Social Phobia

What Is Social Phobia?

It's natural to feel self-conscious, nervous, or shy in front of others at times. Most people get through these moments when they need to. But for some, the anxiety that goes with feeling shy or self-conscious can be extreme.

When people feel so self-conscious and anxious that it prevents them from speaking up or socializing most of the time, it's probably more than shyness. It may be an anxiety condition called social phobia (also called social anxiety).

What Happens When Someone Has Social Phobia?

Extreme feelings of shyness and self-consciousness build into a powerful fear. As a result, a person feels uncomfortable participating in everyday social situations.

People with social phobia can usually interact easily with family and a few close friends. But meeting new people, talking in a group, or speaking in public can cause their extreme shyness to kick in.

With social phobia, a person's extreme shyness, self-consciousness, and fears of embarrassment get in the way of life. Instead of enjoying social activities, people with social phobia might dread them — and avoid some of them altogether.

What Causes Social Phobia?

Like other phobias, social phobia is a fear reaction to something that isn't actually dangerous — although the body and mind react as if the danger is real. This means that someone feels physical sensations of fear, like a faster heartbeat and breathing. These are part of the body's fight–flight response. They're caused by a rush of adrenaline and other chemicals that prepare the body to either fight or make a quick getaway.

This biological mechanism kicks in when we feel afraid. It's a built-in nervous system response that alerts us to danger so we can protect ourselves. With social phobia, this response gets activated too often, too strongly, and in situations where it's out of place. Because the physical sensations that go with the response are real — and sometimes quite strong — the danger seems real too. So the person will react by freezing up, and will feel unable to interact.

As the body experiences these physical sensations, the mind goes through emotions like feeling afraid or nervous.

People with social phobia tend to interpret these sensations and emotions in a way that leads them to avoid the situation ("Uh-oh, my heart's pounding, this must be dangerous — I'd better not do it!"). Someone else might interpret the same physical sensations of nervousness a different way ("OK, that's just my heart beating fast. It's me getting nervous because it's almost my turn to speak. It happens every time. No big deal.").

What Fears Are Involved?

With social phobia, a person's fears and concerns are focused on their social performance — whether it's a major class presentation or small talk at the lockers.

People with social phobia tend to feel self-conscious and uncomfortable about being noticed or judged by others. They're more sensitive to fears that they'll be embarrassed, look foolish, make a mistake, or be criticized or laughed at. No one wants to go through these things. But most people don't really spend much time worrying about it. The fear and anxiety are out of proportion to the situation.

How Can Social Phobia Affect Someone's Life?

With social phobia, thoughts and fears about what others think get exaggerated in someone's mind. The person starts to focus on the embarrassing things that could happen, instead of the good things. This makes a situation seem much worse than it is, and influences a person to avoid it.

Some of the ways social phobia can affect someone's life include:

• Feeling lonely or disappointed over missed opportunities for friendship and fun. Social phobia might prevent someone from chatting with friends in the lunchroom, joining an after-school club, going to a party, or asking someone on a date.
• Not getting the most out of school. Social phobia might keep a person from volunteering an answer in class, reading aloud, or giving a presentation. Someone with social phobia might feel too nervous to ask a question in class or go to a teacher for help.
• Missing a chance to share their talents and learn new skills. Social phobia might prevent someone from auditioning for the school play, being in the talent show, trying out for a team, or joining in a service project. Social phobia not only prevents people from trying new things. It also prevents them from making the normal, everyday mistakes that help people improve their skills still further.

What Is Selective Mutism?

Some kids and teens are so extremely shy and so fearful about talking to others, that they don't speak at all to some people (such as a teacher or students they don't know) or in certain places (like at someone else's house). This form of social phobia is sometimes called selective mutism.

People with selective mutism can talk. They have completely normal conversations with the people they're comfortable with or in certain places. But other situations cause them such extreme anxiety that they may not be able to bring themselves to talk at all.

Some people might mistake their silence for a stuck-up attitude or rudeness. But with selective mutism and social phobia, silence stems from feeling uncomfortable and afraid, not from being uncooperative, disrespectful, or rude.

Why Do Some People Develop Social Phobia?

Kids, teens, and adults can have social phobia. Most of the time, it starts when a person is young. Like other anxiety-based problems, social phobia develops because of a combination of three factors:

• A person's biological makeup. Social phobia could be partly due to the genes and temperament a person inherits. Inherited genetic traits from parents and other relatives can influence how the brain senses and regulates anxiety, shyness, nervousness, and stress reactions. Likewise, some people are born with a shy temperament and tend to be cautious and sensitive in new situations and prefer what's familiar. Most people who develop social phobia have always had a shy temperament.
  
  Not everyone with a shy temperament develops social phobia (in fact, most don't). It's the same with genes. But people who inherit these traits do have an increased chance of developing social phobia.

• Behaviors learned from role models (especially parents). A person's naturally shy temperament can be influenced by what he or she learns from role models. If parents or others react by overprotecting a child who is shy, the child won't have a chance to get used to new situations and new people. Over time, shyness can build into social phobia.
  
  Shy parents might also unintentionally set an example by avoiding certain social interactions. A shy child who watches this learns that socializing is uncomfortable, distressing, and something to avoid. 

• Life events and experiences. If people born with a cautious nature have stressful experiences, it can make them even more cautious and shy. Feeing pressured to interact in ways they don't feel ready for, being criticized or humiliated, or having other fears and worries can make it more likely for a shy or fearful person to develop social anxiety.
  
  People who constantly receive critical or disapproving reactions may grow to expect that others will judge them negatively. Being teased or bullied will make people who are already shy likely to retreat into their shells even more. They'll be scared of making a mistake or disappointing someone, and will be more sensitive to criticism.

The good news is that the effect of these negative experiences can be turned around with some focused slow-but-steady effort. Fear can be learned. And it can also be unlearned, too.

Dealing With Social Phobia

People with social phobia can learn to manage fear, develop confidence and coping skills, and stop avoiding things that make them anxious. But it's not always easy. Overcoming social phobia means getting up the courage it takes to go beyond what's comfortable, little by little.

Here's who can support and guide people in overcoming social phobia:

• Therapists can help people recognize the physical sensations caused by fight–flight and teach them to interpret these sensations more accurately. Therapists can help people create a plan for facing social fears one by one, and help them build the skills and confidence to do it. This includes practicing new behaviors. Sometimes, but not always, medications that reduce anxiety are used as part of the treatment for social phobia.
• Family or friends are especially important for people who are dealing with social phobia. The right support from a few key people can help those with social phobia gather the courage to go outside their comfort zone and try something new.
  
  Putdowns, lectures, criticisms, and demands to change don't help — and just make a person feel bad. Having social phobia isn't a person's fault and isn't something anyone chooses. Instead, friends and family can encourage people with social phobia to pick a small goal to aim for, remind them to go for it, and be there when they might feel discouraged. Good friends and family are there to celebrate each small success along the way.

Overcoming Social Phobia

Dealing with social phobia takes patience, courage to face fears and try new things, and the willingness to practice. It takes a commitment to go forward rather than back away when feeling shy.

Little by little, someone who decides to deal with extreme shyness can learn to be more comfortable. Each small step forward helps build enough confidence to take the next small step. As shyness and fears begin to melt, confidence and positive feelings build. Pretty soon, the person is thinking less about what might feel uncomfortable and more about what might be fun.