Social Anxiety Disorder (social phobia) is the third largest mental health care problem in the world today.
The latest government epidemiological data show social anxiety affects about 7% of the population at any given time. The lifetime prevalence rate (i.e., the chances of developing social anxiety disorder at any time during the lifespan) stands slightly above 13%. (See journal citation on the Social Anxiety Association home page.)
Social anxiety is the fear of social situations that involve interaction with other people. You could say social anxiety is the fear and anxiety of being negatively judged and evaluated by other people. It is a pervasive disorder and causes anxiety and fear in most all areas of a person's life. It is chronic because it does not go away on its own. Only direct cognitive-behavioral therapy can change the brain, and help people overcome social anxiety.
People with social anxiety are many times seen by others as being shy, quiet, backward, withdrawn, inhibited, unfriendly, nervous, aloof, and disinterested.
Paradoxically, people with social anxiety want to make friends, be included in groups, and be involved and engaged in social interactions. But having social anxiety prevents people from being able to do the things they want to do. Although people with social anxiety want to be friendly, open, and sociable, it is fear (anxiety) that holds them back.
People with social anxiety usually experience significant distress in the following situations:
- Being introduced to other people
- Being teased or criticized
- Being the center of attention
- Being watched or observed while doing something
- Having to say something in a formal, public situation
- Meeting people in authority ("important people/authority figures")
- Feeling insecure and out of place in social situations ("I don’t know what to say.")
- Embarrassing easily (e.g., blushing, shaking)
- Meeting other peoples’ eyes
- Swallowing, writing, talking, making phone calls if in public
This list is not a complete list of symptoms -- other symptoms may be associated with social anxiety as well.
The feelings that accompany social anxiety include anxiety, high levels of fear, nervousness, automatic negative emotional cycles, racing heart, blushing, excessive sweating, dry throat and mouth, trembling, and muscle twitches. In severe situations, people can develop a dysmorphia concerning part of their body (usually the face) in which they perceive themselves irrationally and negatively.
Constant, intense anxiety (fear) is the most common symptom.
People with social anxiety typically know that their anxiety is irrational, is not based on fact, and does not make rational sense. Nevertheless, thoughts and feelings of anxiety persist and are chronic (i.e., show no signs of going away). Appropriate active, structured, cognitive-behavioral therapy is the only solution to this problem. Decades of research have concluded that this type of therapy is the only way to change the neural pathways in the brain permanently. This means that a permanent change is possible for everyone.
Social anxiety, as well as the other anxiety disorders, can be successfully treated today. In seeking help for this problem, we recommend searching for a specialist -- someone who understands this problem well and knows how to treat it.
Social anxiety treatment must include an active behavioral therapy group, where members can work on their "anxiety" hierarchies in the group, and later, in real-life situations with other group members.
Social anxiety is a fully treatable condition (link is external) and can be overcome with effective therapy, work, and patience.
Cognitive-behavioral therapy for social anxiety has been markedly successful. Thousands of research studies now indicate that, after the completion of social anxiety-specific CBT, people with social anxiety disorder are changed. They now live a life that is no longer controlled by fear and anxiety. Appropriate therapy is markedly successful in changing people's thoughts, beliefs, feelings, and behavior. The person with social anxiety disorder must be compliant and do what is necessary to overcome this disorder.
National Institutes of Mental Health-funded studies report a very high success rate using cognitive therapy with a behavioral therapy group. Both are essential to alleviating anxiety symptoms associated with social anxiety disorder.
THIS ADVICE (above) only applies to people who have a diagnosable (DSM-5: 300.23) case of social anxiety disorder. You cannot generalize this out to other mental health care conditions.
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