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Shyness, timidity or nervousness are common and normal personality traits. Shyness and timidity often decrease with age as the individual gains more experience and skills in different areas of life. Social boldness also varies according to circumstances: for example, others may become extremely nervous when giving speeches and presentations while others may stress about formal situations.

Fear of social situations is classified as a mental disorder when the fear and other symptoms linked to social situations significantly begin to affect ordinary life and the anxiety associated with these kinds of situations becomes intense. This syndrome is known as social phobia.

Social phobia often occurs along with other anxiety disorders or alcohol and drug problems. Social phobia can trigger a depression.

Social phobias often develop during childhood and adolescence, and it may have a negative effect on school performance. The occurence of social phobias seems to be linked with genes, difficult experiences and learned behavioural patterns. 

So­cial pho­bias can make life very dif­fi­cult

The fear of social situations, i.e. social phobia, restricts and complicates personal relationships, work and studies. Different kinds of situations cause severe anxiety in different people. People suffering from social phobia may become extremely anxious when, for example, they have to speak in a meeting, meet doctors or other people they consider authorities or make telephone calls. Even simple social interaction at work or school may cause anxiety.

At its worst, people suffering from social phobias begin to avoid situations they consider distressing, isolating themselves from work, studies and personal relationships. When the fear of social situations concerns almost all situations involving interaction with other people, we are talking about a generalised social phobia. 

Symp­toms of so­cial pho­bia

The physical symptoms of social phobia include palpitations, vertigo, tremors, sweating, a feeling of pressure in the stomach or head, dry mouth and throat or headache. Coffee, substance use and lack of sleep can make the symptoms worse.

The anxiety experienced in social phobia involves the fear of being humiliated and ashamed. These fears are unrealistic and, to some extent, unconscious. In distressing situations, people suffering from social phobias will become highly focused on their own coping and symptoms.

They may also think that all the other people in the same situation are criticising their coping, even though that is not true.  

So­cial pho­bias may lead to other prob­lems

Generalised social phobia, in particular, may lead to depression or can be strongly linked to depression. Some people suffering from social phobias resort to alcohol or other substances in order to alleviate the symptoms. However, substance use only makes the situation worse. In addition, substance use involves the risk of addiction. The suffering caused by social phobias may even lead to suicidal thoughts.

Social phobias can be treated effectively; treatment should be sought if you identify feelings of intense fear in yourself in connection to social situations. 

Treatment of so­cial pho­bias

You can get used to social situations yourself by exposing yourself to them and accepting that nervousness is something normal and that sensitivity can be an asset. In social situations that cause anxiety, people often focus on their symptoms such as palpitations, blushing, sweating or trembling. It can be helpful to try to direct your thoughts to something else and more positive.

You can strengthen your ability to cope with social situations by ensuring that you have adequate rest and sleep, relaxation and physical exercise. Using alcohol or drugs to reduce anxiety often leads to a worsening of the situation. It is good to avoid tobacco and too much coffee. Web-based self-care programs for social phobia can be helpful for many.

Social phobias can be successfully treated with psychotherapy or medication, or with a combination of both. The form of psychotherapy that has the most support in research is cognitive behavioral therapy (CBT) with exposure to anxiety-provoking social situations, but other forms of psychotherapy have also given good results. The therapy can also be performed remotely on Internet. In addition to individual psychotherapy, good results are also achieved with group psychotherapy.

Antidepressant drugs reduce social anxiety and are the first-line medication for social phobia.

Prevention of social phobia

Social anxiety usually develops already in childhood or adolescence and can affect educational achievement already in school age. The onset of social phobia appears to be linked to hereditary factors, negative experiences, and learned behavioral patterns. Sensitivity and deficient social skills can contribute to the onset of social anxiety.

You can reduce social anxiety by ensuring adequate rest and regular sleep, relaxation and adequate exercise and by avoiding tobacco, alcohol and drugs.

By teaching mental health skills in schools and universities, the risk of later anxiety disorders can be reduced.

Fact check: Kristian Wahlbeck, Adjunct Professor of Psychiatry