Social anxiety is an intense feeling of fear, apprehension or worry regarding any or all social situations or public events. It is sometimes known as social phobia and, less commonly, social trauma. In psychiatry, it is diagnosed as social anxiety disorder, a form of anxiety disorder. It is currently the third largest mental health care problem in the world, according to United States epidemiological data. more...
Psychiatrists often distinguish between generalized and specific social anxiety disorders. People with generalized social anxiety, not to be confused with generalized anxiety disorder, may have great difficulty with most or all social situations. The principle difference between generalized anxiety disorder (GAD) and generalized social anxiety is that the former deals with excessive anxiety of any kind, while the latter is extreme anxiety about being judged and/or embarrassed in a social setting. Those with specific social phobias may experience anxiety only in a few situations. For example the most common specific phobia is glossophobia, the fear of public speaking or performance, also known as "stage fright". Other examples of specific social phobias include fears of writing in public (scriptophobia) and using public restrooms (paruresis).
An extreme degree of this social anxiety is the aforementioned "social trauma", also known as emotional rejection, in which there is an overwhelming fear of being judged, watched or possibly traumatized or publicly humiliated (including being thrown out and banned) as a result of a one's actions, behaviour or appearance. These feelings often lead to isolation and reclusion.
Social phobia should not be confused with panic disorder. Sufferers of panic disorder are convinced that their panic comes from some dire physical cause, and often go to the hospital or call for an ambulance during or after their attacks. Social phobics may experience a panic attack when triggered, but they are aware that it is extreme anxiety they are experiencing, and that the cause is an irrational fear. Few social phobics would willingly go to a hospital in that instance because they fear rejection and judgment by authority figures (such as the medical staff).
Many people have "butterflies" in the stomach or minor nerves before a date, party, or some other event that puts them on public display, but that usually does not prevent them from attending. A true social phobia is an overwhelming fear, which in extreme cases can keep the sufferer housebound and isolated for long periods of time. The critical element of the fearfulness is the possibility of embarrassment or ridicule. The fear may be so severe that it interferes with work, school, and/or other ordinary activities.
Individuals with generalized social phobia are characterized as extremely shy. Sufferers often report that they have been shy most of their lives. The social phobia is often a manifestation of shyness from childhood.
While many people with social phobia recognize that their fear of being around people may be irrational, they are unable to overcome it. For instance, some sufferers have difficulty attending parties or meetings, making a phone call, walking into a shop to purchase goods, entering a classroom or cafeteria full of teenagers, or asking for help from authority figures. To avoid these frightening, panic-like reactions, people often rearrange their lives to sidestep their personal triggers rather than endure the intense anxiety, such as turning down a promotion that requires interacting with groups of people, or ditching school. Extreme humiliation, severe embarrassment, or other stressful experience may provoke an intensification of difficulties (Barlow, 1988). Once the disorder is established, complete remissions are uncommon without treatment.
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