18 years of age or over, according to the National Institute of Mental Health (2009), so the good news is you're not alone. Kind of ironic, huh? Social Anxiety Disorder is a cohort of our old friend Panic Disorder, in that an individual experiencing SAD often has panic symptoms such as heart palpitations, sweating, shaking, confusion, upset stomach--you know the drill--when faced with a feared social situation, or even the anticipation of that situation.
Most people with Social Anxiety Disorder quickly figure out that they can eliminate their symptoms by simply avoiding the social situations they fear. Unfortunately, that avoidance comes with a really high price tag--loneliness, isolation, being "passed over" for things like job promotions, being "under-estimated" in skills or intelligence, or being "left out" of things like parties, romance, and fun. Wow.
hypersensitive to criticism and rejection, and possibly leaning toward low self-esteem. They may fear rejection by others so much that they go out of their way to gain the approval of others, even at their own expense. Or they may avoid closeness to others altogether rather than take the chance of rejection at all. Folks suffering SAD may be fine in one-on-one situations but not okay in groups, or do well after getting to know someone but are hopeless at knowing what to do to make friends in the first place.
People with SAD feel like they are constantly being scrutinized by others, as though they are living out their lives under a microscope. Performing, whether by actually getting up in public to speak (considered by most people to be more scary than death, by the way) or by having to eat in front of a new friend or business associate, or walk up to a podium to receive an award or collect a prize, can create such anxiety in folks with social phobia that they often find themselves avoiding some of the most rewarding aspects of life.
but most usually has its onset in mid-adolescence, and may even begin abruptly after experiencing a stressful or humiliating experience. Although severity may lessen or remit during adulthood, social phobia has a way of rearing its ugly head in certain situations throughout life. It is important to note that shyness and social phobia are not the same thing. A shy person may feel uncomfortable in social interactions, but does not experience extreme anxiety anticipating social situations or feel the need to avoid them. In contrast, a person with SAD may not be shy at all, but still become overwhelmed by anxiety in particular social situations.
in order to be considered a "disorder." Diagnostic criteria for Social Phobia, as determined by the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) are as follows:
In my practice, my clients with Social Anxiety Disorder tend to have thoughts and beliefs about social interaction based on faulty information or learning that trigger their anxiety symptoms. The good news is that with a little work, these thoughts and beliefs can be changed and with them the negative emotions they experience are equally transformed. Voila! Problem solved! Really!
Cognitive Behavioral Therapy with graded exposure is considered the most helpful treatment, and my SAD clients particularly benefit from a Soul-Focused Therapy approach. Occasionally, certain medications may be helpful to get "over the hump" of the worst symptoms, but are best used in conjunction with good therapy with an anxiety treatment specialist for the most effective and long-lasting results.