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Like shyness, nervousness in the presence of strangers is a normal emotional reaction. But for an individual with social phobia, the very idea of being observed by others frightens him. Through this article you will find out what social phobia is, a real disease that affects many people. Update on this disabling disorder and the various treatments that can cure it.
Understanding Social Phobia
Faced with the various disorders of human behavior, it is essential to be able to distinguish those which are common to all human beings, and those which are deeply harmful to their development. Certain simple emotions or almost innocuous situations can thus have a significant impact on phobic people. In the case of social phobia, the subject often has to make considerable efforts to face situations considered banal in the eyes of other people. Hence the importance of understanding social anxiety or phobia and its characteristics.
What is social anxiety?
Social phobia, also called social anxiety, is an intense anxiety disorder, just like post-traumatic stress disorder or obsessive-compulsive disorder. The phobia is characterized by an uncontrolled fear of any social situation in which the person is confronted with the gazes of other people. The disorder is difficult to manage internally, so the person avoids all social contact to preserve it. A simple conversation or light eye contact can make the individual feel uncomfortable. Social anxiety isn’t just about shyness. Even if people prone to this disorder generally showed great shyness from childhood. The transition to adolescence is also the period during which social anxiety disorder appears.
Social anxiety disorder is also the fear of being judged, of being evaluated negatively or of being rejected in a situation that requires the performance of the person. Anxious individuals worry about acting or appearing visibly distressed, awkward, or boring in front of others. According to studies carried out around this disease, social phobia is one of the most common mental disorders today. The person who feels social anxiety thus avoids showing himself in public. And although she recognizes that her fear is excessive and unjustified, she often remains helpless in the face of the manifestations of the disorder.
The diagnosis of social anxiety disorder (made by a doctor only)
In order to properly treat a social phobia, it is essential to be able to determine the various factors that cause it. This process begins with a clear diagnosis established by a health professional. The operation finds all its interest insofar as it makes it possible to determine the true causes at the origin of the anxiety. Indeed, in the absence of a precise examination, the symptoms of social phobia can resemble those of a physical and mental health disorder. The absence of a clear diagnosis can thus bias the treatment to be applied. To carry out this examination, the doctor can refer to the diagnostic criteria established in official manuals such as the DSM (Diagnostic and Statistical Manual of Mental Disorders), or in the ICD (International Statistical Classification of Diseases and Related Health Problems).
The identification of the characteristic signs of social phobia disorder must therefore be based on a precise clinical interview including:
- a physical examination of the patient to assess whether a medical condition or medication may have triggered the anxiety symptoms
- an interview focusing on the symptoms, their frequency and the situations during which the disorder appears in the individual
- a questionnaire for personal evaluation of the symptoms of social anxiety
Symptoms of social phobia
The state of stress or anxiety is a completely normal reaction when a person is confronted with an experience in public. This anxiety increases when the event in question approaches, and disappears as soon as the facts have occurred. However, in the case of social phobia, the state of anxiety intensifies during the event. People with the phobia disorder thus experience intense physical symptoms. These can turn into real crises depending on the situation. Everyone experiences phobia or social anxiety differently, so physical symptoms also manifest in a variety of ways, including:
- persistent and excessive fear or anxiety about specific social situations, for fear of being judged, embarrassed or humiliated;
- avoidance of social situations that generate anxiety or fear;
- intense anxiety unrelated to a health problem, medication, or resulting from addiction to any substance;
- an accelerating heart rate;
- muscle tension;
- dizziness and vertigo;
- stomach problems, with or without diarrhea;
- an inability to catch one’s breath;
- a feeling of being out of body;
- abnormal and excessive sweating, etc.
The causes that can lead to anxiety disorders in society
Fear of the gaze of others is a significant factor that can lead to social phobia. Ultimately, social anxiety disorder is able to cause significant sequelae in the life of the individual. In fact, these people are likely to decline any job opportunity that exposes them to frequent interactions with others. Phobic people generally avoid going out or eating in groups for fear that their hands will shake in public. The symptoms can be so extreme, as to profoundly disrupt their daily life, their social life, and even their professional performance. People with social anxiety are also at an increased risk of developing a depressive disorder or major alcohol-related disturbances.
