Thoughts Of A Social Phobic (Social Phobia Disorder)

Member Name: collingwood21

Product:	Social Phobia Disorder
Date:	18/02/09 (488 review reads)
Rating:

Advantages: None that I can think of

Disadvantages: Makes so many everyday situations harder than they have to be

It is late December and I am sitting in the office on my own desperately trying to make the piece of work I am doing last as long as possible. Next door, a classroom has been appropriated by my team for our office Christmas party and I know that I will have to attend once I have finished this one task. From where I am sitting I can hear the sounds of music, people gathering and laughing, and the chink of wine bottles as they are removed from the kitchen fridge. I know that I will soon have to join in as the party is being held in office hours and I wasn't able to admit that I really don't want to go to it; so I paid up, and regret my weakness more and more as the party approaches and I can do less and less to avoid going to it. Rationally, I tell myself that I enjoy wine, I know there will be good food there and I am familiar with most of those attending so there should be nothing to worry about - but "shoulds" don't really work with phobias. Instead, I focus on my feeling that there will be too many people there and I am not good with people - the word "party" is one of the most terrifying in the English language for me. What if I can't make conversation? What if I do or say something that humiliates me in front of people I have to see on a nearly daily basis thereafter? What if I become the butt of a joke as so often as happened at social events in the past? As I enter the room I can feel the eyes of the people already there turn to face me; I feel very self conscious and hope that my fear isn't showing. Even if they seem nice, everybody must surely notice me blushing, and how can they fail to realise how hard my heart is thumping in my chest or how weak and trembling my voice is when I do manage to speak? They must be thinking awful things about me and the only way out of this is to make up a fake doctor's appointment and leave early, although I sit and analyse the party in minute detail afterwards, ruminating over how silly I must have appeared and feeling embarrassed just thinking about how I behaved. I feel bad about it for days afterwards and make sure I avoid any other social engagements in that time in case those feeling start up again. Instead I stay at home, where I feel lonely but comfortable. Again.

Welcome to the world of the socially anxious.

Reading my opening paragraph will no doubt have left many of you thinking that I'm weird (if not downright crazy) and I can't really blame you for this as I felt this way myself for many years. The reason for me behaving in this odd way - and I can assure you, I do understand it is irrational - is because I have suffered from something known as social phobia or social anxiety disorder (not social phobia disorder as dooyoo would have it) since late childhood. I suggested this category to the site a few months ago because I think it is something that there should be more awareness of; it is considered to be the third most common psychological disorder in the Western world (after depression and alcoholism) but it is far less widely known or understood, having only been recognised as a distinct condition as recently as 1980. I cannot find any figures for the UK, but in the US population, it is estimated that around 3 - 4% of people suffer from social phobia at any given time, with there being twice as many female sufferers as male. Since I put in that suggestion, however, I have been putting off writing about something so very personal that could well make the friends I have made on dooyoo think less of me. But that is the very nature of the condition, and it is only after having three months of therapy for it that I feel confident enough to write this without embarrassment; a small thing, but one for me that feels like a step in the right direction at least.


**What is Social Anxiety Disorder?**
To begin at the beginning, let me start by explaining what social anxiety disorder is. Most of you will at some point have experienced feelings of shyness or nervousness in a social situation - perhaps having to give a presentation to your class, speaking up at a meeting or going on a date, for example. This may not be the most pleasant experience, but it is entirely normal and you know you will get over it pretty quickly. Equally, some of you will also have experienced a phobic reaction at some point, when you experience irrational fear (and usually recognise the fear as irrational) to something that you know cannot cause you any harm. A common one is arachnophobia or a phobia of spiders (which I also have incidentally), where you know full well that the little creature scuttling across the floor can in no way hurt you but you still experience intense panic and fear when you see it. The usual response to a phobia is an excessive desire to avoid the feared object - not too difficult when it is spiders you are talking about, but rather harder when you have a complex phobia such as social anxiety disorder. Just try to imagine that horrible phobic response triggering in response to common social situations that you can encounter on a regular basis and hopefully you will start to understand just how unpleasant and debilitating (not to mention exhausting) this condition can be.

