Have you ever heard of social phobia? Do you know someone who suffers from it, or maybe you have it yourself?
Social phobia is a type of anxiety disorder, in which the person feels a high degree of anxiety or fear in certain (or most) social situations.
In this article we explain the main characteristics of social phobia, as well as its typical symptoms.in addition to which are their typical symptoms, their causes and their possible treatments.
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Social phobia: what is it?
Social phobia is an anxiety disorder, classified as such in the DSM-5 (Diagnostic Manual of Mental Disorders). Specifically, the DSM-5 calls it “social anxiety disorder”. Its main characteristic is an irrational, intense and disproportionate fear of social situations, ranging from interacting with the public to socializing.ranging from interacting with people to public speaking or meeting new people.
A previous edition, the DSM-IV-TR, proposed three types of phobias: agoraphobia, specific phobia (phobia of a specific object or situation) and social phobia. These three types of phobia are characterized because they involve intense fear reactions, accompanied by an induced avoidance of certain objects or situations, which may be real or anticipated (in the case of social phobia, the phobic or feared stimulus is social situations).
On the other hand, such situations do not objectively justify such fear or anxiety responses. Finally, it is not necessary that the aforementioned avoidance occurs if the feared situation is endured with great anxiety or discomfort.
In the social phobia, as in the other types of phobia, the person is not aware that his fear and avoidance are exaggerated or irrational.This criterion, however, is not required in children. In other words, this criterion is not necessary in children in order to be able to make the relevant diagnosis.
The feared situations in social phobia can be of two types: interpersonal situations or public performance situations.
Specific examples of interpersonal situations are: telephoning someone, talking to strangers, talking to authority figures (e.g. a policeman), meeting someone, attending a party, conducting an interview…
On the other hand, as for examples of public performance situations we find: speaking in public, writing while being watched, using public restrooms, shopping in a crowded store, giving a report at a meeting, dancing or singing in front of others, eating or drinking in public, etc.shopping in a crowded store, giving a report at a meeting, dancing or singing in front of others, eating or drinking in public, etc.
In social phobia, anxiety may appear in the first situations, in the second, or in both.
Some interesting facts to know about social phobia are the following:
- We find two types of social phobia: circumscribed (fear of public speaking) and generalized (fear of social situations in general).
- Most people with social phobia present the circumscribed type.
- According to the DSM-5, between 3 and 13% of the population suffers from it.
- It frequently appears together with other specific phobias and agoraphobia.
- It is associated with low self-esteem and a tendency to fear criticism.
The causes of social phobia can be very diverse.. A traumatic event related to people or to being in front of the public can cause it, such as “making a fool of oneself” (or feeling ridiculed) in a public exhibition, when interacting with certain people, at a party, etc.
On the other hand, having a very introverted personality (being “excessively” shy) may also be at the basis of social phobia.
As for biological hypotheses, we find studies that speak of different alterations in anxiety disorders. Examples of these are: alterations of gamma-amino-butyric acid (GABA), hyperactivity of the locus coeruleus (which increases noradrenaline, and therefore anxiety), hypersensitivity of serotonergic receptors, etc. However, none of these hypotheses is conclusive (i.e., none has been 100% proven).
There is agreement, however, that it is likely that some vulnerability to develop an anxiety disorder in general (and not so much a specific anxiety disorder) is inherited. (and not so much a specific anxiety disorder). This individual vulnerability, which some people manifest, coupled with a traumatic event related to negative evaluation by others, can lead to social phobia disorder.
Although we have already summarized the symptoms of social phobia, we will explain each of them below.
Intense fear or anxiety
The main symptom of social phobia is an intense fear or anxiety to the social situations that can imply an evaluation or judgment of oneself or others.by others. Generally, more than fear, it is anxiety, which can even turn into anguish.
As in all phobias there is an avoidance, in this case of social situations.. Examples of social situations are: starting a conversation with someone, presenting a job in public, speaking in public, interacting with new people, making friends, etc.
However, it can also happen that instead of avoiding the situation, it is supported but with a high discomfort (or anxiety).
3. Poor social performance
Another symptom of social phobia is poor social performance by the sufferer. on the part of the sufferer. That is, their social skills are usually quite poor, although not in all cases.
4. Impairment or discomfort
The previous symptoms cause an important deterioration or discomfort in the individual’s life.. In fact, it is this impairment or discomfort that determines the existence or not of a psychological disorder, in this case social phobia.
5. Psychophysiological symptoms
In addition to the above symptoms, physiological symptoms such as tachycardia, sweating, tension, migraine, hot flashespressure in the chest, dry mouth, etc., before the possibility of being exposed to the phobic situation.
The psychological treatment of choice for the treatment of social phobia is the treatment by exposure (in fact, it is the one that has been used to treat the phobia). (in fact, it is the one that has demonstrated the greatest degree of efficacy). This consists, fundamentally, in exposing the patient to social situations, in a gradual manner.
Other possible treatments for social phobia are: cognitive behavioral therapy (usually combined with antidepressants) and social skills training (the latter is mainly used in patients with social skills deficits). All these treatments are slightly less effective than exposure treatment, although they are also useful and widely used.
Finally, another option available to us is pharmacotherapy, which involves the use of antidepressants and anxiolytics (logically, this is the treatment that will be applied by the psychiatrist or family doctor, not the psychologist), although this treatment is the least effective for social phobia so far.
Treatments according to the type of social phobia
We have discussed, in a generic way, the treatments used for cases of social phobia. However, we can we can still specify more, since according to the type of social phobia that the patient presents, the most advisable is a treatment or another.
There are, broadly speaking, two types of social phobia: circumscribed social phobia (in which the patient only feels anxiety when speaking or acting in public) and generalized social phobia (in which the patient fears most social situations outside the family context).
In the case of circumscribed social phobia, exposure therapy is used; on the other hand, in generalized social phobia, a combined therapy is usually used, which includes: exposure, cognitive restructuring and social skills training.