Social anxiety can lead patients to avoid most social situations for fear of “wrong” behavior or misunderstanding.
Social phobia is a disorder that is widespread among the population
According to some studies, the percentage of people who suffer from it ranges from 3% to 13%.
Also, according to these studies, social anxiety seems to be more characteristic of women than men.
Usually, the situation people who suffer from social phobia (or social anxiety disorder) fear most is having to do something in front of other people. Just walking into a room where people are already sitting or talking to a friend can trigger social anxiety.
Features of social phobia
People who suffer from social phobia are afraid to look anxious or to show “signs” of it. That is, fear of blushing, shivering, stuttering, sweating, heartbeat, or doing nothing and being silent. You can talk to others without “ready” jokes.
Finally, people experiencing social anxiety tend to perceive their fears as irrational when not in fear situations, and as a result, blame themselves and blame themselves for not being able to do what others can do. There is often
Left untreated, social phobia tends to remain a stable, chronic condition that often leads to other disorders such as depression.
The disorder usually appears to begin in adolescence or early adulthood.
There are usually two types of social phobia:
- Simple, when a person experiences social anxiety only in one or a few situations (e.g., unable to speak in public, but is fine in other social situations such as attending parties, talking to strangers, etc.) .
- Generalized when a person fears almost all social situations. In its more severe and widespread form, the diagnosis of avoidant personality disorder tends to be preferred.
symptoms of social phobia
The main feature of social phobia is being in a social situation or doing something, such as speaking in public, or more simply speaking, writing, eating, or making a phone call to someone. It’s the fear of being observed.
In fearful social situations, people with social anxiety worry about looking embarrassed and most of all, they are afraid of judging others to be insecure, weak, “crazy,” or stupid. increase.
Symptoms of social phobia include the fear of speaking in public out of fear that you will suddenly forget what you have to say, or others not noticing your hands or voice trembling. This includes extreme anxiety when conversing with others due to fear of being unsure or fear of appearing unclear.
The most commonly recognized (anxiety-related) symptoms of social phobia are heart palpitations (79%), tremors (75%), sweating (74%), muscle tension (64%) and nausea (63%). , dry mouth (61%) %), flushing (57%), redness (51%), headache (46%).
inevitable avoidance
Symptoms of social phobia may lead subjects to avoid eating, drinking, or writing in public for fear of being embarrassed if others see them waving.
Clearly, these people try hard to avoid such situations, or endure them with great discomfort if forced to do so.
Anticipatory anxiety
Another typical feature of this disorder is pronounced social anxiety that precedes the frightening situation and is called anticipatory anxiety.
Therefore, before facing a social situation (for example, going to a party or going to a business meeting), people start worrying about such events.
As is so often the case with phobias, people experiencing these disorders often perceive their fears as completely unreasonable, excessive, or absurd when they are far from the phobic situation. Recognize
Therefore, they blame themselves more for their social phobia symptoms and avoidance behaviors.
social phobia, cure
As with other anxiety disorders, cognitive-behavioral psychotherapy has generally proven to be very effective in treating social phobia.
Certain medications may help.
psychotherapy
Cognitive-behavioral psychotherapy focuses on the here and now and treats symptoms directly.
On the one hand, it aims to change dysfunctional thinking and, on the other, to provide a person with better skills and abilities to deal with fearful situations.
Dysfunctional or irrational beliefs are the thoughts people have about events, find themselves involved, and arise from a rigid and non-adaptive cognitive schema.
For example, the belief that showing anxiety is a sign of weakness, or the belief that you are always watched closely by others.
Such thoughts only work when a person has to face a social situation, so to speak.
In other words, having to expose yourself to judgment from others causes anxiety and, as a result, a feeling of losing control.
Treatment of social phobia aims, on the one hand, at correcting such assumptions during psychotherapeutic work, but, on the other hand, attempts to teach skills for better handling of social situations. is.
These skills typically include both techniques for managing anxiety (such as relaxation training) and techniques for managing verbal interactions.
Cognitive-behavioral therapy for the treatment of social phobia is best done in individual sessions.
This does not detract from the fact that, wherever possible, group therapy offers considerable benefits, starting with the obvious fact that you are already in a social situation.
drug therapy
Pharmacological treatments for social phobia are generally not very effective, but are basically based on two classes of drugs: benzodiazepines and antidepressants.
Prescribing a benzodiazepine alone is rarely definitive.
However, for social anxiety, both alprazolam and clonazepam have been shown to have some effect.
Nevertheless, the use of these molecules should always be evaluated with caution.
The same is true for problems that may arise when you discontinue (such as developing “rebound” anxiety).
Among the tricyclic antidepressants, imipramine is usually the most widely used molecule in this class.
However, the use of these drugs in treating social phobia does not seem particularly promising.
Among the selective serotonin reuptake inhibitors (SSRIs) used to treat social anxiety are fluvoxamine, fluoxetine, sertraline and paroxetine.
All have shown some effectiveness in alleviating symptoms to a greater or lesser extent, but it should be emphasized that results may not always be maintained when the drug is discontinued.
At the very least, these molecules have fewer side effects than other drug classes.
References
Marsigli, N. (a cura di) (2018). Stop all’ansia sociale. Strategies and gestures per control.Torrent: Ericsson
Procacci, M., Popolo, R., and Marsigli, N. (2010). Ansia e ritiro sociale. Valutazione e trattamento. Milan: Raffaello Cortina Edittoale
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