We talk about this anxiety disorder that tends to isolate affected people.
Social phobia, called social anxiety disorder (SAD) in the DSM-5 (Diagnostic Manual of Mental Disorders), is characterized by intense fear or anxiety in one or more social situations.
It is a disorder that can significantly affect a person’s daily life, since we live in society and must interact with many people on a regular basis. In this article we will know the causes of this phobia, its symptoms and treatments.
- Recommended article: “Types of phobias: causes, symptoms and characteristics”
Social phobia: what is it?
Social phobia is an excessively marked fear (or anxiety) that appears as a result of facing situations that involve interacting with other people (for example, in meetings, parties, work, speaking in public, having a conversation, etc.) .
This fear or anxiety is disproportionate to the real threat, that is, it is an “irrational” and “exaggerated” fear according to the sociocultural context and the real social situation. In children, this fear can appear with children of the same age and not only in interactions with adults.
What most worries the person with a social phobia is acting in a certain way or that the symptoms of anxiety are noticed, and that others value it in a negative way. That is, that they are embarrassed, humiliated or rejected for it. He may also be afraid of offending others.
It is for all this that the person avoids facing social situations at all costs, or if he experiences them, he resists them with high anxiety or fear. The symptoms last at least 6 months and cause significant psychological suffering to those who suffer from them.
- Related article: “What is agoraphobia? Causes, symptoms and treatment”
Causes
The origin of social phobia is usually multifactorial ; that is to say, that social, psychological, biological, temperamental and environmental factors intervene.
On the one hand, it may happen that the person has experienced a social situation where they felt humiliated or ashamed; This, added to low self-esteem (as a cause or consequence), and at a particularly sensitive age (for example, adolescence), can end up developing the origin of social phobia.
That is, at its origin there may be traumatic experiences, personal vulnerability factors, hereditary factors (that the father or mother has social phobia), temperamental factors (that the person tends to be especially withdrawn and shy, especially in childhood) , etc.
Symptoms
The most characteristic symptoms of social phobia are the avoidance of social situations and the psychophysiological hyperactivation of the organism . Avoidance can translate into actively avoiding social situations, resisting them with high anxiety, or running away from social situations (for example, at a party).
Physical symptoms of psychophysiological hyperarousal include dizziness, fainting, excessive sweating, flushing, rapid heart rate, rapid breathing, trembling voice, nausea, stomach pain, etc.
In addition, the person has negative thoughts in relation to their own behavior and that of others (for example “I will not know how to greet”, “I will not know what to talk about”, “I will make a fool of myself”, “they will laugh at me”, etc. .).
On the other hand, on an emotional level, the person with social phobia feels excessive concern if he knows that he will have to face a certain social situation (for example, making a presentation in public) and this can occur weeks or even months before the occurrence of the social phobia. situation.
Characteristic
Social phobia usually has its age of onset in adolescence ; It appears around the fear of others judging one’s behavior, and usually within a small group. At the annual prevalence level, in the United States it is estimated to be approximately 7%.
In addition, it coincides with the time of life (adolescence) where one usually pays more attention to what others think of him; On the other hand, it is precisely when the personality of the person is being formed and it is a complicated time in this sense, full of changes, questions and uncertainty. It is for all these reasons that social phobia is usually accompanied by low self-esteem, both in childhood, adolescence and adulthood.
However, we insist that this fear is disproportionate to the real threat, it is not an “adaptive” fear . On the other hand, and contrary to most phobias, social phobia occurs with equal frequency among men and women.
Treatment
The treatment applied to social phobia usually includes a psychological intervention that addresses the patient’s avoidance of facing social situations, based on techniques such as exposure with response prevention or systematic desensitization (which includes relaxation techniques incompatible with anxiety).
Cognitive restructuring is also used (with the aim of modifying erroneous thought patterns, cognitive distortions and wrong attributions made by the patient about their symptoms, their behavior and the behavior of others), etc.
It will be important that the treatment focuses on strengthening self-esteem, teaching the patient to recognize and modify the negative thoughts he has about himself. It will also focus on providing you with skills-enhancing tools to help you gain confidence in social situations.
On the other hand, in the event that the patient has a deficit of social skills that makes it difficult for him to interact with others, social skills training (EHS) can be included, where the therapist models a series of skills (performs them in front of the patient), the patient puts them into practice and is subsequently evaluated (with the relevant corrections) and reinforced for it.
Psychopharmaceuticals
Sometimes the administration of psychotropic drugs for social phobia is also included (it should be complementary to psychological intervention). The main drugs prescribed are SSRI antidepressants (Selective Serotonin Reuptake Inhibitors).
Other types of antidepressants are also used, dual inhibitors (SNRIs) (which reuptake serotonin and norepinephrine).
Bibliographic references
- APA (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid. Pan American.
- Belloch, A.; Sandin, B. and Ramos, F. (2010). Manual of Psychopathology. Volume II. Madrid: McGraw-Hill.
- Perez, M.; Fernandez, JR; Fernandez, C. and Friend, I. (2010). Guide to effective psychological treatments I and II.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.