Are you also afraid of socializing and speaking in front of people? Is that (Social Anxiety Disorder / Social Phobia)? Let's talk about this!

Do you sometimes feel nervous, anxious, or uncomfortable when meeting new people, speaking in front of a crowd, or when someone is looking at you? Do you think, “Will I do something wrong? What will others think of me? Will I be left out?” It can be normal to feel this kind of fear from time to time. But if this fear affects your daily life , if you miss important tasks, it may be more than just embarrassment. We are talking about such a situation today.

What is Social Anxiety Disorder?

Simply put, `Social Anxiety Disorder` (formerly known as `Social Phobia`) is a mental health condition in which you have an intense, persistent fear that others will judge you, make you feel bad about yourself, or look at you . This is not just a minor nervousness, it is something that causes you a lot of stress.

You may experience this fear in different social situations. For example:

• When meeting new people.
• When you have to give a presentation, whether at the office or in class.
• It's okay to make a phone call, it's okay to answer an incoming call.
• Use a public toilet.
• Go to a store or restaurant and ask for help.
• When going on a ``Date`` with someone.
• Answer a question in front of a group.
• Eat in front of others.
• When going for a job interview.

The root of all this is the intense fear that "others will judge me, reject me, and shame me."

Who is most affected by this situation?

Social Anxiety Disorder is a condition that can affect anyone. However, symptoms often begin before the age of 20. The condition is reported slightly more often in women than in men.

How common is this condition?

This is not uncommon. Worldwide, it is estimated that between 5 and 10 out of every 100 people have Social Anxiety Disorder. It is the third most common mental health condition after substance use disorders and depression.

Are there different levels of social anxiety?

Yes, there are different levels of `Social Anxiety Disorder`. While it can affect some people very mildly, it can affect others a little more severely, and it can affect some people very severely.

• Mild Social Anxiety : People with this type of anxiety experience the physical and psychological symptoms mentioned above, but they still participate in social situations and cope with them. Sometimes they may only experience this fear in one type of social situation. For example, they may only be afraid of eating in front of others, but they do other things normally.
• Moderate Social Anxiety: These people also experience symptoms. They participate in some social situations, while avoiding others. For example, they may be able to talk to a small group at the office, but are afraid to speak in a large meeting.
• Extreme Social Anxiety: These people may experience very severe symptoms, sometimes even a panic attack, in social situations. As a result, they avoid social situations as much as possible. These people often feel this fear in almost every social interaction.

Imagine, if you get an invitation to a party, you start to feel anxious days before the party, thinking things like, “What am I going to do, will no one care about me?” This is called `Anticipatory Anxiety` . This is also part of ` Social Anxiety Disorder` .

These levels may change throughout your life. However, no matter what level you have this condition, it is very important to seek medical advice and treatment as it can affect your happiness and success in life.

What's the difference between social anxiety and just shyness?

This is a place where many people get confused. Shyness is something we all feel from time to time. It's normal to feel a little nervous when you go to a new place and in front of strangers.

However, `Social Anxiety Disorder` is something that goes much further than that.

• Interference with daily life: The fear you feel with `Social Anxiety Disorder` continues to interfere with your daily activities. For example, it can affect you to the point where you can't go to the store to buy something, ride the bus, or even just have a conversation with other people.
• Intensity of fear: The fear felt in `Social Anxiety Disorder` is much stronger and more difficult to control than the fear felt in simple shyness.
• Avoidance: This fear causes you to intentionally avoid many social situations.

Simply put, feeling shy from time to time won't have a big impact on your education, career, or personal relationships. But Social Anxiety Disorder can negatively affect all of these.

Many people think this is just their “character,” part of their personality, and so they don’t seek help. But if you continue to have these severe symptoms, it’s important to see a doctor.

What are the reasons for this?

Researchers and doctors are still trying to figure out the exact cause of Social Anxiety Disorder, but they believe that the following factors may play a role:

• Family history (`Genetics`): If someone in your family has had the condition, you are slightly more likely to develop it too. But it is not yet clear exactly how that genetic link works.
• Brain function : This may be related to some changes in the functioning of the parts of our brain that control fear and anxiety.
• Environmental factors and experiences: This can be caused by harsh criticism, bullying, embarrassment, or excessive parental control during childhood. It can also be caused by stressful life events.

What are the symptoms of social anxiety?

A person with `Social Anxiety Disorder` may experience a variety of symptoms, behaviors, and thoughts when faced with doing something in front of others or being in a crowded place.

Physically felt symptoms:

• The face turns red, you sweat profusely, your hands and feet tremble, and your heart rate increases significantly.
• Feeling stomach discomfort and nausea.
• It's hard to look others in the eye when talking to them.
• My body feels stiff and uncomfortable, as if it has been hit by a rock.

