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What is Social Anxiety Disorder?

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  • Written By: Michael Pollick
  • Edited By: Niki Foster
  • Last Modified Date: 01 November 2016
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Social anxiety disorder (SAD), alternatively known as social phobia, is a recognized psychological condition affecting millions of people. While many of us may feel anxious at the thought of delivering a speech or undergoing a job interview, those with this disorder may suffer crippling feelings of inadequacy and public rejection. This is not to be confused with a panic attack disorder, although some of the physical symptoms may be similar. Sufferers understand intellectually that their fears are largely unfounded, but they cannot use the coping mechanisms others have mastered. It's as if they live their entire public lives under a harsh and critical microscope.

This condition is one of five anxiety disorders recognized in the DSM-IV, a classification manual used by psychiatrists and psychologists. Many patients who seek treatment for it may have already been misdiagnosed as schizophrenic, bi-polar, clinically depressed or agoraphobic. The difference is that many social anxiety disorder sufferers exhibit normal social skills when alone or in small groups under private conditions. It is only when confronted with large groups or unfamiliar surroundings that the symptoms of SAD are most noticeable. The person may feel others are constantly judging his or her appearance, or a perceived authority figure will punish him or her in some way.

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Shyness in public is not the same as true social anxiety disorder. In fact, it is not even considered a criteria for diagnosis. What matters more is a definite physical and emotional reaction to social circumstances. A SAD sufferer may feel nauseous at a company mixer, or sweat profusely when asked to speak in public. For the afflicted, relief isn't simply a matter of coming out of one's shell or becoming more animated in public. Many actors and other performers with this condition can function perfectly well on stage, but feel severely uncomfortable around large crowds when not performing.

Treatment is generally a combination of cognitive-behavioral therapy and various drug regimens. Cognitive-behavioral therapy is generally an individual or small group technique in which the counselor and patient discuss the anxiety objectively. Over a number of sessions, the patient experiences more and more social interaction and analyzes his or her reactions. Eventually, many sufferers learn to recognize triggering mechanisms and develop the means to cope with them. Mood-altering drugs may also keep patients from experiencing the unnatural highs and lows which often complicate their condition. Social anxiety disorder may not always be curable, but it can be controlled through cognitive-behavioral therapy and personal determination.

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NAtnael100
Post 8

I don't know, but I think public shyness is different from SAD. You know, sometimes I feel I have SAD, but it is not true because I only get shy when I'm in a group. Not often, but I don't experience most of the symptoms of SAD.

amypollick
Post 7

@anon347520: In the immortal words of Lucy Van Pelt, "you need involvement." Many people (including me) have found a lot of self confidence from martial arts classes, but that may be a little *too* social for you. But if you feel up to it, I highly recommend it.

I think doing positive things for others would help you feel better about yourself and would decrease your social anxiety.

One idea is to look into volunteering at a local nursing home. Many of these folks never have visitors, and would love to see a young face. You wouldn't have to make much conversation; many of them love to talk and would so appreciate a listening ear. Just your coming by to

see them would make their day.

There may also be residents who have dementia who can't communicate, but the sound of a friendly voice calms them and helps them feel better. You could take whatever book you're reading for school and read to them. You would be doing a truly kind act for these people, and I guarantee it would make you feel better, too.

Or, you could talk to your local animal shelter and see if they need someone to walk the dogs, or love on the cats. This helps the animals remain socialized so they are more likely to get a forever home. Again, you'd be doing a service.

I have always found the best way for me to help myself was to help others. I suggest these two ideas because they don't require you to be a social butterfly and they're not critics. You will be appreciated for whatever you can go. Good luck and God bless.

anon347520
Post 6

I absolutely hate my life. I have no friends. Well, maybe I have one. But I feel like I'm becoming more and more distant from everyone at my school. I'm currently a sophomore in high school so I'm fifteen years old. I just feel so estranged from everybody.

I believe I have Social Anxiety Disorder. I always avoid talking to people because I know I make them feel uncomfortable. I hate presentations and I hate being called on in class. My heart races when I have to talk in groups. I feel like I'm judged all the time and that I'm being watched. I can barely make eye contact with people for more than a few minutes without shying away

. It's just so painful for me. I cry almost every day as soon as I come home from school and I feel so lonely from a lack of friends.

Because of my problems, I've started to perform more and more poorly at school and it's so hard to concentrate on my homework. When I'm reading, I feel anxious. When I go to school, I'm anxious. When I'm not at school, I'm anxious. My problem is taking over my life. People talk to me, but I avoid them. All my life, people have always called me quiet. I felt perfectly fine until I started to realize that I was different.

I feel so weak by myself, seeing other people talking with their friends and there's me standing by myself not saying a word. I'm seeking help, but so far, I have not got the help I'm needing.

anon220501
Post 5

I have this disorder and I never knew I had it until I was in my 30's when I finally broke down and tried to kill myself and ended up in a mental hospital.

I knew I wasn't so-called "normal" and never had any friends. School was pure torture for me. Everybody thought I was just shy, and I was always told I would get over it in time. That time never came.

It wasn't until my 30's that I finally found out the name to my problem. I found some comfort in knowing I wasn't the only person out there with this crazy disorder, but saddened really, that others are out there suffering as well.

hidingplace
Post 3

Seems to me like the key as to how to overcome social anxiety disorder is having the willpower and self-determination to do so, which is much easier said than done of course. For sufferers, maybe looking online for support groups who can offer advice and encouragement might help.

Engelbert
Post 2

This is a difficult disorder to diagnose and the way it manifests can be hard to understand. I had a friend who was diagnosed with it a while ago and after reading this article it makes more sense to me. I was always puzzled; on a one-to-one basis he was fine, often funny, insightful. He was definitely quieter than most people though and any time he was around people he didn't know or larger groups he would shut down entirely and not say a word. I can definitely identify with shyness but I could tell it was different from that.

He was on antidepressants for a while and seeing a therapist and he seemed to be doing better, but unfortunately he still begun to withdraw more and more and I basically lost touch with him. I did speak with him recently however and he seems to be trying to do better.

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