Social awkwardness disorder

Social anxiety disorder (social phobia) - Symptoms and causes

Overview

It's normal to feel nervous in some social situations. For example, going on a date or giving a presentation may cause that feeling of butterflies in your stomach. But in social anxiety disorder, also called social phobia, everyday interactions cause significant anxiety, self-consciousness and embarrassment because you fear being scrutinized or judged negatively by others.

In social anxiety disorder, fear and anxiety lead to avoidance that can disrupt your life. Severe stress can affect your relationships, daily routines, work, school or other activities.

Social anxiety disorder can be a chronic mental health condition, but learning coping skills in psychotherapy and taking medications can help you gain confidence and improve your ability to interact with others.

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Symptoms

Feelings of shyness or discomfort in certain situations aren't necessarily signs of social anxiety disorder, particularly in children. Comfort levels in social situations vary, depending on personality traits and life experiences. Some people are naturally reserved and others are more outgoing.

In contrast to everyday nervousness, social anxiety disorder includes fear, anxiety and avoidance that interfere with relationships, daily routines, work, school or other activities. Social anxiety disorder typically begins in the early to mid-teens, though it can sometimes start in younger children or in adults.

Emotional and behavioral symptoms

Signs and symptoms of social anxiety disorder can include constant:

Fear of situations in which you may be judged negatively
Worry about embarrassing or humiliating yourself
Intense fear of interacting or talking with strangers
Fear that others will notice that you look anxious
Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling or having a shaky voice
Avoidance of doing things or speaking to people out of fear of embarrassment
Avoidance of situations where you might be the center of attention
Anxiety in anticipation of a feared activity or event
Intense fear or anxiety during social situations
Analysis of your performance and identification of flaws in your interactions after a social situation
Expectation of the worst possible consequences from a negative experience during a social situation

For children, anxiety about interacting with adults or peers may be shown by crying, having temper tantrums, clinging to parents or refusing to speak in social situations.

Performance type of social anxiety disorder is when you experience intense fear and anxiety during speaking or performing in public but not in other types of more general social situations.

Physical symptoms

Physical signs and symptoms can sometimes accompany social anxiety disorder and may include:

Blushing
Fast heartbeat
Trembling
Sweating
Upset stomach or nausea
Trouble catching your breath
Dizziness or lightheadedness
Feeling that your mind has gone blank
Muscle tension

Avoiding common social situations

Common, everyday experiences may be hard to endure when you have social anxiety disorder, including:

Interacting with unfamiliar people or strangers
Attending parties or social gatherings
Going to work or school
Starting conversations
Making eye contact
Dating
Entering a room in which people are already seated
Returning items to a store
Eating in front of others
Using a public restroom

Social anxiety disorder symptoms can change over time. They may flare up if you're facing a lot of changes, stress or demands in your life. Although avoiding situations that produce anxiety may make you feel better in the short term, your anxiety is likely to continue over the long term if you don't get treatment.

When to see a doctor

See your doctor or a mental health professional if you fear and avoid normal social situations because they cause embarrassment, worry or panic.

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Causes

Like many other mental health conditions, social anxiety disorder likely arises from a complex interaction of biological and environmental factors. Possible causes include:

Inherited traits. Anxiety disorders tend to run in families. However, it isn't entirely clear how much of this may be due to genetics and how much is due to learned behavior.
Brain structure. A structure in the brain called the amygdala (uh-MIG-duh-luh) may play a role in controlling the fear response. People who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations.
Environment. Social anxiety disorder may be a learned behavior — some people may develop significant anxiety after an unpleasant or embarrassing social situation. Also, there may be an association between social anxiety disorder and parents who either model anxious behavior in social situations or are more controlling or overprotective of their children.

Risk factors

Several factors can increase the risk of developing social anxiety disorder, including:

Family history. You're more likely to develop social anxiety disorder if your biological parents or siblings have the condition.
Negative experiences. Children who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to social anxiety disorder. In addition, other negative events in life, such as family conflict, trauma or abuse, may be associated with this disorder.
Temperament. Children who are shy, timid, withdrawn or restrained when facing new situations or people may be at greater risk.
New social or work demands. Social anxiety disorder symptoms typically start in the teenage years, but meeting new people, giving a speech in public or making an important work presentation may trigger symptoms for the first time.
Having an appearance or condition that draws attention. For example, facial disfigurement, stuttering or tremors due to Parkinson's disease can increase feelings of self-consciousness and may trigger social anxiety disorder in some people.

