Social phobia, also known as social anxiety disorder refers to a fear of interacting socially with others and taking part in social situations due to a morbid fear of being judged negatively by others (Walsh, 2002). It is different from all other anxiety disorders in its “early age of onset, occasional symptom remissions followed by relapses, and its exclusive association with social and performance situations” (Liebowitz, 1999, p. 22). People suffering from social phobia are often distressed when introduced to other people, being teased or criticized, being the focus of attention or being watched while performing something. The phobia may be considered a mental disorder when it interferes significantly with the person’s interpersonal and social lives (American Psychiatric Association, 2001). Research shows that there is a 13.3% lifetime prevalence of social phobia with women being more susceptible to this disorder than men. The condition is generally diagnosed only during the teenage period, the mean age of its onset being 16 years (Walsh, 2002). Despite this problem being common and one that affects the quality of life, very few people with social phobia realize they are having a treatable problem. Due to this lack of awareness only 2% of people with social phobia seek treatment (Walsh, 2002).
An example of social phobia may be seen in the case of Ricky Williams, an NFL running back who confessed that though he was young and rich, he was a very unhappy man. He was pathologically shy and his official diagnosis was “social anxiety disorder.” He feared public scrutiny so very much that he even gave media interviews with his football helmet on. He feared meeting his fans or doing his shopping. However, later on in his life he was able to overcome the disease through treatment using antidepressant drug (Elliott, 2003).
The feared situations causing social phobia can vary from interpersonal social interactions in small groups to talking to strangers. Holt, Heimberg, Hope and Liebowitz (1992) have found that social phobia can be precipitated by four kinds of situations: formal speaking and interaction situations such as giving a speech in front of an audience, performing on stage, etc.; informal speaking and interaction as in the case of going to a party, speaking up at a meeting, etc.; assertive interaction that includes expressing disapproval, voicing opinion, returning goods to a store, etc. and social observation, meaning, people feel socially anxious when they are simply observed by others while working, writing or eating (Holt et al, 1992). The exact causes of this disorder are not conclusively known and it has been suggested that there maybe multiple predisposing factors including hereditary, traumatic childhood experiences, modeling on parental behaviors and neurobiological imbalances.
Like most other anxiety disorders, social anxiety disorder may be treated using medicines or psychotherapy (Book and Randall, 2002). Both types of interventions must be aimed at reducing the social fears so that the patients are able face social situations with courage. The main drug classes used to treat social anxiety disorder are monoamine oxidase inhibitors (MAOIs), benzodiazepines, and more recently, selective serotonin reuptake inhibitors (SSRIs). Of all these drugs, SSRIs have been found to be most effective and they work by impacting the brain signaling system using the brain chemical serotonin. Paroxetine (Paxil[R]) is the only medication currently on the market that has been approved by the U.S. FDA for treatment of social anxiety disorder. Cognitive behavioral therapies (CBT) have also been used to treat this order successfully and these include exposure therapy; cognitive restructuring; relaxation training and social skills training (Book and Randall, 2002).
It is dangerous when people do not get treated for social anxiety disorder because most of them often take to alcoholism to overcome their anxiety. About 85% of all people suffering from both social phobia and alcoholism, the former condition preceded the alcohol problem (Jacobson, 81). This underlines the importance of getting social anxiety disorder diagnosed and then treated.
American Psychiatric Association (2001). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC.
Book, W. Sarah and Randall, L. Carrie (2002). Social Anxiety Disorder and Alcohol Use. Alcohol Research & Health, 26 (2), 2002.
Elliott, Carl (2003). American Bioscience Meets the American Dream: Here and Abroad, the Road to Self-Fulfillment Is Lined with Drugs and Surgery. The American Prospect, 14 (6), 2003.
Holt, C.S.; Heinberg, R.G.; Hope, D. A. and Liebowitz, M. R. (1992). Situational domains of social phobia, Journal of Anxiety Disorders, 6, 1992, 63–77.
Jacobson, L. James (2000). Psychiatric secrets. Elsevier Health Sciences, 2000.
Liebowitz, M. R. (1999). Update of the diagnosis and treatment of social anxiety disorder. Journal of Clinical Psychiatry, 60(18), 1999, 22-26.
Walsh, Joseph (2002). Shyness and Social Phobia: A Social Work Perspective on a Problem in Living. Health and Social Work, 27 (2), 2002.