Anxiety disorders include disorders that have features of excessive, anxiety, and related behavioral differences. Anxiety is the precondition of future threat (189). Individuals that have anxiety disorders fear and enters into a fight or flight mode. The brain becomes overly aware of the surroundings around that individual. Richard G. Heimberg author of “Social Anxiety Disorder in DSM-5” states, “[I]ndividuals with widespread interpersonal fears often suffered from an anxiety (phobic) disorder” (473). Social anxiety has impacted many today and there are ways that this disorder is treated, caused, and affected others.
According to the ADAA, it states, “Social anxiety disorder affects approximately 15 million American adults and is the second most commonly diagnosed anxiety disorder following specific phobia (Para. 2). DSM-5 explains, Social Anxiety is where an individual is anxious or fearful when it comes to social events and interactions with one another.
Examples would include speaking in large crowds, meeting, meeting unfamiliar people and parties. Individuals that struggle with social anxiety try to avoid these situation so no harm, embarrassment, or being offended will come upon them. Many fear that they will appear to be seen as weak, boring, crazy, wild, dirty, and etc. an individual fears that once they are in public settings they will choke on their words, blush, or sweat. An example of someone who fears of sweating would avoid shaking hands or eating spicy foods, or they decline going out to eat in fear that their hands will shake.
Individual that are afraid of blushing would avoid intimate conversations, performances, or even bright lights. While there are many levels of social anxiety, a person is gets nervous every once in a while would not be diagnosed as having this disorder. Others will fear or get anxious about events far in advanced before they even happen. Planning on what type of things they would say and worrying about the certain event every day. People that struggle with social anxiety disorder often times will they try to avoid these type of situations.
Individuals that struggle with social anxiety disorder often times overestimate the negative effects of social issues. Individuals with social anxiety lack to keep a high controlling conversation with others, have overly ridge body position, poor eye contact, and speaking with an overly quiet voice. They are shyer than usual and less willing to hold a conversation. Usually having jobs that don’t require any social contact but this is not always the situation. Men delay having a family while women live a life as homemakers (203-04). While many people get nervous at times, someone with social anxiety have a sever amount of distress when it comes to social events.
Rose, a young women describes her experience having social anxiety. She explains during elementary school she started to notice different behaviors such as going to the bathroom to avoid public places and eventually faking to be sick so she wouldn’t have to be surrounded in public situations. Simple things such as talking on the phone and asking for phone numbers was a terrifying thought. Making friends was very difficult and challenging, but the more exposure she experienced the easier it came to be along with help of therapy (Shannon). Most individuals that are diagnoses with Social Anxiety Disorder can overcome their situations by proper help.
There are many ways that individuals treat their social anxiety. Harvard Medical School states, the best way to treat social anxiety is Cognitive Behavioral Therapy (CBT). CBT, is a combination of talk and behavior therapy. Individual’s try to stop negative thinking and replace it with positive thoughts. When used for social anxiety, CBT, displays patients to cringing situation in hopes for them to find positive ways to control the way. On average CBT consist of 12-16 sessions and usually need to go for 12 weeks to see improvement.
There are other types of therapy that are used as well but evidence points that CBT is the best method. Besides therapy medication is an option. Serotonin is a neurochemical in the brain that helps regulate mood, sleep, appetite, sleep, and pain. “SSRIs such as citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft) increase the availability of serotonin.” When an indvidual has a low amount of serotonin, signs of anxiety and depression are shown. 50 to 80% of participants “respond after taking venlafaxine or an SSRI for eight to 12 weeks.” venlafaxine or SSRI is often prescribed at half the dosage to treat depression and slowly increases.
Many Doctors and clinicians recommend others to wait 12 weeks before switching to another prescription. Beta Blockers are often use for individuals with a heart disease its purpose is to slow the heart rate. Individuals that take Beta Blockers for social anxiety suggest taking this type of drug an hour before any type of social situation helps reduce specific social situations. Lastly the other type of medicine used is Benzodiazepines. Benzodiazepines, is used to control GABA, GABA is a neurochemical that helps with the calming effects of the body. Just like with SSRI’s, Benzodiazepines should be taken an hour before any type of situations.