Complications

Left untreated, social anxiety disorder can control your life. Anxieties can interfere with work, school, relationships or enjoyment of life. This disorder can cause:

Low self-esteem
Trouble being assertive
Negative self-talk
Hypersensitivity to criticism
Poor social skills
Isolation and difficult social relationships
Low academic and employment achievement
Substance abuse, such as drinking too much alcohol
Suicide or suicide attempts

Other anxiety disorders and certain other mental health disorders, particularly major depressive disorder and substance abuse problems, often occur with social anxiety disorder.

Prevention

There's no way to predict what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you're anxious:

Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
Keep a journal. Keeping track of your personal life can help you and your mental health professional identify what's causing you stress and what seems to help you feel better.
Set priorities in your life. You can reduce anxiety by carefully managing your time and energy. Make sure that you spend time doing things you enjoy.
Avoid unhealthy substance use. Alcohol and drug use and even caffeine or nicotine use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your health care provider or find a treatment program or support group to help you.

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Social anxiety disorder (social phobia) - Diagnosis and treatment

Diagnosis

Your health care provider will want to determine whether other conditions may be causing your anxiety or if you have social anxiety disorder along with another physical or mental health disorder.

Your health care provider may determine a diagnosis based on:

Physical exam to help assess whether any medical condition or medication may trigger symptoms of anxiety
Discussion of your symptoms, how often they occur and in what situations
Review of a list of situations to see if they make you anxious
Self-report questionnaires about symptoms of social anxiety
Criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

DSM-5 criteria for social anxiety disorder include:

Persistent, intense fear or anxiety about specific social situations because you believe you may be judged negatively, embarrassed or humiliated
Avoidance of anxiety-producing social situations or enduring them with intense fear or anxiety
Excessive anxiety that's out of proportion to the situation
Anxiety or distress that interferes with your daily living
Fear or anxiety that is not better explained by a medical condition, medication or substance abuse

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Treatment

Treatment depends on how much social anxiety disorder affects your ability to function in daily life. The most common treatment for social anxiety disorder includes psychotherapy (also called psychological counseling or talk therapy) or medications or both.

Psychotherapy

Psychotherapy improves symptoms in most people with social anxiety disorder. In therapy, you learn how to recognize and change negative thoughts about yourself and develop skills to help you gain confidence in social situations.

Cognitive behavioral therapy (CBT) is the most effective type of psychotherapy for anxiety, and it can be equally effective when conducted individually or in groups.

In exposure-based CBT, you gradually work up to facing the situations you fear most. This can improve your coping skills and help you develop the confidence to deal with anxiety-inducing situations. You may also participate in skills training or role-playing to practice your social skills and gain comfort and confidence relating to others. Practicing exposures to social situations is particularly helpful to challenge your worries.

First choices in medications

Though several types of medications are available, selective serotonin reuptake inhibitors (SSRIs) are often the first type of drug tried for persistent symptoms of social anxiety. Your health care provider may prescribe paroxetine (Paxil) or sertraline (Zoloft).

The serotonin and norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor XR) also may be an option for social anxiety disorder.

To reduce the risk of side effects, your health care provider may start you at a low dose of medication and gradually increase your prescription to a full dose. It may take several weeks to several months of treatment for your symptoms to noticeably improve.

Other medications

Your health care provider may also prescribe other medications for symptoms of social anxiety, such as:

Other antidepressants. You may have to try several different antidepressants to find the one that's most effective for you with the fewest side effects.
Anti-anxiety medications. Benzodiazepines (ben-zoe-die-AZ-uh-peens) may reduce your level of anxiety. Although they often work quickly, they can be habit-forming and sedating, so they're typically prescribed for only short-term use.
Beta blockers. These medications work by blocking the stimulating effect of epinephrine (adrenaline). They may reduce heart rate, blood pressure, pounding of the heart, and shaking voice and limbs. Because of that, they may work best when used infrequently to control symptoms for a particular situation, such as giving a speech. They're not recommended for general treatment of social anxiety disorder.

