Social Anxiety Disorder Help

Social Anxiety Disorder (SAD), or its psychopathological counterpart, Social Phobia, is centuries old but only  relatively recently was it included in The Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV TR),  the handbook used by mental health professionals for diagnosing mental illness.  Another term for excessive shyness, social anxiety is thought to affect between 2 – 13% of the population with three times more women than men being affected. It usually develops in childhood or early adolescence, but some it can develop in adulthood as well particularly when that person is faced with a new situation.

 

A lot of people are shy and could be said to suffer from social anxiety. However, having Social Anxiety Disorder is more than just being shy. It means that shyness is present to such a degree that quality of lifestyle is affected. It results in avoidance behavior similar to that of agoraphobia, but in this case it is not fear of crowds that is the incentive but rather fear of embarrassment in situations involving people.

 

For some, the predominance of this phobia particularly in the western world begs a philosophical question of why this is so. What is it in western culture that leads to one in twenty people being so afraid of embarrassment and ridicule, of being judged negatively, that they shun all but the most necessary social contact?

 

There are two main environmental factors thought to be responsible for Social Anxiety. The first is that a key role model, usually a parent, was inhibited or very shy and the second is a deeply traumatic event that was experienced in a public place. The fear of such an event happening to them again results in that person avoiding any possible similar situation.  

 

In addition, there do seem to be genetic factors as well as a different neurobiological function in people who suffer from Social Anxiety. Tests have shown that excessively shy people show increased activity in the amygdala and insula – two parts of the brain that are associated with anxiety and processing the emotions.  Studies have shown that there is an increased sensitivity to faces and emotional tones.

 

However, not everyone with this sensitivity goes on to develop Social Anxiety Disorder. If very shy children are encouraged in their interpersonal relationships by successful parenting, then they can go on to become, if not exactly extrovert, then at least not pathologically shy. Should something humiliating occur before they have had the chance to develop adequate social skills, or should those social skills fail to develop at all through lack of encouragement, then that child is at risk to develop Social Phobia or any of the other Anxiety Disorders.

 

In order to diagnose SAD, some or all of the following criteria must be met –

 

  • Marked and Persistent Fear.
  • Anxiety Response: This may take the form of a panic attack
  • Recognition That Fear is Irrational: Adults can recognise that their response is inappropriate.
  • Avoidance or Distress: Either the situation is avoided or suffered under acute distress.
  • Life-Limiting: The sufferer experiences a decrease in quality of life.
  • Six Months Duration: In children and teens, the phobia has lasted at least six months.
  • Not Related to a Physical Disorder.
  • Not Caused by another Disorder.

Anxiety Disorders in Children

It is only as recently as in the last ten years that anxiety disorders in children have been taken seriously. In the past, being fearful was considered a normal part of childhood and so fear and anxiety in children was dismissed as a passing phase. However, newer research has shown that some children and adolescents do feel such anxiety that the diagnosis of an anxiety disorder is warranted. This is an important step as some childhood anxiety disorders are chronic which means that without treatment they will continue into adulthood.

It is now considered that anxiety disorders are one of the most prevalent psychological problems affecting as many as 13% of children and adolescents. They are often accompanied by other conditions such as depression, eating disorders and behavioral problems.

First of all, it is important to distinguish between fear and anxiety. Fear is the body’s way of initiating the ‘fight or flight’ response and avoiding or dealing with danger that can be seen.  Anxiety, on the other hand, can be felt with or without the presence of actual danger. One can feel anxious about an imminent threat and then feel the fear when the threat becomes fact. After the fact, when the threat has been dealt with, anxiety returns in the form of worry about future attacks or consequences.

Children with anxiety disorders typically feel intense fear, anxiety and uneasiness over a long period of time. It is not like seeing a scary movie and needing some reassurance or feeling bad about an event that happened during the day and needing to sleep with the hall light on for a night or two. Children with anxiety disorders can’t be calmed with soft words or a hall light. Their fears and anxieties persist and impact their daily routines negatively.

The kinds of problems include poor performance at school, low self esteem, substance abuse and difficulty in social situations as well as physical symptoms such as high blood pressure, ulcers, diarrhea and respiratory problems.   There are six different types of disorders which affect children –

  • Generalized Anxiety Disorder
  • Separation Anxiety Disorder
  • Phobias
  • Panic Disorder
  • Obsessive-Compulsive Disorder
  • Post Traumatic Stress Disorder.

 

It can be hard to recognize the difference between normal anxiety and pathological anxiety in children as they don’t know that what they are experiencing isn’t any different to what others experience. They cannot express that they are feeling constant fear and anxiety. Parents and carers need to look out for signs that the child is starting to avoid certain places or situations; not wanting to go to school or a neighborhood party for example. Headaches, problems sleeping, poor concentration, low self esteem, being overly critical of oneself and stomach pain are some of the symptoms of a possible anxiety disorder.

The good news is that once these conditions are diagnosed, successful treatment is possible.