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"Shyness" or Social Phobia?
"By the time I was in my early twenties, every area of my life was affected. My fear expanded into even casual meetings with colleagues and to gatherings with friends. It eventually led to insomnia and weight loss. People couldn't believe that I had this real fear--everyone thought I was so relaxed and that I had it all together. They couldn't have been more mistaken."
"In any social situation, I felt fear. I would be anxious before I even left the house, and it would escalate as I got closer to a college class, a party, or whatever. I would feel sick at my stomach--it almost felt like I had the flu. My heart would pound, my palms would get sweaty, and I would get this feeling of being removed from myself and from everybody else.
"When I would walk into a room full of people, I'd turn red and it would feel like everybody's eyes were on me. I was embarrassed to stand off in a corner by myself, but I couldn't think of anything to say to anybody. It was humiliating. I felt so clumsy, I couldn't wait to get out.
"I couldn't go on dates, and for a while I couldn't even go to class. My sophomore year of college I had to come home for a semester. I felt like such a failure."
Millions of Americans suffer from an anxiety disorder characterized by an intense fear of saying and/or doing the wrong thing, of being "found out," of being judged as inferior. Although it's very treatable, a mere one in twenty of those who suffer with social phobia gets professional help.
There are likely many reasons why people don't seek treatment--for instance, not knowing that what they have has a "name" and that it can be treated, not knowing where or how to look for help, or, perhaps, feeling demoralized that they have a problem they can't fix themselves. Another reason is that, too often, social phobia is mistakenly equated with shyness.
What's the difference between shyness and social social phobia?
The difference between shyness and social phobia can be likened to the big distinction between, say, heartburn and a cardiac condition. While one can happen every once in a while and its effects tend to evaporate rather quickly, the other is chronic, has serious symptoms that will not just "go away," and requires serious medical attention.
Unlike the temporary uneasiness and embarrassing awkwardness of shyness, social phobia is a very intense and oftentimes debilitating fear of embarrassment or humiliation that can severely disrupt a person's life and can even lead to other serious physical illnesses and mental disorders. By the time it's finally recognized for what it really is and is accurately diagnosed, social phobia has led to at least one other mental disorder in 81% of its victims, with 61% suffering panic disorder and 90% having clinical depression. Many sufferers of social phobia turn to alcohol for the short-term immediate effect drinking can have on diminishing anxiety and, as a result, nearly 75% become alcoholic.
What are some of the commonly-experienced symptoms?
For those who have social phobia, even the most benign, un-pressured social situations can cause them to experience uncontrollable trembling, sweating, racing heartbeat, and feelings of intense fear. Other common symptoms include:
- Having an intense or persistent fear of the kinds of social situations, such as parties or business meetings, in which people may be judging you
- Being afraid of people in authority and going to great lengths to avoid them
- Feeling fearful of speaking to strangers or meeting new people
- Fearing that others will notice the visible signs of your anxiety, such as shortness of breath, blushing, and difficulty speaking and judge you critically
- Knowing that your feelings of fear and anxiety are excessive and/or unreasonable, but not being able to act cool, calm, collected, and in control, no matter how hard you try
Social phobia can cause a person to avoid job interviews, dating, even eating in public. Individuals with social phobia describe feeling as though their real, self-confident, socially adept selves are "trapped inside." While they want to socialize normally, they're terrified people will see them lose control and they imagine the worst and most humiliating consequences.
Are there different kinds of social phobia?
Two-thirds of those who have social phobia suffer from generalized social phobia that permeates all areas of their lives and leads them to avoid public interaction whenever and however possible. As one former sufferer put it, "I'd wake up each morning dreading who I'd have to say 'Hello' to and seldom made it through a day at work without feeling nearly paralyzed by fear, as if the end of the world was about to occur at any moment."
Those who have non-generalized social phobia (most commonly thought of as old-fashioned stage fright or "performance anxiety") are able to feel comfortable in everyday social situations but, predictably, their heart races, they sweat, feel flushed, and lose their concentration whenever they have to perform or make a speech.
What causes social phobia?
Social phobia usually has an onset in childhood or adolescence--it is rare for it to start after a person reaches their mid-twenties. Although anyone can have the disorder, it seems to affect more women than men.
There is, as yet, no known single cause of social phobia, however, some research suggests that both psychological and biological factors play a role. For example, a person might inherit a pre-disposition to anxiety or shyness. If that pre-disposition is combined with early childhood observations of the behavior and consequences of other (a process called observational learning or social modeling), or if they themselves are the victim of extremely negative childhood occurrences, the combination of what they inherited and what they experienced early on can set the stage for the onset of social phobia.
Other research indicates that social phobia may be inherited outright and that the systems which regulate serotonin and dopamine, two neurotransmitters which are involved in the control of emotions, don't work as they should. Similarly, another line of research is developing a biochemical basis for the disorder and exploring the idea that heightened sensitivity to disapproval may be physiologically or hormonally based.
Fortunately, social phobia can be treated
The earlier social phobia is recognized and treated, the sooner the individual can begin living unencumbered by disproportionate fear and anxiety. Treatment can be medication, therapy, or, most effective of all, a combination of both. While some have found that medication can help short-circuit their suffering, relapses occur in about half of the cases in which medication was the only treatment received, whereas relapse occurs for only one in six who seeks therapy. There are therapists who are especially skilled at helping those with social phobia to reshape their behavior and repair the distorted reasoning that's led them to fear being ridiculed. As one person who struggled for years with social phobia describes her recovery, "I may never be the life of the party...but, thanks to therapy, I finally have a life!"
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