Stick with it

Don't give up if treatment doesn't work quickly. You can continue to make strides in psychotherapy over several weeks or months. Learning new skills to help manage your anxiety takes time. And finding the right medication for your situation can take some trial and error.

For some people, the symptoms of social anxiety disorder may fade over time, and medication can be discontinued. Others may need to take medication for years to prevent a relapse.

To make the most of treatment, keep your medical or therapy appointments, challenge yourself by setting goals to approach social situations that cause you anxiety, take medications as directed, and talk to your health care provider about any changes in your condition.

Alternative medicine

Several herbal remedies have been studied as treatments for anxiety, but results are mixed. Before taking any herbal remedies or supplements, talk with your health care team to make sure they're safe and won't interact with any medications you take.

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Lifestyle and home remedies

Although social anxiety disorder generally requires help from a medical expert or qualified psychotherapist, you can try some of these techniques to handle situations that are likely to trigger symptoms:

Learn stress-reduction skills.
Get physical exercise or be physically active on a regular basis.
Get enough sleep.
Eat a healthy, well-balanced diet.
Avoid alcohol.
Limit or avoid caffeine.
Participate in social situations by reaching out to people with whom you feel comfortable.

Practice in small steps

First, consider your fears to identify what situations cause the most anxiety. Then gradually practice these activities until they cause you less anxiety. Begin with small steps by setting daily or weekly goals in situations that aren't overwhelming. The more you practice, the less anxious you'll feel.

Consider practicing these situations:

Eat with a close relative, friend or acquaintance in a public setting.
Purposefully make eye contact and return greetings from others, or be the first to say hello.
Give someone a compliment.
Ask a retail clerk to help you find an item.
Get directions from a stranger.
Show an interest in others — ask about their homes, children, grandchildren, hobbies or travels, for instance.
Call a friend to make plans.

Prepare for social situations

At first, being social when you're feeling anxious is challenging. As difficult or painful as it may seem initially, don't avoid situations that trigger your symptoms. By regularly facing these kinds of situations, you'll continue to build and reinforce your coping skills.

These strategies can help you begin to face situations that make you nervous:

Prepare for conversation, for example, by reading about current events to identify interesting stories you can talk about.
Focus on personal qualities you like about yourself.
Practice relaxation exercises.
Learn stress management techniques.
Set realistic social goals.
Pay attention to how often the embarrassing situations you're afraid of actually take place. You may notice that the scenarios you fear usually don't come to pass.
When embarrassing situations do happen, remind yourself that your feelings will pass and you can handle them until they do. Most people around you either don't notice or don't care as much as you think, or they're more forgiving than you assume.

Avoid using alcohol to calm your nerves. It may seem like it helps temporarily, but in the long term it can make you feel even more anxious.

Coping and support

These coping methods may help ease your anxiety:

Routinely reach out to friends and family members.
Join a local or reputable internet-based support group.
Join a group that offers opportunities to improve communication and public speaking skills, such as Toastmasters International.
Do pleasurable or relaxing activities, such as hobbies, when you feel anxious.

Over time, these coping methods can help control your symptoms and prevent a relapse. Remind yourself that you can get through anxious moments, that your anxiety is short-lived and that the negative consequences you worry about so much rarely come to pass.

Preparing for your appointment

You may see your primary care provider, or your provider may refer you to a mental health professional. Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

Situations you've been avoiding, especially those that are important to your functioning
Any symptoms you've been experiencing, and for how long, including any symptoms that may seem unrelated to the reason for your appointment
Key personal information, especially any significant events or changes in your life shortly before your symptoms appeared
Medical information, including other physical or mental health conditions with which you've been diagnosed
Any medications, vitamins, herbs or other supplements you're taking, including dosages
Questions to ask your health care provider or a mental health professional

You may want to ask a trusted family member or friend to go with you to your appointment, if possible, to help you remember key information.

