Social phobia, also known as social anxiety disorder, describes people with marked and persistent anxiety in social situations, including performances and public speaking. The critical element of the fearfulness is the possibility of embarrassment or ridicule. Like specific phobias, the fear is recognized by adults as excessive or unreasonable, but the dreaded social situation is avoided or is tolerated with great discomfort. Many people with social phobia are preoccupied with concerns that other people will see their anxiety symptoms (i.e., trembling, sweating, or blushing); or notice their halting or rapid speech; or judge them to be weak, stupid, or “crazy.” Fears of fainting, losing control of bowel or bladder function, or having one’s mind going blank are also not uncommon. Social phobias generally are associated with significant anticipatory anxiety (i.e., anxiety that comes from thinking about an upcoming event) for days or weeks before the dreaded event, which in turn may further handicap performance and heighten embarrassment.
Social phobia is more common in women and the 1-year prevalence of social phobia ranges from 2 to 7 percent (the lower figure likely refers to those individuals who experience significant impairment and distress from their social phobia). If people with chronic shyness who experienced less than a severe level of distress were added to the percentages, it is likely the percentage would be higher than 7%. Social phobia typically begins in childhood or adolescence and, for many, it is associated with the traits of shyness and social inhibition. An occasion of public humiliation, severe embarrassment, or other stressful experience may provoke an intensification of difficulties. Once the disorder is established, complete remissions are uncommon without treatment. More commonly, the severity of symptoms and impairments tend to fluctuate in relation to work/school demands and the stability of social relationships.
An excerpt from Mental Health: A Report of the Surgeon General, U.S. Department of Health & Human Services.
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