Alternative names

Phobia-social

Definition

Social phobia is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, including parties and other social events.

Causes, incidence, and risk factors

Social phobias are characterized by fear and avoidance of situations in which a person may be subject to the scrutiny of others. It may begin in adolescence and may be associated with overprotective parents or limited social opportunity. Males and females are affected equally with this disorder.

Shyness is different from social phobia. Shy people are able to participate in social functions, but people with social phobia are constrained by their condition to the point that it affects their ability to function in work and relationships.

People with social phobia are at high risk for alcohol or other drug dependence because they may come to rely on drink or drugs to relax in social situations.

Symptoms

Some of the most common fears of people with social phobia include:

• Speaking in public
• Meeting new people
• Eating, drinking, and writing in public
• Using public restrooms
• Attending parties and other social occasions

Signs and tests

• Rapid heart rate
• Elevated blood pressure
• History of phobia
• Description of behavior from family, friends, and affected person

Treatment

The goal of treatment is to help the person function effectively. The success of the treatment usually depends on the severity of the phobia.

Systematic desensitization is a technique used to treat phobias. The person is asked to relax, then imagine the components of the phobia, working from the least fearful to the most fearful. Graded real-life exposure has also been used with success to help people overcome their fears.

Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help the person gain comfort in relating to others in a social situation.

Anti-anxiety and anti-depressive medications are sometimes used to help relieve the symptoms associated with phobias.

Expectations (prognosis)

The outcome is generally good with treatment, and antidepressant medications have been shown to be very effective.

Complications

• Alcohol use to combat anxiety
• Alcohol or other drug dependence
• Loneliness and social isolation

Calling your health care provider

Call your health care provider or mental health professional if fear is affecting your work and relationships with others.

Prevention

Taking measures to improve your self esteem can be helpful. Social skills training may be helpful.

Reviewed: 01/2006