Social phobia, also known as social anxiety disorder, is a psychiatric disorder characterized by intense fear of embarrassment or humiliation in common social settings or during the performance of common public tasks. Unlike the more or less universal fears associated with involvement in social situations, the fears in people with social phobia can seriously interfere with the ability to participate in a fulfilling, active lifestyle. Most people develop medically significant social anxiety in the years before adolescence. Girls and women typically have higher risks for the onset of the condition.
Social Phobia Basics
Social phobia belongs to a larger group of psychiatric disorders known as anxiety disorders. It comes in two basic forms, called generalized social phobia and non-generalized social phobia. People with the generalized form of the disorder experience disruptive or debilitating fear in a majority of social situations such as talking with unfamiliar people, talking to authority figures, interacting with groups of age peers, meeting unfamiliar age peers, pursuing sexual relationships, speaking in public, performing work in public, eating or drinking in public, asking or answering questions in group settings, interviewing for a job, or taking a test. People with the non-generalized form of the disorder experience disruptive or debilitating fear in 50 percent or less than 50 percent of these situations. Generally speaking, social phobia produces equivalent effects in both males and females. In most cases, social phobia first appears near a child’s tenth year of life. Common symptoms at this age include nausea, stomach distress, temper tantrums, fidgeting, crying and a tendency to withdraw from social interactions or avoid them altogether. Teenagers with the disorder also tend to withdraw from or avoid social interactions, especially when those interactions involve members of the opposite sex. If left untreated in childhood or adolescence, social phobia can seriously limit an affected individual’s adult prospects for meaningful social participation, involvement in fulfilling personal or intimate relationships, involvement in a wide range of professions, or involvement in prominent jobs within a given profession. Potential factors in the development of social phobia include genetic inheritance, natural tendencies of personality or temperament, and daily interaction with a clinically depressed parent. Aspects of brain function that may play a role include abnormally low levels of neurotransmitting chemicals called serotonin and norepinephrine, and unusual sensitivity (reactivity) in a brain structure called the amygdala, which helps regulate fear-based emotional responses. Premature babies with extremely low birthweight may also have increased risks for the disorder.
Frequency in Girls and Women
Roughly 10 to 15 million children and adults in the US have a medically serious form of social phobia. Out of all recognized forms of psychiatric illness, only depression and substance abuse affect more people. When treated and untreated forms of the condition are considered together, girls and women develop social phobia anywhere from 1.5 to 2 times more frequently than boys and men, Medscape Reference reports. However, boys and men seek or receive treatment for the disorder more frequently than girls and women. Researchers have not identified a clear reason for the difference in treatment rates between men and women.
Comorbid Relationships to Other Conditions
People with social phobia commonly develop a number of additional mental health disorders, including attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder and phobias to specific places, things, or situations. Children with social phobia also frequently develop selective mutism, autism spectrum disorder, or separation anxiety disorder. All of these disorders have a comorbid relationship with social phobia. This means that they interact with social phobia’s symptoms, alter the course of the illness and produce intensified amounts of harm in the affected individual. In teenagers, generalized social phobia can also appear comorbidly with panic disorder, post-traumatic stress disorder (PTSD) and oppositional defiant disorder. In addition, young children, teenagers, and adults with social phobia have increased risks for comorbid cases of depression.
Many people equate social phobia with shyness. However, people who are merely shy don’t experience the same sorts of intense anxiety found in people with social phobia; they also typically don’t attempt to avoid or withdraw from social situations with the same insistence or tenacity as socially phobic individuals. In addition, although it may seem counterintuitive, socially phobic people frequently show no signs of shyness outside of the specific situations that trigger their symptoms. Most adults with social phobia are aware of their condition and the impact it has on their lives; in some cases, this awareness intensifies the impact of the disorder. Children frequently lack awareness of social phobia or its effects.