In its simplest form, social anxiety disorder is a fear of being around people, and I have heard it described as such. This is not really the whole story, though. It is more specifically a fear of being watched, criticised, judged or rejected by other people, of feeling embarrassment or humiliation in front of other people, and social phobics hate being the centre of attention in particular - so I am fine walking through a busy city street where I don't have to interact with other people, for example, but put me in a situation where there are fewer people but I have to in some way "perform" socially in front of them, then I experience anxiety. This can range from a racing heartbeat to sweating to a dry mouth to going very pale or blushing, and is occasionally is accompanied by nausea as well. I feel a desperate need to get away from the situation, and once it has passed I have a tendency to dissect what happening in minute detail and beat myself up over how I reacted, what I said, or how I must have embarrassed myself. Needless to say, social phobia goes hand in hand with low self esteem and is often accompanied by depression as well. On a bad day it can even make it hard for me to make a phone call (wouldn't I be bothering the person who answered?), especially when there are other people my end who would overhear what I am saying. This is what is known as generalized social anxiety, which affects around 70% of sufferers - the other 30% have a specific social anxiety tied to certain situations (such as public speaking or eating in public) and do not feel anxious in other social situations.

Such a reaction in inconvenient to say the least. It can make many everyday situations difficult, and many already difficult situations such as job interviews or driving tests pure torture. What is worse, for me at least, is the loneliness it can create, as social anxiety disorder can make it so incredibly difficult to make (and keep) friends. How exactly do make a new friend when the thought of talking to someone you don't know is difficult and actually doing it can make you feel so nervous you begin to worry that you might faint? How might another person like you when your anxiety prevents you from stringing enough words together to make coherent conversation? I have been fortunate enough to make a couple of close friends, but there have been too many occasions in my life when the loneliness has been easier to cope with than the stress of social events that might alleviate it.


**What Causes Social Anxiety Disorder?**
This is still an open question, as no one knows the exact cause of social anxiety disorder. There is certainly evidence of there being a genetic predisposition to it, however, as a researcher from Harvard University has demonstrated. He studied children from infancy through to early adolescence and found that 10 - 15% of children were irritable infants who become shy, fearful and behaviourally inhibited as toddlers, and then remain cautious, quiet and introverted in their early school years. In adolescence, they had a much higher than expected rate of social anxiety disorder, suggesting people who inherit certain traits can develop socially anxious tendencies in later life. This fits in with other research I have read, particularly a book called "The Highly Sensitive Person" by Elaine Aron (http://www.hsperson.com/pages/hsp.htm) that I found in my early twenties, and which was the first thing I had come across that suggested that I might not be alone in my particular anxiety. I don't have space to go into this book here, but I can recommend it as interesting reading to anyone who is experiencing similar feelings to me.

Another physical cause could be an imbalance of the neurochemical serotonin, which has an important role in regulating mood, and incorrect levels in the brain can trigger anxiety and depression. It is also possible that social anxiety may be a learned response; a child with a parent exhibiting stress, fear or anxiety towards social situations may pick up on these cues and learn to fear them themselves. A further idea is that an event a person finds emotionally traumatic may cause the disorder in some individuals in much the same way that other phobias are started off when fear becomes associated with a particular object or situation. I think for this to be the case for social phobia it would require the person to be a bit shy or predisposed to social anxiety anyway, and for something to happen in a social context; this would be more likely to be the case if it happened either in early childhood when we are less able to deal with these sorts of emotions or in adolescence where we feel more socially conscious anyway. Social phobia rarely develops after the age of 25.


**What Can Be Done About Social Anxiety Disorder?**
As I stated earlier on, I developed social anxiety in late childhood, through I believe a combination of a predisposition to this sort of anxiety and a couple of key events that compounded this behaviour (which I have no desire to go into here). I therefore spent a good ten years of my life believing that I was alone in my feelings, that I was odd, weird, abnormal or even crazy, until I read "The Highly Sensitive Person" and first began to think that there were others like me out there. I did further research and found that there isn't a huge amount of help available - perhaps because to seek treatment involves social interaction, putting sufferers in a catch 22 situation. Many people with social anxiety disorder chose to self-medicate as alcohol and some drugs lower inhibitions and anxiety and therefore offer temporary relief from symptoms; I can certainly think of several unavoidable social events where I have drunk more than I should to try and relax and be able to talk to people. This is not a constructive way to deal with it of course; research has found that around a fifth of people with this disorder go on to develop alcohol dependence as a result of doing just this.

