an anxiety disorder, such as general anxiety, phobias, panic attacks or obsessional compulsive disorder, or wish to withdraw from tranquillisers and anti-depressants, then Anxiety Alliance is there to help, advise and support you.
PO Box 3760, Bath, BA2 3WY
Tel: 0845 600 9601 Web: www.topuk.org
Runs a national network of structured, self-help groups for adults (16+) with phobias.