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©2006-2011 Deborah Wiig
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Jane wants me to meet her friends, thinks Joe. But I won’t be able to think of anything to say, my hands will shake, and I’ll feel like I’m choking. They’ll think I’m boring and strange. I’ll make up an excuse not to go.

Joe has social anxiety. People who have social anxiety disorder, or the current term, social phobia, worry that other people will judge and reject them. They imagine the worst. They tend to isolate themselves, so they’re often lonely.

You may have social phobia if your fear interferes with your life; is more intense, more frequent and occurs in a wider range of situations than for other people; and is accompanied by physical symptoms.

Social phobia can be reduced or eliminated with treatment. You can feel more comfortable in feared situations, enjoy life more and have the confidence to take on new challenges.  

What is social phobia?
Symptoms occur in three categories: physical, mental and behavioral, according to Martin M. Antony, Ph.D. and Richard P. Swinson M.D. in The Shyness and Social Anxiety Workbook.

Physical symptoms (how you’re feeling) may include pounding heart, trouble breathing, blushing, sweating, shaking or trouble concentrating.

Mental symptoms (what you’re thinking) include sadness, anxiety or anger. You may make inaccurate or exaggerated assumptions about what other people are thinking about you and predictions about what’s going to happen. You may think: “If I don’t present myself well at this meeting, my boss is going to fire me.”

Behavior symptoms (what you’re doing) You may avoid eye contact and speak softly, stick close to someone familiar, even stay home from social activities.  

But avoidance can actually make things worse. By skipping the party, the meeting, the job interview, you reinforce your negative self image.

How is it treated?
Three types of treatments have been found to be effective for social phobia symptoms.

1. Cognitive behavior therapy (CBT) has been shown to be more effective than other psychological treatments. With the help of a qualified therapist, you will learn to change your beliefs and behaviors.

2. Exposure therapy teaches you to confront the situations you’re afraid of, gradually and repeatedly, until they no longer make you afraid.

3. Medications. Paxil, Zoloft and Effexor are FDA-approved for treating the disorder. But a number of drugs, used “off-label,” have been found to be effective, including some antidepressants, such as citalopram, and anti-anxiety drugs. Medications are often combined with therapy.

Medications can have side effects, and symptoms are likely to return if the medications are stopped. Learning strategies for coping with anxiety is a longer-lasting solution.

The most effective methods for recovery require working with professionals, but there are self-help approaches you can take, at least initially, or in combination with therapy.

Related articles
Catastrophizing: Fearing the worst
Managing your anxiety
More articles

Sources

Monica Ramirez Basco, assistant professor of psychology, University of Texas at Arlington, founding fellow of the Academy of Cognitive Therapy. Wright, Jesse and Monica Ramirez Basco, (2002) Getting your Life Back-The Complete Guide to Recovery from Depression

Somjee, Lubna PhD, clinical psychologist, Media Ambassador, New York State Psychological Association, columnist, Poughkeepsie Journal

Antony, Martin M. Ph.D., Swinson, Richard P. M.D (2000) Shyness and Social Anxiety Workbook, New Harbinger Publications, Inc.

Anxiety Disorders Association of America

Page updated November 1, 2010