Social Anxiety Disorder

About Social Anxiety Disorder

Social anxiety disorder, formerly called social phobia, involves intense fear or anxiety about social or performance situations in which a person may be scrutinized, judged or embarrassed. It is among the most common anxiety disorders. Feared situations often include public speaking, meeting new people, eating or writing in front of others and dating, and the person typically avoids them or endures them with intense distress. Physical symptoms such as blushing, sweating, trembling and a racing heart can themselves become a focus of fear, creating a self reinforcing cycle. A performance only specifier applies when fear is limited to speaking or performing in public. The condition typically begins in childhood or adolescence and, without treatment, often follows a long course, with increased risk of depression, other anxiety disorders and alcohol misuse. Selective mutism in children is closely related. Cognitive behavioral therapy, which combines gradual exposure to feared situations with work on negative beliefs about how one is seen by others, has strong evidence. SSRIs and SNRIs are among the medications used, and beta blockers are sometimes used for physical symptoms in specific performance situations, though they are not effective for the broader disorder. MAOIs are an older option limited by dietary restrictions.