Some questions to ask your health care provider may include:

What do you believe is causing my symptoms?
Are there any other possible causes?
How will you determine my diagnosis?
Should I see a mental health specialist?
Is my condition likely temporary or chronic?
Are effective treatments available for this condition?
With treatment, could I eventually be comfortable in the situations that make me so anxious now?
Am I at increased risk of other mental health problems?
Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your health care provider

Your health care provider or a mental health professional will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your health care provider may ask:

Does fear of embarrassment cause you to avoid doing certain activities or speaking to people?
Do you avoid activities in which you're the center of attention?
Would you say that being embarrassed or looking stupid is among your worst fears?
When did you first notice these symptoms?
When are your symptoms most likely to occur?
Does anything seem to make your symptoms better or worse?
How are your symptoms affecting your life, including work and personal relationships?
Do you ever have symptoms when you're not being observed by others?
Have any of your close relatives had similar symptoms?
Have you been diagnosed with any medical conditions?
Have you been treated for mental health symptoms or mental illness in the past? If yes, what type of therapy was most beneficial?
Have you ever thought about harming yourself or others?
Do you drink alcohol or use recreational drugs? If so, how often?

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Social phobia

Social phobia is understood as a widespread disease that, along with agoraphobia, is included in the group of anxiety-phobic disorders and is a persistent unmotivated fear of performing any public actions (for example, public speaking), actions accompanied by attention from the outside strangers (fear of using catering places, public toilets, inability to do anything while being watched from the side, etc. ), or even just communicating with strangers and people of the opposite sex. In the general case, social phobia is expressed in the fear of being in the center of attention, which manifests itself in painful fears of a negative assessment of others and in the avoidance of such situations.

In its manifestations, social phobia resembles panic disorder, differing mainly in the presence of a clear and stable, as a rule, the only, situational cause or social situation that causes this condition and triggers a cascade of psychovegetative reactions, which at the height of their manifestation can be indistinguishable from panic attacks (flushing of the face, palpitations, sweating, hand trembling, respiratory failure, etc.).

In the absence of timely diagnosis and adequate therapy, social phobia leads to a decrease in working capacity. Starting in early adolescence and being unrecognized, this disease can continue throughout the life of the patient.

The prevalence of social phobia among the population varies from 3 to 13%. However, patients suffering from social phobia come to the attention of psychiatrists relatively rarely. Only 5% of patients with uncomplicated social phobias receive specialized care. Most often, those suffering from this disorder, when contacting a doctor, focus on concomitant, mainly associated with a mood disorder (affective), symptom complexes. Among patients not covered by therapeutic measures, persons with subthreshold (almost imperceptible to others) social phobias that do not significantly affect daily activity predominate.

Social phobia usually manifests itself in adolescence and early adulthood. Often the appearance of a phobia coincides with adverse psychogenic or social influences. At the same time, only special situations (an answer at the blackboard, passing exams, public speaking, appearing on stage) or contact with a certain group of people (teachers, educators, examiners, representatives of law enforcement agencies, persons occupying higher social status, or belonging to the opposite sex). Communication with relatives and close acquaintances does not cause fear.

Anxiety of anticipation of unfavorable situations from the point of view of the patient and avoidance behavior are also indispensable attributes of social phobia and most often arise in connection with the possibility of falling under the supervision of strangers. Many signs of social phobia, such as fear of public speaking, are also found in healthy individuals, so the diagnosis of social phobia is made only if the anxiety causes significant discomfort, and phobic experiences are assessed as excessive and unreasonable.

Social phobia may occur intermittently or tend to develop chronically. Patients suffering from this disease, more often than healthy ones, live alone, have a lower level of education. Being observed most often in single women with low socioeconomic status, sociophobia is often combined with depression, as well as with other anxiety-phobic disorders (simple phobias, agoraphobia, panic disorder), affective pathology, alcoholism, drug addiction, eating disorders. Combinations of any other mental disorder and social phobia worsen the prognosis of the disease and increase the risk of suicidal attempts.

