Social Anxiety Disorder - Causes, Symptoms and Treatment

Social Phobia

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Social Anxiety Disorder (SAD): What is it?

Social anxiety disorder (SAD), also known as social phobia, is a condition marked by fear and anxiety in social situations, resulting in considerable distress and impaired functioning in certain areas of daily life.  People can feel threatened by scrutiny if they perceive or experience it. Those suffering from social anxiety disorders fear negative assessments.

In addition to excessive blushing and sweating, palpitations, trembling, and nausea are common symptoms. Speaking rapidly may occur with stammering. Fear and discomfort can also trigger panic attacks. In order to reduce their nerves and inhibitions, some sufferers use alcohol or other drugs. Especially if they are undiagnosed, untreated, or both, people suffering from social phobia are likely to self-medicate in this way; this will often lead to alcoholism, eating disorders, and other kinds of substance abuse. Sometimes, SAD is described as a disease of lost opportunities due to the major lifestyle changes individuals make to cope with the disease. Social phobia is basically described by two criteria according to ICD-10 guidelines: fear of being the centre of attention or fear of embarrassing or humiliating behaviour, as well as avoidance and anxiety. Social anxiety disorder can be detected with standard rating scales and the severity of anxiety can be measured with them.

For social anxiety disorder, cognitive behavioural therapy (CBT) is the first step in treatment. For social phobia, SSRI medications, particularly paroxetine, can be effective. In either a group or individual setting, CBT is effective in treating this disorder. Through cognitive and behavioural interventions, anxiety-inducing situations are altered in how people think and react. With the approval and marketing of drugs designed to treat social anxiety disorder, the attention given to it has greatly increased since 1999. A number of antidepressant medications may be prescribed such as Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), Monoamine Oxidase Inhibitors (MAOIs), and Selective Serotonin Reuptake Inhibitors (SSRIs). A beta-blocker and a benzodiazepine are also commonly used medications.

A person with social anxiety disorder avoids people, which interferes with their lives. Stress may negatively impact your daily routine, work, school, or relationships. Taking medications for social anxiety disorder and learning coping skills in psychotherapy will improve your ability to interact with others and build confidence.

What are the Symptoms of Social Anxiety Disorder (SAD):

Particularly in children, feeling shy or uncomfortable in certain situations isn't always indicative of social anxiety disorder. The degree to which we feel comfortable in social situations is determined by our personalities and experiences. There are people who tend to be reserved, and there are others who tend to be more outgoing. The impact of social anxiety disorder on relationships, daily routines, work, school, and other activities differs from normal nervousness. Sometimes social anxiety can begin in younger children or adults, though it typically begins in the early to mid-teens. Symptoms relating to emotions and behaviours regarding Social Anxiety Disorder:

Social Anxiety Disorder

  • A social anxiety disorder's signs and symptoms include:
  • Anxiety about being negatively judged in certain situations
  • You fear embarrassing yourself or being humiliated
  • A fear of speaking to strangers or interacting with them
  • Being worried that others will see you as anxious
  • Feeling uncomfortable when your physical symptoms are embarrassing, such as blushing, sweating, trembling or speaking shakily
  • Having a fear of embarrassment that prevents you from doing things or speaking with people
  • Keeping yourself out of situations where you could be the centre of attention
  • You are afraid of an activity or event you find stressful
  • Anxiety or fear caused by social situations
  • Consider your performance in a social situation and pinpoint any flaws you may have
  • The worst possible outcome is expected when an experience is negative during a social situation
  • The behaviour of crying, having temper tantrums, or refusing to speak in social situations can be signs of a child's anxiety about interacting with adults or peers.
  • You suffer from social anxiety disorder if you have intense feelings of fear and anxiety when performing or speaking in public, but not when interacting in more general social situations.

Physical symptoms regarding Social Anxiety Disorder:

Social anxiety disorder is sometimes accompanied by physical signs and symptoms, including:

  • Blushing more often than usual
  • Rapid heartbeat
  • Feeling trembling
  • Excessive sweat
  • Having an upset stomach or feeling nauseated
  • Breathing problems
  • Having lightheadedness or dizziness
  • Having a blank feeling in your head
  • Tension in the muscles
  • Keeping your distance from common social situations
  • A social anxiety disorder makes it difficult to cope with everyday experiences, such as:
  • Getting into a conversation with a stranger
  • Partying or socializing
  • Working or attending school
  • Engaging in a conversation
  • Make eye contact with one another
  • Relationships
  • Having meals in front of others
  • Going to the restroom in a public area

There can be changes in symptoms of social anxiety disorder over time. When you find yourself facing a lot of change, stress, or demands in your life, they may flare-up. However, no matter how short-term relief you may get from avoiding anxiety-producing situations, constant avoidance will likely cause your anxiety to worsen in the long run.

Social Anxiety Disorder - When you should see a doctor 

When you fear social situations and avoid them because they make you nervous, or anxious, see your doctor or mental health professional.

What are the Causes of Social Anxiety Disorder (SAD):

Behavioural and environmental factors play a significant role in the emergence of social anxiety disorder, as with many other mental health conditions. The following factors may be involved:

Traits that are inherited: Family history has been linked to anxiety disorders. Nevertheless, it is unclear how much of this may be genetic in nature, as well as how much may be learned behaviour.

Role of Brain structure: The amygdala is believed to control the fear response in the brain. Social anxiety may be heightened in people with hyperactive amygdalas, causing them to react in a fearful way.

Role of Environment: Social anxiety disorders may be acquired behaviours - some people may develop major anxiety after embarrassing or unpleasant social situations. It is also likely that social anxiety disorder is associated with either parent who models anxiety in social situations or parents who are protective of their children.

