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Social phobia

Socialphobiaisatypeofanxietydisorder.Peoplewhohavesocialphobiaexperienceextremeand
persistentanxietyassociatedwithsocialorperformancesituations.Apersonwithsocialphobia
experiencesanxietyinsituationswheretheyarelikelytobescrutinisedandobservedbyothers.
Theymayhavepersistentfearsaboutbeingjudged,criticised,ridiculedorhumiliated.
Mostpeoplefeelshyornervousincertainsocialsituations.Publicspeakingorenteringaroomfulof
strangerscancauseanxietyinmanypeople.However,thiskindofcommonapprehensiondoesnt
indicateasocialphobia.Forpeoplewithsocialphobia,socialsituationsprovokefeelingsthat
extendbeyondsimpleanxietyornervousness.
Asocialphobiaoccursforapersonwhen:
Thereisapersistentfearofoneormoresocialorperformancesituationswheretheyare
exposedtounfamiliarpeopleortopossiblescrutinybyothers.Thepersonfearsthatthey
willactinawaythatwillbeembarrassingandhumiliating.
Fearedsituationsareavoidedorenduredwithintenseanxietyanddistress.
Apersonrealisesthatthesocialanxietyisexcessiveandunreasonable,butfeelstheyare
unabletochangeorcontrolthefeelingsorbehaviour.
Itinterferessignificantlywiththeirdailylifeincludingwork,education,familyandsocial
life.
Fearoravoidanceisntduetoageneralmedicalconditionorthephysiologicaleffectsofa
substance(suchasdrugsormedications).
ItisestimatedthataroundthreepercentoftheAustralianpopulationexperiencesocialphobiain
anyoneyear.Upto13percentofthepopulationmaydevelopsocialphobiaduringtheirlifetime.
Menandwomenareequallyaffected,thoughahighernumberofmenseektreatment.
Inmanycases,socialphobiabeginswithshynessinchildhoodandprogressesduringadolescence.
Theonsetofsocialphobiagenerallyoccursaroundages11to15.Socialphobiaisalsoknownas
socialanxietydisorder.
Symptoms of social phobia
Whenexposedtoafearedsocialsituation,apersonwithsocialphobiamayexperiencesymptoms
ofextremeanxiety,including:
Blushing
Trembling
Feelingasifyouhavenothingtosay
Acceleratedheartrate
Shallow,fastbreathing
Sweatypalms
Nausea
Tensemuscles
Drythroat
Stomachpain
Feelingfaintorlight-headed
Feelingsofself-doubtanduncertainty
NegativethoughtssuchasImmakingafoolofmyself
Difficultyconcentratingonanythingotherthanphysicalsensationsofanxiety,negative
feedbackfromothersandnegativethoughts
Anoverwhelmingurgetofleethesituation
Therealisationthatthesefeelingsareirrationalandoutofproportion.
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A range of feared social situations
Somepeoplewithsocialphobiafearandavoidspecificsituations(suchasperformanceanxiety),
whileothersmayfeelgeneralisedanxietyaboutseveralsocialsituations(generalisedsocial
phobia).Apersonwithsocialphobiacanfear(andtrytoavoid)arangeofsituations,including:
Crowdsandparties
Publicspeaking
Startingorhavingaconversation
Talkingtoalargegroup
Voicingopinions
Meetingsomeonenew,shakinghands
Dating
Usingpublictoilets
Shopping
Talkingwithsomeonewhoisinapositionofseniorityorauthority
Beingwatchedwhiledoingsomething,suchaseating,signingpapersortalkingonthe
telephone
Situationsthatputtheminthespotlight,suchaspartiestocelebratetheirownbirthday.
Underlying fears
Someofthefearscommonlyarousedbysocialsituationscaninclude:
Worrythatotherswillnoticetheirphysicalsymptomsofanxiety,suchasblushing,
sweating,andstammering
Fearoflookingstupid,silly,orridiculous
Fearofappearingquiet,boringanduninterestingtoothers
Fearofbeingjudgedassociallyinadequate.
Before and after the social event can be stressful
Apersonwithsocialphobiacanfeelanxiouswhilesimplyanticipatinganupcomingsocialevent.
Aftertheevent,thepersonmayreplaytheconversationstheyhadandratetheirperformance.
Broodingonthesefeelingsofsocialfailurecanmakethepersonfeelevenworse,andreinforcethe
desiretoavoidsocialsituationsinthefuture.
Common complications of social phobia
Ifleftuntreated,socialphobiacanseverelyaffectqualityoflife.Someofthecommon
complicationsmayinclude:
Usingalcoholtocopewithanxietyduringsocialevents
Alcoholabuse
Misuseofprescriptionandnon-prescriptiondrugs
Difficultyformingandmaintainingrelationships
Curtailededucationoremploymentopportunities
Depression
Suicidalthoughts
Isolationfromfamily,peersandcommunity.
Treatment options
Recoveryfromsocialphobiaispossiblewithappropriatetreatment.Dependingontheindividual,
treatmentoptionsmayinclude:
Cognitivebehaviourtherapy(CBT)
Anxietymanagementtechniques
Socialskillstraining
Medication.

