Social Anxiety Disorder: Not Just Shyness

IMAGE We all get butterflies at some point in our lives, but when fear of social interaction threatens to take over your life, it is time to seek help. Suzanne, an intelligent woman in her thirties, had been lonely for much of her life. She had been stuck in the same secretarial job because she was afraid of working with people above her job level. She wanted to meet a man, but was sure she would say something stupid and be rejected. Her few good friends could not get her to go to restaurants or even parties because she was afraid other people might think she was a sloppy eater. The few times she agreed to go, her heart was pounding and she began to blush and perspire. When her primary care doctor finally referred her to a psychologist with experience in anxiety disorders, she was relieved to discover she had a treatable condition with a name, social anxiety disorder.

What Is Social Anxiety Disorder?

Many people get nervous in certain social or business situations. There is nothing unusual about feeling anxious before making a presentation, going out on a first date, going to a party where you do not know many people, or having dinner with the boss. What is different about social anxiety disorder is that you have an extreme fear of being judged by other people and acting in ways that might embarrass or humiliate you. You are also afraid of becoming the center of attention and worry that everyone is looking at you. As a result, you go to great lengths to avoid the social situations you fear. If you find yourself in one of these situations, such as a party, you experience intense anxiety that is out of proportion to the event. Social anxiety disorder usually begins in adolescence, although symptoms like extreme shyness may occur in earlier years. The disorder is chronic, although stress may cause the intensity to fluctuate.

How Does It Differ From Shyness?

On the surface, shyness and social anxiety disorder may seem the same. The main difference is the reaction of the person with the disorder. People with social anxiety disorder often avoid social situations and have intense, physical symptoms. Although social anxiety disorder responds readily to treatment, many people remain undiagnosed or misdiagnosed, in part because many people who suffer from social anxiety disorder are embarrassed to admit it. In addition, many clinicians do not know how to recognize social anxiety disorder and provide appropriate treatment. Because a large number of people with social anxiety disorder also suffer from depression, or alcohol or drug problems, diagnosis and treatment can become more complicated.

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