Common risk factors for people with social phobia include:
- speaking in public or in front of strangers;
- going out together in a public space;
- establish eye contact;
- use public toilets;
- participate in parties;
- eating with other people;
- accompanying a child to school;
- go to work ;
- start a conversation, etc.
Moreover, the reasons for fearing certain social situations are evident in the individual affected by phobia. But in general, the factors revolve around excessive fear:
- to be judged by others;
- being embarrassed or humiliated, sweating or shaking;
- accidentally offend someone;
- of being the center of attention of others, etc.
Similarly, other fears that are essentially of a psychic nature are associated with it, such as:
- fear of intervening or speaking in public;
- fear of blushing in public;
- fear of attending a meeting;
- fear of interacting with co-workers;
- fear of facing performance situations, such as a test or an exam;
- a personality disorder, etc.
Finally, people with social anxiety disorder harbor negative thoughts about themselves, such as low self-esteem. They thus pay great attention to the behavior of other people, to the point of interpreting everything in a negative way. They conceive each gesture or remark as being a rejection or a criticism against them. They thus give way to depression or excessive consumption of substances with anxiolytic effect, such as alcohol. Faced with certain more intense personality disorders, these individuals may consider acts of suicide.
What solutions to overcome social phobia?
Despite the many treatments for social anxiety, less than 5% of people with this disorder seek treatment within a year. More than a third of people report symptoms that have been present for a decade, before deciding on treatment. The care provided thus depends on the extent to which the social anxiety disorder affects the person’s ability to react on a daily basis.
The type of treatment commonly sought to cure social anxiety is psychotherapy. This practice is primarily aimed at providing a comfort zone and improving the symptoms present in most people with the disorder. During the therapy sessions, you first learn to recognize and change your negative thoughts. This stage leads you to develop skills to gain confidence in social situations. It turns out that the cognitive-behavioral approach is the most effective type of psychotherapy for social anxiety. This method can be applied individually or in groups, as appropriate.
During exposure-based cognitive behavioral therapy, you gradually work to deal with the situations you fear most. This greatly improves your coping skills and helps you develop the confidence to deal with situations that create anxiety. You can also participate in job training or role play to practice your social skills. You will gain both comfort and confidence. Don’t be afraid to challenge your body by exposing yourself to social situations. This will allow you to deal with your worries on your own.
The effects of hypnosis are also known to manage phobias. The modified state of consciousness of the patient, obtained under hypnosis, approaches a deep state of relaxation. In addition, several studies demonstrate the effectiveness of hypnosis in managing anxiety.
If the chosen treatment does not quickly give the result you hoped for, do not give up. Know that you can continue to make progress in psychotherapy for several weeks or even months.
Treat social phobia with medication
Several types of medication are available to treat social phobia. SSRIs, or Selective Serotonin Reuptake Inhibitors, are the top drugs that can treat persistent symptoms of social anxiety. In order to reduce any risk of side effects, your doctor is able to prescribe you low dose medications, which he will gradually increase. It may take several weeks to several months of treatment for your symptoms to noticeably improve.
You can also turn to the antidepressants that seem to you to be the most effective. Treatments based on benzodiazepine, phenelzine, paroxetine (DEROXAT®), sertraline or venlafaxine (EFFEXOR®) can reduce your level of anxiety. However, you must absolutely go to a health professional before taking it. It is essential that you know which antidepressant will have the least side effects on your body. Although this type of medicine often works quickly, it can become habit-forming or addictive. That’s why these antidepressants are usually prescribed for short-term use.
The beta-blocker class of drugs also works by preventing the stimulating effect of adrenaline, the hormone responsible for increasing heart rate. These drugs are thus able to reduce both heart rate, blood pressure, and heartbeat, as well as tremors in the voice and limbs of the body. However, they are more recommended when faced with a one-off situation such as speaking in public rather than for regular use. For some people, the symptoms of social anxiety disorder may subside over time, requiring them to stop taking medication. Other people, on the other hand, will find it more difficult to recover and will require treatment and follow-up for several years.
In order to get the most out of treatment with medication, follow your medical or therapeutic prescriptions. Set goals to address social situations that cause you anxiety. Tell your doctor about any changes in your condition.
Prioritize the contributions of phytotherapy
Several herbal remedies have proven successful in treating social anxiety. These include St. John’s wort, omega 3, 5-http or SAM-e. Even if this type of treatment is one of the natural health approaches with many benefits, do not hesitate to seek advice from a naturopath. He will be able to direct you towards the products most suited to your situation. Also note that some plants have drug interactions.
