Social phobia affects an estimated 5.3 million adults across the U.S., and is the third largest mental health issue in the world. Social phobia is characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with persistent social phobia have a persistent, intense, and chronic fear of being watched and judged by others and of being embarrassed or humiliated by their own actions. Many times this fear is so severe it interferes with school, work, and other activities. Sometimes people with this disorder recognize their fears may be excessive or unreasonable, but are still unable to overcome them. Social phobia typically develops in adolescence and rarely develops after age 25; it affects more women than men, although more men seek treatment for it.

WHAT CAUSES SOCIAL PHOBIA?
Research is still new about what causes social phobia. Currently it is thought that a small structure in the brain called the amygdala controls the symptoms of social phobia. The amygdala controls fear responses. Other research suggests that social phobia could also be an inherited disorder, while still other research suggests that social phobia could be a physiological or hormonal reaction, meaning that, like other disabilities, social phobia is a chemical imbalance. One other line of research is suggesting that social phobia is a learned response acquired by observing the behavior and consequences of others.
So really, no one knows for sure, and unfortunately for those who suffer from social phobia, many people are unaware that this diagnosis exists. Many youth and adults who suffer from social phobia are originally diagnosed with everything from panic disorder and personality disorder to clinical depression and schizophrenia.

SITUATIONS AND SYMPTOMS
Different situations will trigger the person’s anxiety. Situations such as:
 Being introduced to other people
 Being teased or criticized
 Being the center of attention
 Being watched or observed while doing something
 Meeting people in authority, or even
 Swallowing, writing, talking or making phone calls in public

These situations can trigger the reactions social phobia causes: anxiety, intense fear, nervousness, automatic negative thinking cycles, racing heart, blushing, excessive sweating, dry throat and mouth, trembling and muscle twitches.
Some common signs of social phobia for those who might be observing the person, and not experiencing it for themselves, is watching the person avoid going to school, work or any other social event. A key complaint by the person is a fear of appearing foolish or doing something that would invite teasing or criticism.
Social phobia can also co-occur with other anxiety disorders, such as panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, specific phobias, and/or generalized anxiety disorder, or depression. Sometimes individuals suffering from social phobia try to self-medicate by using drugs or alcohol, which could lead to problems with abuse or dependence on these substances.

TREATMENT
The good news is that social phobia can be treated very effectively. There are a variety of methods that, quite simply, involve a certain short-form psychotherapy (or “talk therapy”) called cognitive-behavioral therapy and medication. Sometimes one or the other can work best for the patient, but many times it’s a combination of the two that proves to be most effective. It will depend on what the doctor and the patient decide together.
Types of medication could include types of antidepressants like selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), or even high-potency benzodiazepines. In some cases, such as those with performance phobia, beta-blockers, which are used to control high blood pressure, have been helpful.

FOR FAMILY AND FRIENDS
If you think your child has social phobia, then talk to his or her doctor immediately. The doctor should be able to determine if the symptoms are caused by social phobia or if they are caused by some other condition. The doctor should also be able to refer you to a mental health professional experienced with this kind of emotional behavior. When looking for a mental health professional, look for someone:
o trained in working with children,
o who has used cognitive-behavioral or behavior therapy,
o who has and understanding of prescribed medications for this disorder, or
o who cooperates with a doctor who does so appropriately.

What else can you do?
o Make sure you keep yourself educated about your child’s disability,
o get accurate information from libraries, hotlines, or other resources,
o ask questions about treatments and services, and
o seek out support groups in your area. (A great source of information comes from the people who have already had a similar
experience.)
Make sure you, your child and the mental health professional partner with your child’s school to ensure success.

Resources

Facts About Anxiety Disorders, Facts About Social Phobia, and Social Phobia: A Real Illness booklet
National Institute of Mental Health
www.nimh.nih.gov

Social Phobia/Social Anxiety Association
www.socialphobia.org

The Child Anxiety Network
www.childanxiety.net
childanxietyinfo@childanxiety.net

Children and Adolescents with Anxiety Disorders Fact Sheet
Center for Mental Health Services
http://www.mentalhealth.samhsa.gov/cmhs/
1-800-789-2647

Anxiety Disorders in Children and Adolescents Fact Sheet
Substance Abuse and Mental Health Services Administration
http://www.samhsa.gov/
1-877-696-6775