Emotional Health

Social phobias

If you suffer from social phobia, you tend to think that other people are very competent in public and that you are not. Small mistakes you make may seem to you much more exaggerated than they really are. Blushing may seem painfully embarrassing, and you feel as though all eyes are focused on you. You may be afraid of being with people other than those closest to you. Or your fear may be more specific, such as feeling anxious about giving a speech, talking to a boss or other authority figure, or dating. The most common social phobia is a fear of public speaking. Sometimes social phobia involves a general fear of social situations such as parties. More rarely, it may involve a fear of using a public restroom, eating out, talking on the phone, or writing in the presence of other people, such as signing a check.

Although this disorder is often thought of as shyness, the two are not the same. Shy people can be very uneasy around others, but they don’t experience the extreme anxiety in anticipating a social situation, and they don’t necessarily avoid circumstances that make them feel self-conscious. In contrast, people with social phobia aren’t necessarily shy at all. They can be completely at ease with people most of the time, but particular situations, such as walking down an aisle in public or making a speech, can give them intense anxiety. Social phobia disrupts normal life, interfering with career or social relationships. For example, a worker can turn down a job promotion because he can’t give public presentations. The dread of a social event can begin weeks in advance, and the symptoms can be quite debilitating.

People with social phobias are aware that their feelings are irrational. Still, they experience a great deal of dread before facing the feared situation, and they may go out of their way to avoid it. Even if they manage to confront what they fear, they usually feel very anxious beforehand and are intensely uncomfortable throughout. Afterwards, the unpleasant feelings may linger, as they worry about how they may have been judged or what others may have thought or observed about them.

About 80% of people who suffer from social phobia find relief from their symptoms when treated with behavioral therapy or medications or a combination of the two. Therapy may involve learning to view social events differently; being exposed to a seemingly threatening social situation in such a way that it becomes easier to face; and learning anxiety-reducing techniques, social skills, and relaxation techniques.

The medications that have proven effective include antidepressants called MAO inhibitors. Drugs called betablockers have helped people with a specific form of social phobia called performance phobia. For example, musicians or others with this anxiety may be prescribed a betablocker for use on the day of a performance.