Other herbal supplements, such as kava and valerian, are often associated with this category of natural skincare. Be very careful, however, as they increase the risk of serious liver damage in some patients. Supplements like passionflower or theanine can have a calming effect, but often need to be combined with other products. It is therefore difficult to validate their specific effects on the symptoms of anxiety.
Note that before taking any natural herbal remedies or supplements, talk to your doctor. The goal is to make sure they are appropriate for social phobia and will not interact with any medications you are taking.
Be accompanied by loved ones
Apart from therapeutic care and drug treatments, people with social phobia can seek help from those close to them (family and friends). They must show empathy, understanding and patience with the phobic person. It is advisable to:
- provide support during stressful social situations, until the person is independent;
- provide them with sound advice for starting a conversation or speaking in front of an audience;
- teach him to regain self-confidence;
- help him to set concrete objectives;
- show him why his social phobia is unfounded, by highlighting his qualities;
- prove to him that he is not in danger of being ridiculed, of being judged, of being evaluated negatively or of being rejected, etc.;
Home remedies for social anxiety
If you have been able to discover the benefits of the previous solutions, know that personal habits are also effective in curing social anxiety. For some of them, only you can do them. The challenge is daunting, however difficult or painful it may seem at first. By regularly dealing with situations that you consider complex, you will continue to develop and strengthen your coping skills. Indeed, although social anxiety disorder usually requires the help of a medical expert or trained psychotherapist, there are some “home remedies” you can try to manage situations that may be triggering your phobia symptoms:
- adopt stress reduction techniques;
- do regular exercises or physical activities;
- get enough sleep;
- have a healthy and balanced diet;
- avoid alcohol and caffeine;
- participate in situations in public by talking to people with whom you feel comfortable;
- eat with a close relative, friend or acquaintance in a public place;
- make eye contact, return greetings to others, or be the first to say hello;
- pay someone a compliment;
- ask a salesperson to help you find an item;
- dare to ask for directions on the way;
- show interest in others by asking questions about their homes, families or hobbies;
- call a friend for a Saturday night plan;
- be prepared for social situations, etc.;
Face your deepest fears
In this part, you will reconsider your fear of others in order to identify the situations that cause your social anxiety the most. You can do some of the following activities gradually until they cause you less anxiety. Set daily or weekly goals for situations that seem difficult to you. The more you train, the less anxious you will feel. Consider taking steps to identify the situations that make you nervous:
- prepare your conversation by reading the newspaper for example in order to identify an interesting story to talk about;
- focus on the personal qualities you like about yourself;
- set realistic goals;
- pay attention to how often the embarrassing situations you are afraid of occur. You may notice that the scenarios you fear usually don’t happen;
- when distressing situations arise, remember that your feelings will pass, and that you have the opportunity to deal with them until the event is over. Most people around you won’t notice, or are more forgiving than you think;
- Avoid turning to alcohol to calm your nerves. It can certainly help you temporarily, but in the long term, its consumption can make you more anxious.
Can You Cure Social Phobia Naturally?
Here are other quite achievable and original techniques that can unlock you from certain difficult situations. They are not a cure but they may help you in some situations:
Bring your pet (dog, cat, etc.) on your outings and cuddle it from time to time. Although you probably won’t be able to take him everywhere you go, try to increase contact with him. His presence will certainly help you calm your social anxiety.
Get into the theatre. You have certainly heard of the Coué method. It applies very well in the case of a social phobia. The principle is simple: you must convince yourself that you are comfortable in public. Just pretend, if only to feel the sensation. You can take acting classes to improve your acting skills until you are completely comfortable.
The invisible body
This new technology, developed in Sweden, made it possible to reproduce the patient’s body in an invisible state. The phobic person was able to examine his behavior through a virtual reality helmet, in front of social situations, in the presence of unknown people. This feeling of invisibility surprised people with social phobia. The experiment was thus able to demonstrate how the perception of the body can change the way the brain processes social signals.
Phobia or social anxiety is an imbalance that can be treated and cured in many ways. What is most important is your will and the energy you will devote to your recovery and to a lifestyle that promotes your daily well-being.