Social Phobia

Have you ever become so nervous before a social event that you've opted to skip it? If so, you are not alone. In a given year, close to 5.3 million Americans suffer from social phobia, an anxiety disorder characterized by intense fear of public humiliation or peer disapproval.

Most people look forward to socializing at birthday parties, holiday gatherings, and weddings. For others, these seemingly harmless occasions can result in a tremendous amount of anxiety. They may experience blushing, sweating, a racing heartbeat, difficulty talking, or nausea and vomiting.

"Some people think it's a trivial disorder, but it's not," according to Dr. Eric Hollander, Professor of Psychiatry and Director of the Compulsive, Impulsive, and Anxiety Disorders Program at The Mount Sinai School of Medicine in New York, NY. "People with social phobia may have trouble speaking in public, eating at restaurants, or urinating in public bathrooms."

There are two major types of social phobia: general and performance. People with the performance variety fear situations like public speaking, acting, eating in front of others, or using public restrooms, which may trigger an anxiety response. The more generalized type is characterized by anxiety or stress in most social situations. Sufferers often worry about social humiliation or embarrassment.

Social phobia is two times more likely to occur in women than in men. It usually begins in childhood or adolescence, and hardly ever develops after the age of 25. People with social phobia may recognize that their fear is excessive or unreasonable, but have difficulty conquering it.

The treatment for social phobia varies for the different types, according to Hollander. For people with generalized social phobia, selective serotonin reuptake inhibitors (SSRI's) have proven to be useful. Hollander also recommends cognitive/behavioral therapy, which can stop negative thought patterns and help patients reenter feared situations. For performance social phobia, beta blockers can alleviate anxiety symptoms caused by the fear of performing in public.

Sources:

The Merck Manual of Medical Information. Simon and Schuster, New York: 1998.

Harvard Medical School Family Health Guide. Simon and Schuster, New York: 1999.