Social phobia can be either an isolated or a generalized disorder. The first of these include monophobia, accompanied by relative restrictions in the field of professional or social activity (fear of public speaking, communication with superiors, performing work operations in the presence of others, eating in public places). In essence, isolated social phobias are the fear of not performing habitual actions in front of people, associated with anxious expectations of failure (expectation neurosis), and as a result, avoidance of specific life situations. At the same time, there are no difficulties in communication outside of such key situations. Ereytophobia also belongs to this group of phobias - the fear of blushing, showing awkwardness or confusion in society, in the company of people of the opposite sex. Accordingly, shyness, embarrassment appear in people, accompanied by internal stiffness, muscle tension, trembling, palpitations and other unpleasant sensations.

The development of severe mental health disorders, the development of inadequate coping strategies, and the occurrence of morbid conditions associated with social phobia can be prevented or reduced with early effective treatment. As a rule, the decision to prescribe a special course of therapy for social phobia is made in cases where the symptoms of the disease or avoidance behavior are associated with significant psychosocial impairment. Treatment is offered to every patient whose avoidance behavior interferes with work or social life, who has severe anxiety concerns, or who has a severely impaired ability to form social bonds.

Many patients suffering from social phobia have never heard of such a disease. They may consider their symptoms to be extreme timidity or special character traits, so they should be reassured that long-term treatment can help them.

There are a number of complementary approaches to convince the patient of the need for treatment:

• explain to the patient that his symptoms should be interpreted as a social phobia;

• emphasize that social phobia is a well-understood disease and that it responds well to treatment;

• explain that phobic avoidance of painful situations is caused by unmotivated anxiety, and drugs can reduce it;

• explain that the drug treatment is not addictive, will not be habit-forming, and will not cause withdrawal symptoms when stopped.

In addition, the following can significantly help the patient in complying with medical recommendations: a description of the treatment regimen; establishing a realistic time frame for a possible improvement in his condition; a promise to regularly review the treatment regimen in order to optimize it.

Traditionally, social phobia was considered as a condition more suitable for psychotherapeutic correction. However, its selection as an independent diagnostic category contributed to the development of pharmacotherapeutic methods of treatment.

Medicines that have a healing effect in case of social phobia include drugs that neutralize the effect of the monoamine oxidase enzyme in the central nervous system, of which the so-called. reversible monoamine oxidase inhibitors (RIMAOs). Other drugs used in the treatment of social phobia include benzodiazepines, beta-blockers, and selective serotonin reuptake inhibitors (SSRIs).

Pharmacotherapy should begin with one of the most effective and safest drugs available. For example, representatives of the OIMAO group (pyrazidol, moclobemide, etc.), demonstrating high efficiency (65 - 80%) and the absence of significant side effects even with prolonged (up to 6 months) use. In addition, the use of these drugs leads to a significant decrease in the number and frequency of pathological episodes, as well as the severity of expectation anxiety.

After an initial treatment period (1 to 2 months), physicians evaluate the clinical effectiveness of therapy. If the patient's symptoms persist to a significant extent, the doctor may increase the dose to the maximum effective one or prescribe a drug from a different group.

Less effective drugs, however, for the treatment of social phobia are benzodiazepines. Among them, clonazepam should be noted, which also has an effect that activates the production of serotonin. Sufficiently high efficiency in social phobia shows alprazolam (Xanax), actively suppressing anxiety and improving the mood of patients. According to some reports, a positive reaction to the treatment of social phobia with benzodiazepines is observed in 70 - 75% of people receiving these drugs. However, their treatment of social phobia has some drawbacks, not the least of which is the danger of developing physical dependence in patients receiving this therapy for a long time.

A number of other drugs can be used for social phobia. The most promising of these are buspirone (a non-benzodiazepine anxiolytic), as well as fluoxetine (Prozac) and fluvoxamine (selective serotonin reuptake inhibitors).

There is very little evidence that beta-blockers have any beneficial effect on the underlying disease in social phobia. However, they can be taken intermittently to relieve the tremors, palpitations, and tachycardia that people with social phobia often experience in certain situations that force them to be active. For this reason, many patients with social phobia take drugs such as propranolol and other drugs of this type when necessary.

In general, it should be noted that one of the main conditions for the treatment of social phobia is an extremely slow pace of increasing doses of drugs.

