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David Baxter

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Understanding Social Phobia
American Academy of Family Physicians, 1999

What is social phobia?
Most people feel nervous in social situations, like having a job interview, going to a high school reunion or giving a speech. Most of us worry about what we're going to say, do or even wear during these events. These events often become easier with some experience. However, in people with social phobia (also called social anxiety disorder), these events and other social situations can be frightening and disabling.

Social phobia usually begins in the early teens, although some people have had it for as long as they remember. Others feel it coming on later in life, as social demands increase. It often runs in families. Sometimes it leads to other problems, such as depression or substance abuse.

How does a person with social phobia feel?
Most people with social phobia have a strong fear of being humiliated or embarrassed in front of other people. People with social phobia feel as though everyone is watching them, until they blush, sweat or otherwise show their fear. They often believe that showing anxiety is a sign of weakness or inferiority. They also believe other people are more confident and competent than they really are.

People with social phobia usually know their fears are not completely rational, but they still find themselves dreading social situations. They may go out of their way to avoid going to some events. If they do go to them, they usually feel very nervous before and very uncomfortable during the event. Afterward, the unpleasant feelings may linger as they worry about what other people thought of them.

How often is social phobia a problem?
Some people have social phobia in only one or two situations, like performing in public or talking to an important person. Others will have it in many situations, including using a public bathroom, eating in a restaurant, talking on the telephone or signing their name in front of people.

What helps social phobia?
Social phobia is a persistent disorder that usually has to be helped with medical care. It's not just shyness. Cognitive behavioral therapy (called CBT) helps people see social situations differently. The therapy also involves learning how to reduce anxiety, and improving social and conversational skills. Antidepressants and benzodiazepines can also help some people with social phobia. People with a certain form of social phobia, called "performance anxiety," can take medicines called beta blockers just before they perform. Even if you're worried about your social phobia, your doctor can help you control your fears.
 

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Enigma

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Is social phobia diagnosed, or is it just by having the symptoms that one is able to tell? (I know it's not worded well, but I want to know how I can tell if I really have social phobia) Is one forced into believing that they have social phobia when it's not really true?
 

David Baxter

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Enigma said:
Is social phobia diagnosed, or is it just by having the symptoms that one is able to tell? (I know it's not worded well, but I want to know how I can tell if I really have social phobia) Is one forced into believing that they have social phobia when it's not really true?
When it comes to dealing with issues like "social anxiety" / "social phobia", it probably doesn't really matter that much whether you meet the full criteria for an "official diagnosis" (a list of criteria for each "disorder" is published in the Diagnostic & Statistical Manual of Mental Disorders (DMS-IV-TR) but these are mainly useful to practitioners and insurance companies).

For individuals, if being with people, talking to people, meeting people, etc., causes you anxiety or discomfort, you can be treated for this whether it is a "mild case" that doesn't meet the DSM criteria or a full-blown more severe case that meets all the criteria.
 

Enigma

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I was talking to my teacher who asked if I am diagnosed with Social Phobia/Social Anxiety. I said no, but does that dismiss the fact that there is something wrong? If one feels overwhelmed in social situations and is not diagnosed, do we draw the line and say nothing is wrong?
 

David Baxter

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No. As I said, if social interactions or social events cause you distress, that's a problem, obviously. In Canada, at least, only a physician or a psychologist has the legal right to diagnose a "mental disorder", so technically if you were being treated by a different kind of counsellor for the problem you would not be officially diagnosed -- that doesn't mean there isn't a problem.

Your teacher may simply have been wondering whether your problem is with social anxiety/social phobia per se, or with something else. Also, remember that your teacher, however well-meaning and kind he/she may be, is not a mental health professional and does not have training in the area of diagnosis.
 

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