How Distressing is Social Phobia?

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I remember a friend in college who would blush, sweat, and tremble when required by a teacher to speak in class. A few weeks before presentation, he was anxious, nervous and could not sleep. Since I was a student, I did not have a clue what he experienced. But I knew that something was wrong.

A few years ago at the airport, I saw a man who will wait for everyone to leave the washroom before he would use the urinal. He was not comfortable that someone would see him urinate.

In retrospect, I can say (now that I'm a psychiatrist) that those two individuals may suffer from Social Phobia or Social Anxiety Disorder (SAD). I just hope that they are doing well now but their symptoms manifested when it is consistent with this devastating disease.

How bad is Social Phobia or SAD?

Social Phobia or SAD is a type of anxiety disorder characterized by extreme fear, anxiety, or distress when exposed to a social gathering or when doing something before a group of people.

Public speaking is the most common situation that exposes an individual's social fears. Individuals suffering from this disorder develops significant anxiety symptoms such as sweating, fast heartbeat, tremulousness, and restlessness when making a presentation or give a small lecture. Even small corporate or committee meetings can cause grave suffering.

Urinating in public toilets, eating at fast food restaurants, writing in front of people or signing documents in the bank can also trigger feelings of fear and discomfort. Individuals with this disease are preoccupied with shame or criticized by others. Some patients feel that the people are so focused on them and just wait for the error occurred.

So Social Phobia can destroy many patients and their families. Because of their difficulties in social environment, some of them have ended up losing their jobs, friends, and couples. It is a disease that has wrought havoc for many people. It is therefore vital that Social Phobia should be recognized and treated without delay.

Is there a treatment for this disease?

Fortunately, some of the newer antidepressants such as paroxetine and venlafaxine are known to work and has led to a significant help to many individuals. However, these drugs do not work right away. They must be taken every day for several weeks to see any benefit. In addition, the maximum effect of the drug 'may occur within 6-8 weeks or more. To maintain stability after feeling "normal," patients may have to take medication for several months to several years.

In addition to medications, cognitive-behavioral interventions also work well. By restructuring the person's cognition, patients eventually learn to face social situations without fear and uncertainty.

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