It should also be borne in mind that, despite the rapid decrease in the severity of anxiety and somatic manifestations of the disease during treatment, as well as the decrease in patients' sensitivity to public situations, the stereotype of avoidance behavior usually persists for many months, which requires mandatory additional psychotherapeutic work. .

The goal of psychological care is to help patients cope with negative attitudes, such as the belief that failure or failure is inevitable in social situations, attitudes that are thought to underlie social phobia. Since one of the main goals of psychotherapy is to help patients cope with their anxiety, group forms of treatment are especially useful for social phobia.

Social phobia - what is it, symptoms, causes and treatment

Social phobia, or social phobia, is a disorder that is expressed in the fear of interacting with people. Almost any action in which there is a risk of communication can become a trigger for experiences: talking on the phone, speaking in public, taking an exam, going to the store. Who are social phobes, what are the signs and causes of social anxiety disorder and how to get rid of it, we tell in the Forbes Life material.

From Hippocrates to the Zoom conference

Sociophobia, or social anxiety disorder, was indirectly described by Hippocrates at the beginning of the 5th century BC. The ancient Greek philosopher was the first to figuratively formulate the feelings inherent in a person with a social phobia: fear of being seen, fear that interaction with people will necessarily lead to a negative result - ridicule, insults, or even violence. Hippocrates called such emotions “shyness” - only later, at the turn of the 19th and 20th centuries, did Western researchers in the field of psychiatry suggest that such feelings that grip people are actually more like a mental disorder and can be much more dangerous than simple embarrassment.

The terms "social phobia" and "social neurosis" were first mentioned by experts at the beginning of the 20th century - they were attributed to people with "extreme shyness". Nevertheless, a full understanding of what exactly social phobia consists of and how it manifests itself became possible only in the second half of the last century - after the systematic desensitization method developed by psychologist Joseph Wolpe became widespread in psychiatry. This approach, the purpose of which is to reduce the emotional sensitivity of a person in situations that cause fear, formed the basis of cognitive-behavioral therapy, and mainly allowed a deeper look at what a particular phobia is and in what ways a person is able to overcome her.

Types and symptoms of social phobia

Social phobia is a fear of social interactions and, unlike the shyness with which it was previously compared, has the potential to affect many areas of life, from school and work to personal relationships and daily tasks . Social phobes, as a rule, experience stress not only before any communication, but also during it and even after it - and this is one of the main differences between such a phobia and the usual, even highly developed, shyness. Almost any activity that involves the risk of communicating with someone can become a trigger for feelings: talking on the phone, performing on stage, taking an exam, shopping in a store or meeting friends in a public place will be a serious stress and test for a person with social phobia.

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Social phobia, according to various estimates, is "the third most popular mental disorder" in the world: according to researchers, 7% of US residents have experienced it, another 13% of Americans are at risk of developing it. In Europe, these figures are slightly lower (6.7% on average), while the lowest rates are recorded in China and Japan. In Russia, they can presumably be even higher than in North America, at least according to foreign researchers. Interestingly, over the years, celebrities have also encountered social phobia, whose life without communication with the public is impossible. Among them are singers Barbra Streisand and Taylor Swift, TV presenter Oprah Winfrey, model Kourtney Kardashian, actresses Whoopi Goldberg and Kristen Bell.

Clinical psychologist Galina Laisheva identifies two main types of social phobia. Their basis is the type of fear experienced by the person himself. “Social phobia is always a destructive and intense fear that can be associated with a specific situation or be diffuse. In the first case, we are talking about the fear of doing something in public: eating, talking, performing. In the second - about any situations where there is social interaction in general. A person can easily do something when there is no one around or if close people are nearby, but cannot if strangers are nearby, ”explains the specialist. The American Psychiatric Association adheres to a similar division, distinguishing generalized and non-generalized “social anxiety” according to the same principle. According to Laisheva, sociophobes can be afraid of judgment, aggression, or negative reactions from others, while they themselves remain absorbed in thoughts about how they behave awkwardly, and fear that any of their social actions will lead to a terrible, humiliating result.