Characteristics related to thoughts and behavior:

• They think too much about themselves when they are in front of others (they become very self-conscious).
• I always feel ashamed, embarrassed, and inadequate.
• My mind goes blank and I can't think of what to say.
• Negative thoughts like, “Others will judge me, reject me, think I’m stupid” keep coming.
• I feel afraid and reluctant to go to places where other people, especially strangers, are, and talk to them.
• Avoid crowded places as much as possible.

How to recognize this condition?

This condition can be diagnosed by a doctor, psychologist, psychiatrist, or qualified counselor. They use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Some of those criteria are:

• Persistent, intense fear of social situations due to fear that others will judge you negatively or embarrass you.
• Avoiding fearful social situations, or facing them with intense fear and anxiety.
• The anxiety that arises is much greater than is appropriate for the situation.
• This fear and anxiety interferes with your daily life (study, work, relationships).
• This fear and anxiety is not caused by another physical condition, medication, or drug use.

The doctor will ask you about your symptoms, your medical history, the medications you are taking, and whether you have any other medical conditions. Usually, symptoms that have persisted for at least 6 months are considered to be Social Anxiety Disorder.

Is there a special test to detect this?

There is no special blood test or scan for this. However, doctors and psychologists use special questionnaires to gain a deeper understanding of what you are experiencing. Based on your answers to those questionnaires, they can conclude whether or not you have `Social Anxiety Disorder`.

Is there a treatment for this?

Absolutely yes! `Social Anxiety Disorder` is a very treatable condition. There are two main treatment options:

1. Cognitive Behavioral Therapy (`Cognitive Behavioral Therapy – CBT`)

2. Medication – especially antidepressants and sometimes beta-blockers.

What is `(Cognitive Behavioral Therapy – CBT)`?

CBT is a psychological treatment method in which a trained psychologist or counselor works with you to help you change your unhealthy, unhelpful thinking patterns and behaviors .

This is not something that happens overnight. You will have to attend several sessions over a period of weeks, perhaps months. Your counselor will talk to you, ask you questions, and help you look at your problems in a different way. Through this, you will learn to better cope with and manage stress, anxiety, and difficult social situations.

What are the medications for social anxiety?

Doctors prescribe various medications for `Social Anxiety Disorder`.

• SSRIs (`Selective Serotonin Reuptake Inhibitors`): These are a type of `Antidepressant`. These are often the first medications prescribed for `Social Anxiety Disorder`. Examples: `fluoxetine (Prozac®)`, `sertraline (Zoloft®)`, `paroxetine`, `citalopram`, `escitalopram`.
• SNRIs (`Serotonin-Norepinephrine Reuptake Inhibitors`): This is also a type of `Antidepressant`. Examples: `venlafaxine`, `duloxetine (Cymbalta®)`.
• Benzodiazepines: These are medications that reduce anxiety. However, they are only given for a short period of time. They are given until the antidepressants start working, or to control anxiety in an emergency. They are not good for long-term use, as they can be addictive. Examples: lorazepam, alprazolam .
• Beta-blockers : These medications are usually prescribed for high blood pressure. However, they can also help control the physical symptoms of social anxiety, such as rapid heartbeat and trembling hands. Examples: propranolol, metoprolol.

It may take some time to find the right medication and dosage for you. But the most important thing is to start treatment. Remember that you will get better little by little.

Are there any side effects of the medication?

Yes, like any medication, these medications can cause some side effects. It depends on the medication you take and how your body responds to it. It is very important to talk to your doctor about it before starting any medication.

How long does it take for the medicine to work?

• Antidepressants (SSRIs and SNRIs) can take several weeks (perhaps 4-6) to work. So, don't expect a big change right away when you start taking the medication. It's important to be patient and continue taking the medication as prescribed by your doctor.
• Anti-anxiety medications like `Benzodiazepines` work quickly. But, as mentioned earlier, they are not used long-term.
• Beta-blockers also have a rapid effect on physical symptoms.

What are the risk factors that contribute to this condition?

As mentioned before, the exact causes are still being investigated. However, the following have been found to increase the risk of developing Social Anxiety Disorder:

• Genetic: If someone in the family has this condition.
• Parental behavior: If the parents were overly controlling or invasive parenting during childhood.
• Stressful and frightening events in life.

What is the outlook for this situation? `(Prognosis)`

People with Social Anxiety Disorder respond very well to treatment. This means that they can make a significant difference with either CBT, medication, or both. Some people may need to take medication at a low dose for the rest of their lives. Others may only need medication or counseling for a short period of time.

The most important thing is that it can be harmful if left untreated. If left untreated, this condition can have a major impact on your education, work, personal relationships, and happiness in life. Sometimes it can even lead to major depression or alcohol use disorders. Therefore, if you think you have symptoms, be sure to seek medical advice.

How long will I have this condition?