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Cognitive behaviour therapy (CBT)
Thistreatmentaimstohelppeoplechangethewaytheythink,feelandbehaveinsocialsituations.
Thesetechniquesmayhelppeopletoconfronttheirfears.Intime,peoplecometorealisethat
othersareunlikelytojudgethemharshlyandevenifitdoeshappen,theyrealiseitsnotamajor
tragedy.Theywillalsolearnthattheycanexertsomecontrolandchoiceovertheirthoughtsand
feelings.
TreatmentusingCBTmayinclude:
Educationaboutthenatureofsocialanxiety
Challengingandchangingfalseordistortedthoughtsandbeliefs
Gradualexposuretofearedsituations
Attentiontraining.
Anxiety management techniques
Relaxationtrainingandbreathingtechniquesmayhelpapersonmanagetheiranxietysymptoms.
Somephysicalanxietysymptomsmaybetriggeredbyhyperventilation(overbreathing).Taking
slow,deepbreathsfromtheabdomenratherthanfast,shallowbreathsfromthechestcan
reduceanxiousfeelings.
Relaxationtechniquesinclude:
Progressivemusclerelaxation
Meditation
Visualisation
Isometricrelaxationexercises.
Social skills training
Somepeoplewhohavesufferedwithsocialphobiaformanyyearsmaydevelophabitsthatmakeit
difficultforthemtotakestepstowardsrecovery.Forexample,theymay:
Finditdifficulttomakeormaintaineyecontact
Usesoftorhesitantspeech
Displayclosedbodylanguage
Haverigidfacialexpressions
Needalargepersonalspace
Havedifficultylisteningorkeepingaconversationgoing.
Socialskillstrainingmethodsincludemodellingtheappropriatebehaviour,role-playingandthen
practisinginreal-lifesituations.
Medication
Somemedications,suchasselectiveserotoninre-uptakeinhibitors(SSRIs),canhelpiftheperson
isalsosufferingfromdepression.Intheshortterm,drugssuchasbeta-blockersmaybeusedto
helpmanagesomeofthesymptomsofanxiety.
Where to get help
Yourdoctor
Psychologist
Yourlocalcommunityhealthcentre
AnxietyRecoveryCentreVictoriaHelplineTel.(03)98300533or1300ANXIETY(269438)
AustralianPsychologicalReferralServiceTel.(03)86623300or1800333497
Things to remember

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Socialphobiaisatypeofanxietydisorder.Peoplewhohavesocialphobiaexperience
extremeandpersistentanxietyassociatedwithsocialorperformancesituations.
Somepeoplewithsocialphobiafearandavoidspecificsituations,whileothersmayfeel
anxietyaboutseveralsocialsituations.
Treatmentoptionsincludecognitivebehaviourtherapy,anxietymanagementtechniques,
socialskillstrainingandmedication.

This page has been produced in consultation with, and approved by:

AnxietyRecoveryCentreVictoria
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