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In terms of age, adolescents and young adults are most susceptible to social phobia. “There is a hypothesis that at this very moment in social groups there is a kind of struggle for power, which may include open aggression and even bullying. Sociophobia in this case will be a person’s reaction to such violence, even if he simply acts as an observer, ”explains Laisheva. The causes of social phobia can be other factors, such as genetic (according to the expert, there is a 30% chance that a parent's social phobia can be passed on to a child) or even congenital. In the latter case, we are talking about a tendency to anxiety or increased emotional sensitivity, in which social contacts will be perceived more acutely.

Psychologists identify several signs that can clearly indicate that a person has a social phobia:

• anxiety that occurs against the background of everyday tasks - communicating with strangers, talking on the phone, etc.;

• an attempt to avoid social interaction - refusal of meetings, friendly conversations, personal contacts;

• fear of doing something in front of strangers: it seems to the person that he is being watched with condemnation;

• fear of being criticized, desire to avoid eye contact.

These signs are often accompanied by physical symptoms: palpitations, sweating, skin redness, hand tremors, high blood pressure. Despite the fact that all this can bring serious discomfort to a life where social contact is inevitable, social phobes rarely turn to specialists for help. This leads to the fact that such a disorder in a person can develop over the years. “In this scenario, people either try to avoid social interactions altogether, or tolerate them and perform them with great difficulty, feeling uncomfortable. Both of these patterns of behavior are bad, because avoidance can negatively affect many areas of life and deprive a person of communication and personal life, ”says Laisheva. In her opinion, avoidance itself does not help people get rid of constant anxiety: a person continues to be afraid and tries to choose only ways of communication and communication that are convenient for him. Anxiety remains in any case and leads to cognitive impairment: it will be more difficult for people with it to concentrate, remember something and be productive.

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Methods of combating social phobia: from therapy to drugs

“Social phobia can be treated, which can include both psychotherapy and medication,” Laisheva notes. Each of these forms of therapy for social phobia addresses both the autonomic symptoms and the disorder itself. “Antidepressants and tranquilizers help reduce anxiety and stress, correct autonomic symptoms - redness, sweating, rapid heart rate and more. On the psychological side, people suffering from social phobia are well helped by cognitive-behavioral therapy, ”says the psychologist. According to Laisheva, at the level of behavior, psychotherapy allows you to master and train the skills of confident and safe behavior with other people, as well as generally work out behavior in specific, especially stressful situations that a psychologist can model together with a client.

However, it may not always be possible for a specialist or necessary medicines to be available, and it is not uncommon for people to cope with social phobia on their own. In such situations, psychologists advise using the “five senses” technique: being in a stressful situation, a person with social anxiety is advised to focus on what he sees, hears, feels with body parts, etc. This approach helps to focus solely on your feelings and be distracted from the thoughts that someone can follow, evaluate or condemn him, in other words, the most disturbing thoughts of a person with social phobia.

If the symptoms of social anxiety come on suddenly, a breathing practice can help to cope with them, which can be repeated in a circle until the unpleasant sensations pass:

sit in a comfortable position, keeping your back straight;
relax your shoulders;
place one hand on the abdomen, the other on the chest;
inhale slowly through your nose - focus on how the hand on the stomach rises, while on the chest, on the contrary, remains motionless;
hold your breath for two seconds and then exhale for another six seconds.

Psychologists insist that despite the fear, one should not refuse social interactions even when they seem very unpleasant. Fighting your own fear and overcoming it in this way is extremely important, and it will be most effective to do this by adding useful therapeutic practices to everyday life. One of them is keeping a diary in which you can note successes and failures and record your own feelings from each social interaction with people.

To cope with social phobia, such habitual things as regular maintenance of a healthy lifestyle (exercising, avoiding alcohol, switching to a balanced diet) and setting clear goals that I would like to achieve in the foreseeable future also help. They can be, for example, the performance of just the social interactions themselves, whether it be a phone call, participation in a video conference or a presentation. For every successful step in the fight against fear, experts recommend praising yourself, since communication is more difficult for a person with social phobia than for others, and even a step that is insignificant in the eyes of society can be of tremendous importance for him.

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