The first port of call for many sufferers is their GP, although finding one familiar with and sympathetic to this condition might be easier said than done. Personal experience of overcoming my issues to ask for help with my more serious case of depression has put me off this as a route to getting help (I asked four GPs for assistance, incidentally, two dismissed me without offering any help, one sent me away with a patient leaflet that told me less than I already knew, and one put me on medication for less than the minimum recommended period for depression). The medication I was on was an SSRI (selective serotonin reuptake inhibitor - medication intended to increase the level of serotonin in the brain), which is often recommended as a treatment for social anxiety disorder as well. However, as with depression, the pharmacological approach treats the symptoms rather than the cause and I don't consider them to be anything more than a crutch to help you get through whatever treatment you need to get to the root of your problem. If you don't feel up to asking for help yet, there are various ways that you can help yourself, including taking non-prescription medication (I find Kalms to be quite effective) and trying to explain to someone close to you what you are experiencing to try and get their support. There is also a support group listing (sadly none near me, so I cannot comment) and a helpful chatroom at http://www.social-anxiety.org.uk/ that social phobics may find useful. Also remember that complete avoidance only heightens anxiety at future occasions that you can't avoid (like a job interview), so small amounts of regular exposure to social situations is actually beneficial, however daunting it may initially appear.

A few months ago I reached a point where I realised that I would have to find some serious help; I had a forthcoming wedding and all my coping mechanisms and strategies for handling my anxiety were never going to manage me being the centre of attention like that for an entire day. Speaking to my partner resulted in him happily agreeing to a small wedding with only 23 guests, a short ceremony and no public dancing to help me, but the thought of being in the midst of an occasion where I would be watched and judged all day just terrified me. In way it is a good thing, though, as it pushed me to seek the treatment I had needed for years. There are a number of different psychological treatments for social anxiety, such as exposure therapy, cognitive behaviour therapy and social skills training (please see http://www.thehealthcenter.info/ adult-social-anxiety/social-anxiety-treatment-opti ons.htm for further information) but with the NHS offering me so little I ended up having to research private therapies available in my area. I figured that if I could alleviate this disorder the effect on my life would be so potentially beneficial that it would be well worth raiding my savings to fund treatment. My choice in the end was a specialised form of hypnotherapy with a therapist who specialised in treating social phobia. The therapy was not easy, but I feel it is helping me to get better; it is something too personal for me to want to discuss in detail, but if anyone wants to know the name and professional organisation of this particular form of therapy, please message me and I will send you it privately. I hope you will forgive me for not wanting to announce it publically so soon.


**Final Thoughts**
Well done if you have managed to make it this far; I hadn't intended this to be quite so long, but I'm afraid my thoughts just ran away with me. I guess twenty years of experience mean you have to lot to say when you end up writing it all down. I do hope that I have achieved something through writing this - even if it is just for one person to realise what is happening to them and be able to start getting better. Social anxiety disorder is an unpleasant thing to be lumbered with, but it is not untreatable any more, and I hope my choice of therapy continues to help me improve to the point where I can relax enough on my wedding day to have fun. OK, I am never going to love parties, but I feel more able to cope with (dare I say even enjoy?) social situations more now than I have ever done before. It doesn't have to be a life sentence and I would encourage anyone reading this with social anxiety disorder to try and reach out for the help they need, whichever therapy that may be.


**Useful links**
Social Anxiety UK: www.social-anxiety.org.uk/
Social Anxiety Self Test: www.thehealthcenter.info/selftest.php?id=8
Royal College of Psychiatrists Helpsheet: www.rcpsych.ac.uk/mentalhealthinfo/problems/ anxietyphobias/ shynessandsocialphobia.aspx

Summary: A wearying condition, but one that is starting to be taken seriously at last