Social phobia

Social anxiety disorder

Social phobia is a persistent fear about social situations and being around people. It's one of the most common anxiety disorders.
Much more than just "shyness", social anxiety disorder causes intense, overwhelming fear over what may just be an everyday activity like shopping or speaking on the phone.
People affected by it may fear doing or saying something they think will be humiliating.

Social anxiety disorder disrupts normal life, interfering with social relationships and quality of life, and impairing performance at work or school.
It's generally more common in women than men and often starts in adolescence, or sometimes as early as childhood.
If you think you may have social anxiety disorder, don't be afraid to see your GP or to start the Panic Away Program. It is a recognised condition that can be effectively treated.

What are the signs of social anxiety disorder?

A child with social anxiety disorder may cry a lot, freeze, or have tantrums. They may fear going to school and participating in class and school performances.
Teens and adults with social anxiety disorder may:
dread everyday activities such as:
meeting strangers
talking in groups or starting conversations
speaking on the telephone
talking to authority figures
working
eating or drinking with company
going shopping
have low self-esteem and feel insecure about their relationships
fear being criticised
avoid eye-to-eye contact
misuse drugs or alcohol to try to reduce their anxiety  
They may just fear one particular situation, such as speaking on the phone, or all social situations.

Panic attacks

Sometimes, the fear and anxiety of a social situation can build up to a panic attack, a period of usually just a few minutes when the person feels an overwhelming sense of fear, apprehension and anxiety.
There may be physical symptoms too, such as feeling sick, sweating, trembling and having heart palpitations.
These feelings reach a peak and then pass rapidly. They are alarming but cannot cause any physical harm. 

Other mental health problems

Many people with social anxiety disorder will also have another mental health problem, such as depression, generalised anxiety disorder, panic disorder and/or post-traumatic stress disorder.
Some people may have a substance or alcohol misuse problem, as they use drugs or alcohol as a way of coping with their anxiety.

What are the causes?

We don't really know what causes social anxiety disorder, but it is likely to involve a combination of factors. Genes may play a role.
Also, the behaviour of parents may have an influence on whether their child will develop social anxiety disorder. According to Anxiety UK, people with the disorder have described their parents as:
overprotective
not affectionate enough
constantly criticising them and worrying they may do something wrong
overemphasising the importance of manners and grooming
exaggerating the danger of approaching strangers

Getting help

If you think you may have social anxiety disorder, don't be afraid to see your GP for help.
They'll make it as easy as possible for you to have a consultation with them. You might be offered an assessment over the phone if you find that easier, or an appointment at a time when the surgery is less crowded or busy, before or after normal hours. 
If your anxiety is severe, or you'd like your child to be assessed, your GP may be able to visit you at home.


Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is one of the most effective types of treatment for social anxiety disorder. You'll be offered individual CBT specially developed for social anxiety disorder, which is usually 14 sessions over approximately four months. 
Generally, CBT works by helping you identify unhelpful and unrealistic beliefs and behavioural patterns. You and your therapist work together to change your behaviour and replace unhelpful beliefs with more realistic and balanced ones.
CBT teaches you new skills and helps you understand how to react more positively to situations that would usually cause you anxiety.
Your therapy sessions may include education about social anxiety, video feedback to correct distorted views of yourself, and behavioural exercises and experiments.

Supported self-help

If you wish to try a different psychological therapy to CBT, you may be offered supported self-help. You may, for example, be offered a CBT-based book or computer programme to try over three to four months.

Learn more about self-help therapies.