Social phobia

Synonyms

• fear
• phobia

English: fear

definition

A social phobia is the permanent fear of meeting and confrontation with other people and, above all, the fear of negative evaluation by others.
With social phobia, like any other phobia, the sick person feels a logically incomprehensible (irrational) fear. This fear In social phobia, as the name suggests, it relates to social situations.

Epidemiology

As with other phobias, women are affected significantly more often than men by the social phobia. Often the first symptoms appear in childhood.

The problem is that a large number of patients only go to the doctor when their symptoms have worsened so much that e.g. leads to massive problems in professional life.

The probability of developing symptoms of a social phobia in the course of life is around 15-20%. However, since the severity of the individual symptoms is very different, one speaks of approx. 3-5% of the population who suffer from a social phobia, which should be treated.

Author's note

Many people suffer from more or less pronounced Exam anxiety or afraid to speak in front of a lot of people. This does not mean that we all have a social phobia (including the author). Rather, it must be emphasized at this point that the so-called pressure of suffering and the impairment in life play the decisive roles that turn social anxiety into an illness that requires treatment.

diagnosis

The diagnosis should be made by a psychologist, a psychiatrist or a therapist experienced in the subject.

Symptoms

A person suffering from social phobia is tormented above all by the fear that he might attract attention when dealing with other people. He is afraid of blushing, sweating or otherwise attracting negative attention. Out of this fear he begins to avoid certain situations associated with this fear.

Typical avoidance situations are:

• Establishing contact with other, strangers
• speaking in front of a crowd
• Exam situations
• argue with the supervisor or an authority
• Communicate your own opinion and stand by it
• getting to know a sexual partner etc.

There are big differences in how much the individual is disturbed by the disease. Some patients experience only a few situations as difficult or threatening, but others experience this type of phobia as almost all-encompassing (generalized) and thus avoid a very large number of social situations.

In severe cases, these social situations can lead to states that are very similar to a panic attack (see also panic disorder). Potential problems that arise from such a disruption can be very threatening. It is not uncommon for an additional (secondary) addiction disease to occur, as the long-term anxiety symptoms can often only be endured in this way.

Also read: Attachment disorder

therapy

Most important approach in Therapy for social phobia is the so-called here too Behavior therapy. The therapeutic approach here is a very practical one. The patient is introduced to difficult situations in various exercises. On the one hand, this can happen when a patient and the therapist imagine a “dangerous” situation and thus experience it in their head (Therapy in sensu), or exposes himself to the situation “live and in color”. (Therapy in vivo).

Example: social phobia

A young insurance agent has felt very uncomfortable in his job since he started working. Whenever he has to talk to a customer, he gets palpitations and sweats and has to break off the conversation more and more frequently. He has the feeling that the other person is just waiting for his mistake to be exposed. On the therapeutic side, the situation of a customer conversation is now simulated in the patient's imagination. When the patient has a certain feeling of security, an exercise is done with him in which he makes contact with others. (e.g. asking for directions, etc.) If this hurdle has also been overcome, one can try to bring the patient into a specific conversation with the customer.

The aim of “in vivo” therapy, in particular, is that anxiety will decrease the more frequently the patient is exposed to a situation that makes him fearful.

If necessary, the treatment is supplemented by what is known as "social skills training". Here, the patient learns competently in difficult social situations in role play alone or in a group, i.e. to act confidently (e.g. how do I learn to say "NO", how do I exchange a shirt, how do I start a conversation and keep it up, etc.).

If the social phobia goes hand in hand with pronounced physical symptoms of anxiety, it is also advisable to teach and apply relaxation training.

In severe cases of social phobia, treatment is also available Medication advisable. Similar to other anxiety disorders, a antidepressant for use. Two groups in particular should be mentioned here. 1. The so-called SSRI and 2. The mono-amino-oxidase inhibitor, also called MAO-inhibitor. (see also Therapy for depression).

Even with social phobia, the therapeutic side can be Benzodiazepines be useful.
However, since the risk of dependency is very high here, they should only be used by competent specialists and only for a short time (max. 2-3 weeks) (see also Generalized anxiety disorder therapy).