Social phobia is a major problem for about 8 per cent of the population, writes DR HARRY BARRY
SOCIAL ANXIETY disorder (often called social phobia) relates to a condition where a person suffers intense mental and physical symptoms of anxiety in social situations for a period of greater than six months.
The sufferer will experience persistent fears of being judged harshly by others and are intensely self-critical of themselves in social situations. These fears are usually triggered by actual or perceived scrutiny by others.
The classical symptoms of anxiety in social situations may be accompanied by blushing, excessive sweating, stammering or mind going blank and it is often these symptoms that encourage the person to seek help.
The famous Charles Darwin was a sufferer and, in fact, described the symptoms himself.
Most of us as teenagers and young adults tend to become anxious in social situations as we are like caterpillars slowly turning into butterflies and unsure of what others will make of us!
However, for about 8 per cent of the population this social anxiety persists and causes major problems in their lives. We can learn much about this condition by examining their thoughts and behaviours in typical social and working situations. There will be many reading this who will quickly identify with them.
Take Dave for example. He is 24 and has been hiding his battle with these symptoms since the age of 16. Tonight he is due to meet his friends at a local pub.
The closer he gets to the meeting with them the more anxious he becomes. The thoughts are flying through his emotional brain: “I hope they all like me”; “But what will I talk to them about – after all I have nothing interesting to say and they will probably think I am boring”; “I know I am going to say or do something really stupid – and they will all notice and judge me accordingly”; “What if they see me blushing or sweating – they will feel I am weak and secretly laugh at me.”
Even when he meets the friends – usually after hours of trying to figure out how to avoid the social contact – the thoughts persist. He adapts his usual behavioural safeguards – stays close to the exit; keeps his coat on to prevent his friends noticing he is sweating; tries to remain invisible and anonymous by saying nothing controversial; constantly mentally assessing how well he is coming across in the group; rehearsing what he is going to say in his mind before broaching the topic; and gripping his glass of beer as tightly as possible.
When he comes home from the meeting he replays over and over his “performance” on the night and finally falls asleep exhausted from all his efforts. Unfortunately the following day brings new opportunities for social anxiety by the bucketful as he heads into his workplace and the cycle repeats itself.
For many this is “their life” and one that they learn to dread. It is one thing to be fearful or phobic about snakes but it’s pretty difficult to go through life when your fear relates to other people.
Social anxiety usually involves fear of either performance or social interaction situations. The classical example of the former is the most common social fear – that of public speaking and I will deal with this in another piece.
The latter relates in particular to so many everyday situations like speaking to strangers, going to parties or social gatherings, talking to people in authority, talking or socially interacting with strangers – to name but a few.
Unfortunately, many with social anxiety learn to quickly lean on the use of alcohol to get through such ordeals and in some who are vulnerable may develop secondary addiction or depression. This tragically is one of the few anxiety disorders that may lead to suicide.
There will be many reading this – some young people, parents who may be suspicious it is going on, and in other cases adults who have struggled with this for decades. It is just me!
The good news is that this anxiety state is immensely treatable and that medication is not the cure.
A sensible mixture of lifestyle changes and cognitive behavioural approaches can transform the life of the sufferer. The first and crucial step is to recognise and name the enemy; then to seek help from a doctor or therapist who can empathise with your plight.
At the heart of social anxiety is an extreme form of self-rating or judgment and it is this that needs to be tackled if we are to get well. We also have to challenge many of our ingrained safety behaviours that make us feel anxious. It is helpful to work with a trained professional to change both thoughts and behaviour.
For many with this condition – I hope that reading this article will be the first step!
- Dr Harry Barry is a GP and author of Flagging the Therapy – pathways out of anxiety and depression(Liberties Press) and director of Aware
