At sometime in everyone's life, we will experience anxiety during a social or performance situation. Whether it's butterflies in the stomach, or even blushing.

What is Social Anxiety Disorder?

Social anxiety disorder is the extreme version of this sensation. It includes excessive levels of social anxiety, which are bad enough to be significantly uncomfortable, and can interfere in the sufferer's daily life and routines. Frequently sufferers of Social Anxiety Disorder will avoid social situations altogether since they find them so uncomfortable.

The symptoms of Social Anxiety Disorder include:

• The individual experiences excessive and persistent fear of one or more social or performance situations.

• The individual experiences feelings of anxiety, fear, or panic immediately upon encountering the feared social situation.

• The person recognizes that the fear is excessive, unreasonable, or out of proportion to the actual risk in the situation.

• The individual tends to avoid the feared social situation, or if he or she doesn ' t avoid, the situation is endured with intense anxiety or discomfort.

• The individual ' s fear, anxiety, or avoidance causes significant distress or significant interference in the person ' s day to day life.

• In children younger than 18 years of age, the problem must be present for at least six months before a diagnosis of social anxiety disorder would be considered appropriate.

• It must be established that the anxiety symptoms are not being caused by a medical condition or by a drug or substance. As well, if the individual has a medical condition with visible symptoms, the fear must not be only of others noticing these medical symptoms.

• If the person fears most social situations, his or her social anxiety disorder is described as generalized. A person, however, can be extremely anxious and fearful of only one social situation and still be diagnosed with social anxiety disorder, as long as the problem causes significant interference or distress.

Situations that are feared and commonly avoided by people who suffer from Social Anxiety Disorder include:

• Public speaking

• Talking in meetings or classes

• Participating in sports or working out in front of others

• Performing music or acting on stage

• Writing in front of others

• Eating or drinking in front of others

• Using public restrooms when other people are nearby

• Making mistakes in front of others

• Being in public areas such as a shopping mall or a bus

• Going to a party

• Initiating or maintaining conversation

• Talking to strangers

• Inviting friends over for dinner

• Talking on the phone

• Expressing personal opinions

• Being assertive

• Being in intimate situations

• Talking to people in authority

• Returning items to a store or sending food back in a restaurant

Causes can be biological or psychological. Biological causes of social anxiety disorder are:

• Brain activity

• Neurotransmitters

• Genetics and heredity

Psychological factors include:

• Learning and personal experiences

• Attention and memory

• Beliefs and interpretations in social situations

• Avoidance and generally anxious behaviors.

Treatments of Social Anxiety Disorder depends on the cause.

For biologically caused Social Anxiety Disorder, medications are the most widely accepted solution. Psychologically caused Social Anxiety Disorder include cognitive therapy, "exposure" to situations therapy, "exposure" role playing therapy, and social skills training. Combined treatments among medications and psychological therapies can also be very useful.

SUGGESTED READINGS

Butler, G. (1999). Overcoming social anxiety and shyness: A self-help guide using cognitive behavioral techniques. London, UK: Robinson.

Hope, D.A., Heimberg, R.G., Juster, H.R., & Turk, C.L. (2000). Managing social anxiety. San Antonio, TX: The Psychological Corporation.

Soifer, S., Zgourides, G.D., Himle, J., & Pickering, N.L. (2001). Shy bladder syndrome: Your step-by-step guide to overcoming paruresis. Oakland, CA: New Harbinger Publications.

These publications can be found in our reading room