Social anxiety disorder

Social anxiety disorder, also called social phobia, is an anxiety disorder in which a person has an excessive and unreasonable fear of social situations. Anxiety (intense nervousness) and self-consciousness arise from a fear of being closely watched, judged and criticised by others.

A person with a social phobia is afraid that he or she will make mistakes and be embarrassed or humiliated in front of others. The fear may be made worse by a lack of social skills or experience in social situations. The anxiety can build into a panic attack. As a result of the fear, the person endures certain social situations in extreme distress or may avoid them altogether. In addition, people with social anxiety disorder often suffer "anticipatory" anxiety -- the fear of a situation before it even happens -- for days or weeks before the event. In many cases, the person is aware that the fear is unreasonable, yet is unable to overcome it.

People with social anxiety disorder suffer from distorted thinking, including false beliefs about social situations and the negative opinions of others. Without treatment, social anxiety disorder can negatively interfere with the person's normal daily routine, including school, work, social activities and relationships.

People with social phobias may be afraid of a specific situation, such as speaking in public. However, most people with social anxiety disorder fear more than one social situation. Other situations that commonly provoke anxiety include:

• Eating or drinking in front of others.
• Writing or working in front of others.
• Being the centre of attention.
• Interacting with people, including dating or going to parties.
• Asking questions or giving reports in groups.
• Using public toilets.
• Talking on the telephone.

Social anxiety disorder may be linked to other mental illnesses, such as panic disorder, obsessive-compulsive disorder, and depression. In fact, many people with social anxiety disorder initially see the doctor with complaints related to these disorders, not because of social anxiety symptoms.

What are the symptoms of social anxiety disorder?

Many people with social anxiety disorder feel that there is "something wrong", but don't recognise their feeling as a sign of illness. Symptoms of social anxiety disorder can include:

• Intense anxiety in social situations.
• Avoidance of social situations.
• Physical symptoms of anxiety, including confusion, pounding heart, sweating, shaking, blushing, muscle tension, upset stomach and diarrhoea.

Children with this disorder may express their anxiety by crying, clinging to a parent or throwing a tantrum.

How common is social anxiety disorder?

The Royal College of Psychiatrists says 5% of people have some degree of social phobia, with women two or three times more likely to be affected. The disorder most often surfaces in adolescence or early adulthood, but can occur at any time, including early childhood. It is more common in women than in men.