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Health

Dealing with Social Phobia

Did you know that the most commonly reported fear is that of speaking in public or in front of a group? Many people feel that butterflies-in-the-stomach sensation, have sweaty palms and a racing heart, or even feel like they will throw up if they have to speak in front of a group. But most of the time, people manage to do these things when they need to.

A little anxiety before you give the big speech or get on stage for the school play helps to pump you up for a great performance. But occasionally some people can't manage the intense anxiety they feel when facing certain social situations. For them, responding to a question in class, giving a presentation, or even talking at the lunch table may cause a surge of anxiety that's excruciating. This anxiety condition is called social phobia.

What Is Social Phobia?
Social phobia (also sometimes called social anxiety) refers to an intense fear of being in social situations. The fear is so intense that someone with social phobia will avoid these situations whenever possible. And just like with other phobias, this fear is out of proportion to the actual danger that's present. Although many people fear being embarrassed in certain social situations, some find it incredibly difficult to cope with this embarrassment. Someone with social phobia is usually overrating the danger of embarrassment while underrating his or her ability to get through the situation.

Most people feel very self-conscious during their teenage years. All the physical and emotional changes that occur at this time in our lives can lead to shaky self-esteem. And teens who feel a little less confident to begin with will be more sensitive to things that threaten their confidence during this time.

Many teens feel reluctant to be the focus of attention, especially those who are by nature a little more shy than some of their peers. And most find it stressful and anxiety provoking to ask someone on a date, talk in front of a group, or sit at a lunch table with people they don't know well. But most teens find a way to deal with this and can cope with making a few mistakes.

Social phobia is much more than just normal shyness or the awkward feelings most people have from time to time. Social phobia is shyness to the extreme, and this shyness is accompanied by anxiety that causes people to avoid doing things they might like to do or to avoid situations that might result in having to be with or to talk with or in front of others.

When someone is so extremely shy or so fearful about talking to others that he or she just doesn't talk in school, to certain people, or in certain social situations, that's a form of social phobia known as selective mutism. This term simply refers to not talking (being "mute") in certain situations but not in others (selective). People who feel too anxious to talk because of social phobia or extreme shyness do have completely normal conversations with the people they're comfortable with (such as parents or siblings, or a best friend) or in certain places (like home). But other situations cause them such extreme discomfort that they may not be able to bring themselves to talk at all.

What Causes Social Phobia?
Certain teens are a bit more likely to have problems with anxiety. Those whose parents or other close relatives have anxiety problems may be more likely to develop a problem with anxiety, too. This may be due to biological traits that family members have in common. Certain traits may affect the function of brain chemicals (neurotransmitters and certain stress hormones) that regulate mood states like anxiety, shyness, nervousness, and stress reactions.

Some people are born with a cautious personality style and have a tendency to be shy and sensitive to new situations. This may contribute to social phobia. Others may learn a cautious style depending on experiences they have, the way others react to them, or the behaviours they see in their parents and others. Low self-confidence and a lack of coping skills to manage normal stress can also play a role in social phobia. Those who tend to be worriers, perfectionists, and who have a hard time dealing with small mistakes may also be more likely to develop it.

Dealing With Social Phobia
Therapists can help people who have social phobia to develop coping skills to manage their anxiety. This involves understanding and adjusting thoughts and beliefs that help create the anxiety, learning and practising social skills to increase confidence, and then slowly and gradually practising these skills in real situations.

One element of the therapy might include learning relaxation techniques (such as breathing and muscle relaxation exercises). Behavioural rehearsal can be helpful as well, during which the therapist and the teen might role play certain situations, trying out new behaviours ahead of time. This can make it much easier and more automatic to put these behaviours into practice when the teen is faced with real situations.

Someone might also learn to correct self-talk that leads to anxiety by learning self-talk that is more positive and promotes self-confidence and builds coping skills. A teen may be guided by a therapist to tune into current thinking about particular situations and to modify certain thoughts, especially worry thoughts.

Understanding Worry Thoughts and Self-Talk
Worry thoughts have particular qualities. They often are in the form of a question that begins "what if . . ." and tend to be negative rather than positive. Examples of worry thoughts include, "What if there's no one to sit with at lunch?" and "What if I fail the test?" Worry thoughts also tend to get worse and worse, until the person having them expects not just bad things, but the worst possible outcome.

When someone with social phobia thinks about a teacher calling on him or her, chances are that thoughts run through that person's mind like, "What if I say the wrong thing?" or "What if I make a mistake?" or "What if they laugh at me?" There may also be thoughts like: "I can't do it. It's too hard and too scary. I'll mess up. I'll get it wrong." Usually the self-talk makes the anxiety worse and worse, and supports the person's pattern of avoiding the feared situations. The main messages people give themselves during this self-talk are "It's too scary" and "I'm not able to cope."

Therapists can help people identify and examine these thoughts. For example, students who worry about being called on in class might examine how likely it is that they'd actually give the wrong answer: If a student realises he or she usually knows the right answer, then a mistake would be unlikely. Next the therapist can work on coping skills in case a student does make a mistake and how to replace worry thoughts with calm, reassuring ones when faced with stressful social situations. People might imagine what they'd say to a friend who needed reassurance, for example, and learn to think that way themselves.

For some teens, medications can be helpful as part of the treatment for social phobia. Certain medications that help to regulate the function of serotonin (a brain chemical that helps to transmit electrical messages having to do with mood) are sometimes used. Though medication doesn't solve the whole problem, it can reduce anxiety so a teen can put into practice some of the positive techniques described above.

Source: kidshealth.org