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Social Anxiety Symptoms and Effects

Women with social anxiety disorders feel discomfort, and self-consciousness which can seem overwhelming. Social anxiety disorder is the most common of all anxiety disorders; it is a risk factor for depression, addictive disorders, and eating disorders. Anxiety disorders are the most pervasive class of mental disorders, with 18% of people having the condition.

People with social anxiety disorder fear having other people look at them. The concern in such situations is that the individual will say or do something that will result in embarrassment or humiliation. These concerns can be so pronounced that the individual stays away from most encounters with others, or endures such situations only with intense discomfort. Social phobia is a strong fear of being judged by others and of being embarrassed. This fear can be so strong that it gets in the way of going to work or school or doing other everyday things.

People with social phobia are afraid of doing common things in front of other people. For example, they might be afraid to sign a check in front of a cashier at the grocery store, or they might be afraid to eat or drink in front of other people, or use a public restroom. Most people who have social phobia know that they shouldn't be as afraid as they are, but they can't control their fear. Sometimes, they end up staying away from places or events where they think they might have to do something that will embarrass them.

Individuals with social anxiety disorder are typically shy when meeting new people, quiet in groups, and withdrawn in unfamiliar social settings. When they interact with others, they might or might not show overt evidence of discomfort such as blushing or not making eye contact, but invariably experience intense emotional or physical symptoms, such fear, racing heart, sweating, trembling, or trouble concentrating. They crave the company of others, but stay away from social situations.

Major depression and social anxiety disorder may go hand in hand. Social anxiety disorder frequently co-occurs with bipolar disorder. Social anxiety may co-occur with eating disorders and in such instances it is important to determine that embarrassment about eating disorder symptoms or behaviors such as purging or diarrhea is not the sole source of social anxiety before a diagnosis of social phobia is made.

Someone with social anxiety has its own independent functional disability including difficulty in work productivity, increased financial costs, and reduced health-related quality of life. They exhibit high self-criticism and often have depressive symptoms. Combined with concern on the part of the individual about their shyness and evidence that it has a detrimental effect on functioning, it can no longer be regarded as normal or just being shy.

What Causes Social Anxiety Disorder?

Social phobia sometimes runs in families, but no one knows for sure why some people have it while others don't. Researchers have found that several parts of the brain are involved in fear and anxiety. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.

There is some evidence that genetic factors are involved. Social phobia is often accompanied by other anxiety disorders or depression. Addictions, eating disorders, and even self-mutilation may develop if people try to self-medicate their anxiety.

What Are the Signs and Symptoms?

Social anxiety disorder is a chronic mental health condition. Sufferers may experience actual physical symptoms when forced to confront their fears.

Physical signs and symptoms of social anxiety disorder may include:

  • Blushing
  • Sweating
  • Trembling
  • Nausea
  • Upset stomach
  • Difficulty talking
  • Tenseness in the body
  • Confusion
  • Palpitations
  • Diarrhea
  • Cold hands
  • Difficulty making eye contact

Emotional and behavioral signs and symptoms are:

  • Intense fear of being in situations with unknown people
  • Fear of being judged
  • Worry about embarrassment or humiliation
  • Fear that others will notice anxious or awkward behavior
  • Anxiety that disrupts daily routine, work, school or other activities
  • Avoiding doing things or speaking to people out of fear of embarrassment
  • Fear of being the center of attention

Personality traits of those with social anxiety disorder may include low self-esteem, trouble being assertive, negative self-talk, and poor social skills.

Treatment of Social Anxiety Disorder

Social anxiety disorder or social phobia is treated best in a very safe, small, nurturing setting. It is generally treated with psychotherapy, medication, or both. A type of psychotherapy called Cognitive Behavior Therapy (CBT) is especially useful for treating social phobia. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and fearful. It can also help people learn and practice social skills. Components of CBT can include psycho-education, progressive muscle relaxation, social skills training, imaginal and in-vivo exposure, video feedback, and cognitive restructuring.

Medication. Doctors also may prescribe medication to help treat social phobia. The most commonly prescribed medications for social phobia are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.

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