There are a few pitfalls with taking Benzodiazepines, they become highly addictive to the patient. Individuals start to become attached to the pill when used for more than two weeks. When taking Benzodiazepines it is best when individuals reduce usage to avoid any type of withdrawal symptoms. While medicine works faster than CBT, CBT is a more effective and has lasting-longer effects to that individual. Medicine is used for short-term time period and the more an individual becomes dependent on such drugs starts to have substance abuse.
Two studies that followed patients for nine to 11 months, for example, reported that 4% to 14% of patients relapsed when they continued SSRI treatment, compared with 36% to 39% of those on placebo. To reduce risk of relapse, clinicians advise that patients who benefit from a medication continue taking it for at least six to 12 months, and then gradually reduce the dose rather than stopping it abruptly. (par. 35)
Both treatments have their benefits one helps to cope with the symptoms and the other helps reduce symptoms as well.
Development and Prevalence
Average age of being diagnosed of social anxiety is roughly around the age of 13. Most experience social anxiety in early childhood development, but social anxiety can happen to an individual no matter how old or young they are. Usually individuals experience social anxiety by stressful or humiliating situations examples would be bullying, getting sick in public, or embarrassing falls. Anxiety in children usually is expressed by, “crying, tantrums, freezing, clinging, shirking, or failing to speak in social situations.” Higher social anxiety is founded more in women than men.
The prevalence or statistical concept for social anxiety in a 12 month period estimates that the US is approximately 7%, however, prevalence decreases with age. Prevalence in the US is higher in American Indians, lowers in African American, Hispanics, Asian and Afro-Caribbean compared to whites (DSM-5, 204). The British Psychological Society authors of “Social Anxiety Disorder” state, individuals that develop social anxiety during adolescents years are likely to recover before hitting adulthood, if social anxiety continue into adult years “the chances the chance of recovery in the absence of treatment is modest when compared with other common mental disorders” (par. 8). While development of social anxiety can happen at any age there are coping mechanisms.
- Normative Shyness: While shyness is a common factor to have in an individual and sometimes can be helpful. However, when an individual is effected by social or occupation skills as well with other, social anxiety should be considered. Nancy A. Heiser, et.al, writers of Differentiating Social Phobia from Shyness claim, “[T]he relationship between social phobia and shyness remains unclear. Furthermore, shyness is a condition many view as a normal personality trait that should not be confused with social phobia” (par. 1).
- Agoraphobia: This is an anxiety disorder where an individual will avoid going to public places or situations because they feel trapped or causes them to have a panic attacks. Most often people with Agoraphobia have a hard time feeling safe and secure in crowds because escape or help might not be available. With Social anxiety the individual is fearful by others. Individuals with social anxiety are likely to be calmer when left alone but is not always the case with Agoraphobia.
- Panic Disorder: Is the reoccurring effect of having panic attacks that are unexpected. Individuals that have panic attacks feel terror for no obvious case. Symptoms included sweating, increase pulse rate, and difficulty breathing. While individuals who struggle with social anxiety might have panic attacks the concern is over fear or negative experiences not with panic attack themselves.
- Generalized Anxiety Disorder (GAD): Everyone will experience some anxiety in their life. GAD, is when an individual worries about number of things in their life. Usually individuals with GAD tend to worry more than necessary or start imaging the worst possible outcome. According to the ADAA they state, “GAD is diagnosed when a person finds it difficult to control worry on more days than not for at least six months and has three or more symptoms” (par.4). Individuals with GAD feel like their situation is out of control. While social anxiety worries are focused in social performance and other’s judgement.
- Separation Anxiety Disorder: Individuals with separation anxiety tend to avoid social settings when they are separated by attachment figures or loved one. When an individual has that attachment with them in public settings they seem to be fine. Social anxiety occurs even if they are in presence of their figures.
- Selective Mutations: This is where others may be too embarrassed to speak for the fear of negative evaluations, they don’t fear negative evaluations when no speaking is happening like social anxiety.