If left untreated, a person can have Social Anxiety Disorder for the rest of their life. However, those who receive proper treatment can greatly reduce and control their symptoms. They learn to live with their fear and face society without succumbing to it.

Is it possible to overcome social anxiety?

It is very difficult to completely recover from `Social Anxiety Disorder` without treatment. Because, it is a medical condition. Like any other illness, it also needs treatment. As mentioned earlier, `CBT` and medication have been proven to be very effective in managing this condition.

If I have social anxiety, what should I do?

If you think you have symptoms of `Social Anxiety Disorder`, the first and most important thing to do is to tell a doctor. It can be a little uncomfortable and scary, but it is essential.

If a doctor has already diagnosed you with this condition, you can do these things to manage your symptoms and stay well:

• Sleep well and exercise daily.
• Avoid using alcohol and other drugs. While these may seem like temporary relief, they can make the problem worse in the long run.
• If you have been prescribed medication, take it on time and in the prescribed dosage. Don't skip doses.
• If you are going to a counseling session like `CBT`, attend those sessions as directed.
• Ask for support from your family and friends who understand you. Talk to them about your feelings.
• Look for support groups where you can meet and talk to other people with Social Anxiety Disorder and share experiences.
• See your doctor regularly.

When should I see the doctor?

If you think you have symptoms of `Social Anxiety Disorder`, see a doctor as soon as possible to talk about it. Starting treatment is the best way for you to get better and live your life to the fullest.

If you have been diagnosed with this condition and are receiving treatment, see your doctor regularly. If you feel your symptoms are getting worse, or if the treatment you are taking is not working, tell your doctor right away. Never stop taking your medication or change the dosage on your own without talking to your doctor.

What should I ask the doctor?

Talking to a doctor about your mental health and asking for help can be a bit difficult and uncomfortable. But remember, your mental health is just as important as your physical health. So, don't be afraid to talk to your doctor about your symptoms. It can be helpful to ask yourself questions like:

• Should I see a therapist, psychologist, or psychiatrist?
• If there are such people, can you recommend some good, experienced ones?
• Are there any medications I can take for `Social Anxiety Disorder`?
• Do you know of support groups for people with this condition?
• Are there any books I can read to learn more about this?
• After recognizing that I have this condition, what should I do next?

What is the difference between social anxiety disorder and agoraphobia?

Although both of these are anxiety-related mental conditions, there is a difference between the two.

• `Social Anxiety Disorder` is, as mentioned earlier, an intense fear of being judged, stared at, and embarrassed in social situations.
• A person with `agoraphobia` feels extreme anxiety, helplessness, and fear in certain places (e.g., crowded places, queues, buses, movie theaters) or in certain situations (e.g., leaving the house alone). They are mainly afraid that if something goes wrong in such a place (e.g., having a `panic attack`) , it will be difficult to escape and that help will not be available . `agoraphobia` is an anxiety disorder that usually develops after one or more `panic attacks`.

What is the difference between social anxiety and social phobia?

There is actually not much difference between the two. The old name for `Social Anxiety Disorder` is `Social Phobia`. Before 1994, if someone was diagnosed with `Social Phobia`, it mainly meant the fear and anxiety they felt when performing in front of others (e.g., giving a speech, singing a song). However, in 1994, the `Diagnostic and Statistical Manual of Mental Disorders (DSM)` changed the name to `Social Anxiety Disorder` and expanded the criteria for diagnosing the condition. It included, in addition to the fear of performing in front of others, the fear of being judged and stared at .

How do you help someone with social anxiety?

If you think a friend or family member has Social Anxiety Disorder, or if they have told you, there are several ways you can help them:

• Learn about Social Anxiety Disorder: Read up on the condition to understand exactly what he or she is going through. Don't assume you know everything.
• Treat them with compassion and understanding: Don't belittle their feelings and experiences. Don't say things like, "What's that, it's just a fear in my heart." Let them know that you are there to listen to them and support them. If possible, try to put yourself in their shoes.
• Encourage professional help and treatment: Your understanding and support are invaluable. However, Social Anxiety Disorder is a medical condition. Therefore, these people may need either CBT, medication, or both to manage the condition. If they have symptoms, gently encourage them to talk to a doctor.
• Be patient: It can take a while for someone to get better after starting treatment. This is not an overnight cure. Understand that this is a long, complex process, and that their symptoms and behaviors will improve gradually and gradually.

The take-home message from this article

So, `Social Anxiety Disorder` is a mental health condition that affects many people around the world, but is often misunderstood. If you have the symptoms mentioned in this article, or if someone you know has this problem, remember that you are not alone. Experiencing social anxiety can be a truly frightening and life-threatening experience.

But the good news is that there are very effective treatments for this. Your mental health is just as important as your physical health. So, don't be afraid or embarrassed to talk to a doctor about what you're going through. The sooner you start getting help and treatment, the sooner you'll feel better and be able to enjoy your life again.