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Social Phobias

What is a Social Phobia?

For 5.3 million Americans, an impending social engagement or performance situation brings fear that prompts avoidance or otherwise interferes with functioning. Social phobia typically begins before adulthood and is best treated with cognitive-behavioral therapy, with or without medications.


Social phobia, also called Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and of being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work, school, or other activities. While many people with social phobia recognize that their fear of being around people may be excessive or unreasonable, they are unable to overcome it. They often worry for days or weeks in advance of a dreaded situation. In addition, they often experience low self-esteem and depression.


Social phobia can be limited to only one type of situation -- such as a fear of speaking in formal or informal situations, or eating or drinking in front of others -- or, in its most severe form, a person experiences symptoms whenever they are around other people. If left untreated, social phobia can have severe consequences. For example, it may keep people from going to work or school on some days. Many with this illness are afraid of being with people other than family members. As a result, they may have a hard time making and keeping friends.


Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, trembling, and other symptoms of anxiety, including difficulty talking and nausea or other stomach discomfort. These visible symptoms heighten the fear of disapproval, and the symptoms themselves can become an additional focus of fear. Fear of symptoms can create a vicious cycle: as people with social phobia worry about experiencing the symptoms, the greater their chances of developing the symptoms.

Social phobia often runs in families and may be accompanied by depression or other anxiety disorders, such as panic disorder and obsessive-compulsive disorder. Some people with social phobia self medicate themselves with alcohol or other drugs, which can lead to addiction.

Prevalence of Social Phobia

About 3.7% of the U.S. population -- approximately 5.3 million Americans -- is affected by social phobia. Social phobia occurs in women twice as often as in men, although a higher proportion of men seek help for this disorder. The disorder typically begins in childhood or early adolescence and rarely develops after age 25.


A diagnosis of social phobia is made only if his avoidance, fear or anxious anticipation of a social or performance situation interferes with daily routine, occupational functioning, social life or if he is markedly distressed by having the phobia. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR(tm)) provides the following criteria for diagnosing social phobia. Please note: guidelines are provided for information only; they cannot substitute a visit to a doctor or mental health practitioner.


Fear of one or more social or performance situations if the person is exposed to unfamiliar people. And the individual fears that she will behave in a manner that causes embarrassment:


  • Exposure to social situations causes intense anxiety

  • The level of anxiety is recognized by the individual as excessive

  • The feared situation must be avoided, or endured with anxiety and distress

  • The avoidance, anxious anticipation, or distress interferes significantly with the person's social, academic or occupational functioning


Treatment: Fortunately, most anxiety disorders can be treated successfully by a trained health or mental health care professional.


Research has shown that there are two main forms of effective treatment for social phobia: short-term psychotherapy called cognitive-behavioral therapy, and certain medications.

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