- Major Depressive Disorder: This is the condition where individuals struggle with the idea that others will judge them in negative way, have the thought they are not loved, cared for, or they think of themselves as bad. Individuals are worries about being judge in social or physical situations.
- Body Dysmorphic Disorder: The disorder of when an individual is too concerned about their appearance; they usually notice every flaw about themselves, this makes the specific person avoid social situations. Individuals that struggle with social anxiety are not too concerned about how they look physically, but how they will act in front of one another.
- Autism Spectrum Disorder: Having communication defects are present and have a hard time holding a conversation. Individuals with social anxiety have “adequate age-appropriate social skills.” They may just come across having flaws when having first time conversations with an individual.
- Personality Disorder: Social anxiety mirror some personality disorder, the most overlap though is with Avoidant Personality Disorder. Avoidant personality shows patterns of extreme social restriction and have a broader avoidance tendency then those with social anxiety.
While there are many others disorders that have common factors with social anxiety. The main thing point is social anxiety is when social fears is the center of the activity.
Notable Individuals with Social Anxiety
Kim Basinger, American actress, singer and former fashion model. Opened up about her feelings with the struggles of having social anxiety and Agoraphobia. Kim worst fear when growing up was reading aloud in class and teachers would assume she was experimenting nervous breakdowns. Although she feels her condition has improved, with the help of therapy, she still remains shy and vulnerable in social settings (Odozi, par. 1).
Barbra Streisand, famously known as her character Fanny Brice on the musical “Funny Girl.” This iconic Broadway singer opened about her struggle with anxiety. For over 30 years Barbra hid from the public audience because she forgot one of her lyrics while performing and created intense fear of performing in public again. Barbra reported that medication was used in her life to take control of her situation to overcome her fear of singing in public (Odozi, par. 2).
Lastly Olivia Munn opened up about her struggles with anxiety. Stated in“People Magazine,” ‘If I were to walk into someone’s birthday party, I’d have a bad anxiety attack.’ She states the way that helps her overcome her situations is about overcoming the idea of what makes her fearful in life. She manages her situation by taking control of her actions. (Odozi, par. 5).
In conclusion, Social Anxiety is where an individual is anxious or fearful when it comes to social events and interactions with one another. The brain becomes overly aware of the surroundings around that individual. Medication and therapy are available to help others overcome their situations. Many struggle with overcoming their disorder but they are able to receive coping mechanism. Simple things such as ordering food from a restaurant can feel terrifying to others. While we all get anxious every now and then individuals that struggle with social anxiety are in constant distress.
- American Psychiatric Assotiaion. (2013). Diagnostic and Statistical Manual of Mental Disorders, (5th ed). Pp.189-208. Washington DC
- Heiser, Nancy A, et.al. Differentiating Social Phobia from Shyness, HHS Public Access, Oct 15. pp. 469-76, NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2692184/
- National Collaborating Centre for Mental Health (UK). Social Anxiety Disorder: Recognition, Assessment and Treatment. Leicester (UK): British Psychological Society; 2013. (NICE Clinical Guidelines, No. 159.) 2, SOCIAL ANXIETY DISORDER. https://www.ncbi.nlm.nih.gov/books/NBK327674/
- Odozi, Tanya. 2016, May 30. 7 Social Figures who Fought Social Anxiety Disorder https://medium.com/@floridahelpline/7-social-figures-who-fought-social-anxiety-disorder-9b1b518aa53f
- Rose Shannon. “My Socail Anxiety.” Youtube, Jennifer Shannon, Feb 2013, https://www.youtube.com/watch?v=tq4klkup4mk
- Social Anxiety Disorder, Anxiety and Depression Association of America(ADAA), https://adaa.org/understanding-anxiety/social-anxiety-disorder
- Treating social anxiety disorder, Harvard Mental Health Letter, March 2010, https://www.health.harvard.edu/newsletter_article/treating-social-anxiety-disorder
- Treatment, Anxiety and Depression Association of America (ADAA), https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad