Have you ever heard of social phobia? Do you know someone who has it, or maybe you have it yourself?
Social phobia is a type of anxiety disorder, in which the person feels a high degree of anxiety or fear in certain social situations (or most of them).
In this article we explain the fundamental characteristics of social phobia, in addition to what are its typical symptoms, its causes and its possible treatments.
Social phobia: what is it?
Social phobia is an anxiety disorder, classified as such in the DSM-5 (Diagnostic Manual of Mental Disorders). Specifically, the DSM-5 calls it "social anxiety disorder." Their main characteristic is an irrational, intense and disproportionate fear of social situations, ranging from interacting with people to speaking in public or meeting new people.
An edition prior to the one discussed, the DSM-IV-TR, raised three types of phobias: agoraphobia, specific phobia (phobia of a specific object or situation) and social phobia. These three types of phobia are characterized because they involve intense fear reactions, accompanied by avoidance induced by certain objects or situations, which can be real or anticipated (in the case of social phobia, the phobic or feared stimulus is social situations). .
On the other hand, such situations do not objectively justify such responses of fear or anxiety. Finally, comment that it is not necessary for the aforementioned avoidance to occur if the feared situation is endured with great anxiety or discomfort.
In social phobia, as in other types of phobia,the person is unaware that the fear and avoidance of it are exaggerated or irrational ; this criterion, however, is not required in children. That is, in children this criterion is not necessary to be able to make the relevant diagnosis.
Feared situations
The feared situations in social phobia can be of two types: interpersonal situations or public performance situations.
As concrete examples of interpersonal situations we find: phoning someone, talking to strangers, talking to authority figures (for example a policeman), meeting someone, attending a party, having an interview…
On the other hand, As for examples of public performance situations we find: speaking in public, writing while being watched, using public toilets , shopping in a busy store, giving a report at a meeting, dancing or singing in front of others, eating or drinking in public, etc.
In social phobia, anxiety can appear in the first situations, in the second, or in both.
General characteristics
Some interesting facts to know in relation to social phobia are the following:
Causes
The causes of social phobia can be very diverse A traumatic event related to people or to being in public, can casuarla, such as "making a fool of yourself" (or feeling ridiculous) in a public exhibition, when interacting with certain people, at a party, etc.
On the other hand, having a very introverted personality (being “excessively” shy) can also be at the root of social phobia.
Regarding biological hypotheses, we found studies that speak of different alterations in anxiety disorders. Examples of these are: changes in gamma-amino-butyric acid (GABA), hyperactivity of the locus coeruleus (which increases norepinephrine, and therefore anxiety), hypersensitivity of serotonin receptors, etc. However, none of these hypotheses is determinative (ie none have been 100 proven).
There is agreement, however, that it is probable that a certain vulnerability to developing an anxiety disorder in general is inherited (and not so much a specific anxiety disorder). This individual vulnerability, manifested by some people, added to a traumatic event related to the negative evaluation by others, can cause the disorder of social phobia.
Symptoms
Although we have already seen in summary what the symptoms of social phobia are, we are going to explain each of them below.
one. Intense fear or anxiety
The main symptom of social phobia is an intense fear or anxiety of social situations that may involve evaluation or judgment of oneself , by others. Generally, more than fear, it is anxiety, which can even become anguish.
2. Avoidance
As in all phobias, there is an avoidance, in this case of social situations Examples of social situations are: starting a conversation with someone, present a job in public, speak in public, interact with new people, make friends, etc.
However, it can also happen that instead of avoiding the situation, it is endured but with high discomfort (or anxiety).
3. Poor social performance
Another symptom of social phobia is poor social performance on the part of the person suffering from it. That is, their social skills are usually quite deficient, although not in all cases.
4. Impairment or discomfort
The above symptoms cause significant deterioration or discomfort in the individual's life. In fact, this deterioration or discomfort is what determines the existence or not of a psychological disorder, in this case social phobia.
5. Psychophysiological symptoms
In addition to the above symptoms, physiological symptoms may appear such as tachycardia, sweating, tension, migraine, hot flashes, chest pressure, dry mouth, etc., given the possibility of being exposed to the phobic situation.
Treatment
The psychological treatment of choice to treat social phobia is treatment by exposure (in fact, it is the one that has shown the highest degree of of efficacy).This consists, fundamentally, in exposing the patient to social situations, gradually.
Other possible treatments for social phobia are: cognitive behavioral therapy (usually combined with antidepressants) and social skills training (the latter is mainly used in patients with deficits in social skills ). All of these treatments are slightly less effective than exposure treatment, although they are also useful and widely used.
Finally, another option available to us is pharmacotherapy, which involves the use of antidepressants and anxiolytics (logically, it is the treatment that the psychiatrist or family doctor will apply, not the psychologist), although this treatment is the least effective for social phobia to date.
Treatments according to the type of social phobia
We have commented, in a generic way, the treatments that are used for cases of social phobia. However, we can still specify more, since depending on the type of social phobia that the patient presents, the most recommendable is one treatment or another.
There are, broadly speaking, two types of social phobia: circumscribed (in which the patient only feels anxiety about speaking or acting in public) and generalized (in which the patient fears most social situations that occur outside the family context).
In the case of circumscribed social phobia, exposure therapy is used; On the other hand, in generalized social phobia, a combined therapy is usually used, which includes: exposure, cognitive restructuring and training in social skills.