Social anxiety disorder, often referred to as SAD or social phobia, is an anxiety disorder. Characteristics of social anxiety include fear or intense anxiety in social situations, self-consciousness in social situations, obsessive self-defeating thoughts, panic attacks, and avoidance of social situations. Social anxiety often occurs alongside other psychiatric disorders, especially depression or other anxiety disorders, and sufferers are also more likely to self-medicate by abusing alcohol or illicit drugs. Some people with social anxiety make life choices based on their perceived social limitations, meaning that social anxiety can have severe and long-term effects in all arenas of life, including relationships, education, and work. Treatment for social anxiety includes cognitive behavioural therapy and medication.
One of the most striking cognitive symptoms of social anxiety is obsessive thoughts. People with social phobia feel constant anxiety about how they appear to others, or about what others think of them (or will in the future). These thought patterns are overwhelmingly negative, and they are often inaccurate and self-defeating. For example, a person with social anxiety may dwell for days or even weeks on a certain remark or situation, or spend hours reviewing their interactions to find behavior which they consider embarrassing or not normal.
People with social anxiety are often obsessed with seeming “normal,” or the perceived fact that they are “weird,” or “not normal”. Since the cognitive symptoms of social anxiety disorder feature cognitive distortion (exaggerated thought patterns which focus on irrational beliefs), they are often treated using cognitive behavioural therapy, which focusses on eliminating unhelpful thoughts and problem-solving).
Since social anxiety disorder leads to “shyness” or fear which is excessive and which may lead to some sort of social or occupational impairment. Behaviors associated with social anxiety disorder include avoiding social situations, fear of telephone calls or interactions with unfamiliar people, avoidance of eye contact, and isolation. For example, a person with social anxiety may hang back and behave in a “distant” or “standoffish” way during a social occasion with a large group of people, such as at a party. They may avoid certain social situations all together. They may keep away from talking to shopkeepers or unfamiliar people, or they may simply feel nervous or sick before, during, or after these interactions. Social anxiety disorder has physiological effects which are similar to other anxiety disorders. People with social anxiety may sweat excessively, shake, or feel nausea due to social interactions. All of these physical symptoms are a result of the fight-or-flight response, and they may be managed with medication.
Social anxiety is often present alongside other psychiatric problems, including depression, low self-esteem, and problems with substance abuse. Owing to its close association with these co-morbidities, social anxiety must be treated by doctors and therapists with a mind to these other conditions as well. Prompt treatment of social anxiety can prevent the development of other psychiatric problems. The first-line treatment for social anxiety is cognitive behavioral therapy and other psychotherapy. Medication such as selective serotonin reuptake inhibitors are also commonly used, but often only in patients who are not interested in therapy. Social skills training and support groups can also help those who suffer from social anxiety.