Shyness or Social Anxiety?

Shyness or Social Anxiety?

When is it more than garden variety “shyness”? When should one seek professional support? From a diagnostic standpoint, a diagnosis of social anxiety requires that a person have an intense and persistent fear of one or more social or performance situations. The avoidance and anxiety that accompanies this fear must have lasted at least 6 months, and cause significant distress or impairment in social, occupational, academic functioning, or impact another important life arena. Also, this anxiety must not be due to a medical condition or substance. Social anxiety disorders occur in children, teens, and adults, although the incidence tends to go down over time so adults are somewhat less likely to develop this as they age.

In a social anxiety disorder, people have an irrational fear of doing something they feel would be embarrassing or humiliating (such as throwing up, forgetting their lines, soiling themselves, stuttering, etc;) in front of a group. There is a marked fear of being scrutinized and criticized by an audience. Social anxiety can also be present alongside other issues such as eating disorders or OCD, and sometimes this can make diagnosis a bit tricky. People with social anxiety often have a whole host of unpleasant physical sensations when they anticipate they will need to speak or perform. They may have a racing heart, sweating, churning stomach, and a dry mouth, among others. There are irrational beliefs that create in internal conversation that leads to a worsening of the physical sensations and which lead to avoidance or escape behaviors (turning down party invitations, not applying for jobs that would require public speaking, missing class, and so on). Sufferers talk about feeling others will think they are stupid, incompetent, boring, or untalented. The degree of self-scrutiny is enormously high and there is an on-going fear of failure despite successful outcomes in the past. People often talk of dread and worry starting days in advance of an anticipated social situation they find uncomfortable. The fear and worry are out of proportion to the actual situation.

Cognitive-behavior therapy is very effective in treating social anxiety, and a qualified Clinical Psychologist can be an excellent resource.
Contact Dr. Risa Sanders at (703) 919-1959. for more information.


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