Social Anxiety Disorder Risk Factors:

It is possible to develop a social anxiety disorder for several reasons, including:

The history of the family:  If your parents or siblings suffer from a social anxiety disorder, you are more likely to develop the disorder yourself.

Experiencing negative events: The incidence of social anxiety disorder may be higher among children who are bullied, rejected, ridiculed, or humiliated. A person with this disorder may also be impacted by negative life experiences, such as family conflict, trauma, or abuse.

Role of Temperament: Children who remain reserved or withdrawn when faced with new people or situations are more likely to experience trouble.

Changing social or professional demands: Symptoms of social anxiety disorder begin during teenage years, but making a speech in public or presenting something important at work may trigger the disorder for the first time.

A distinctive appearance or condition: Some people may feel self-conscious about their appearance and may develop a social anxiety disorder as a result of disfigurement, stuttering or tremors caused by Parkinson's disease.

Complications of Social Anxiety Disorder:

Without treatment, social anxiety disorders can dominate your life. You may experience anxiety problems in your career, school, relationships, or every area of your life. Anxiety problems can lead to:

  • Feeling low about yourself
  • Having difficulty being assertive
  • Talking negatively to yourself
  • Oversensitivity to criticism
  • Insufficient social skills
  • Having trouble relating to others and feeling isolated
  • Poor academic and employment achievements
  • Abuse of substances, such as excessive alcohol consumption
  • Thought about suicides or suicide attempts
  • With a social anxiety disorder, specific anxiety disorders and other mental health conditions are common, especially major depressive disorder and substance use disorders.

How to Prevent Social Anxiety Disorder:

An anxiety disorder can develop for any reason, but here are some ways to reduce the impact of symptoms if you suffer from one:

Seek help as soon as possible: The longer you wait to seek help for anxiety, the harder it will be to treat it.

Keeping a journal is important: Your mental health professional can help you identify what's causing you stress and what seems to make you feel better by keeping track of your personal life.

Decide what is most important to you: Time and energy management can greatly reduce anxiety. Focus on your interests.

Stay away from unhealthy substances: Drinking alcohol and using drugs, as well as smoking and using caffeine, can contribute to anxiety. Quitting can make you anxious if you are dependent on any of these substances. Find a support group or treatment program if you cannot quit on your own.

Social Anxiety Disorder: Diagnosis

In addition to assessing if a social anxiety disorder is associated with another physical or mental health condition, you should ask your health care provider whether any other conditions may be causing your anxiety. The diagnosis may be determined by:

  • An examination to determine if any medical conditions or medications may trigger anxiety
  • Discuss your symptoms, their frequency, and the situations in which they occur
  • Identify situations that cause you anxiety by reviewing a list
  • Social anxiety symptoms are self-reported through questionnaires
  • Intense fear or anxiety about being judged negatively, humiliated, or embarrassed during certain social situations
  • Social situations that cause anxiety or that are endured with intense fear or anxiety
  • Unreasonably high levels of anxiety
  • Interruption of your daily life due to anxiety or distress
  • When there is no apparent medical cause, medication or substance abuse to explain fear or anxiety

Social Anxiety Disorder: Treatment

Depending on the severity of social anxiety disorder, there is a range of treatment options. Treatment options for social anxiety disorder include psychotherapy (also known as psychological counselling) and medications.

Psychotherapy

The symptoms of social anxiety disorder are usually improved by psychotherapy. During therapy, you gain skills that prepare you for social situations and help you to change negative thoughts about yourself. In both individual and group settings, cognitive behavioural therapy (CBT) has proven most effective in treating anxiety disorders. By gradually exposing yourself to your fears, exposure-based CBT helps you overcome them. By practising this, you can learn to cope with anxiety-provoking situations in a more confident way. To gain comfort and confidence in your relationship with others, it is also useful to participate in skills training or role-playing. Familiarizing yourself with social situations is an ideal way to ease worry.

Social Anxiety Disorder: Medications

  • In the case of persistent social anxiety symptoms, selective serotonin reuptake inhibitors (SSRIs) are commonly the first type of medication to be tried. Sertraline (Zoloft) or paroxetine (Paxil) may be prescribed by your healthcare provider.
  • A social anxiety disorder may also benefit from venlafaxine (Effexor XR), an SNRI. You may be prescribed a low dose of medication at first and gradually increased to a full prescription dose in order to reduce the risk of side effects. If your symptoms do not improve within several weeks or several months of treatment, please seek medical attention.

Other medications can also be prescribed by your doctor to relieve social anxiety symptoms, including:

  • Antidepressants in general: Finding the antidepressant with the fewest side effects might require you to try several different antidepressants.
  • Anxiety-reducing medications: You may experience less anxiety by taking benzodiazepines. In spite of their quick results, they may be habit-forming and could sedate, so they are typically prescribed only for short-term use.
  • A beta-blocker: In essence, they are medications that block the effect of epinephrine (adrenaline). Among the side effects, they may cause are reduced heart rate, blood pressure, pounding of the heart, and shaking of the limbs and voice. In addition, these drugs might be most effective when used infrequently to manage symptoms during a particular scenario, like giving a speech. In general, these drugs should not be prescribed for social anxiety disorder.

*Disclaimer – This blog provides the information only; it doesn’t claim that the above-mentioned information can cure any diseases or can be the replacement of any medicine. For the illness kindly consult a doctor.


Social Anxiety Disorder   SAD   Social Phobia   Causes of Social Anxiety Disorder   Symptoms of Social Anxiety Disorder   Treatment of Social Anxiety Disorder   Diagnosis of Social Anxiety Disorder  


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