From the library of

Frank Barnhill M.D.
 

Social Anxiety Disorder (SAD) is an excessive and sometimes recurring fear of being judged and criticized by others during social events and times you are required to perform. The most common specific SAD example would be a person with fear of public speaking or performing before audiences. However, the more generalized type of SAD is by far the most common and usually most severe. A person suffering with generalized SAD just can't quite put their finger on what is causing their sudden onset of fear. Generalized SAD can be so debilitating that it can push a person into avoiding social situations to the extent such behavior affects normal daily living, causes family and friendship friction, decreases educational experiences and even results in the inability to keep a job.

Social anxiety disorder has been a hot topic in the press over the past year. It's probably the most common form of anxiety and the third most common emotional problem behind major depression and alcohol dependence. Research indicates that between 5 and 19 million people in the United States are SAD sufferers. Unfortunately, SAD patients often do not realize they have a disorder and won't see a doctor until they are very depressed or start having drug and alcohol problems.

The most important discovery has been that SAD seems to start during childhood and adolescence, usually between ages 11 and 16. The disorder almost always persists into adulthood and can result in significant problems within a marriage and other social relationships. When combined with depression or alcohol dependency, the disorder predisposes one to many other emotional problems such as suicide, drug addiction, inability to control anger, problems with the law, and other excessive and unreasonable personality traits. Spotting SAD in children can be very tough, as kids may not realize their fear is out of proportion to the social event and they won't say anything about it. Sometimes a child's fear is expressed in crying episodes, tantrums, hiding from unfamiliar family or shying away from other people, and outbursts of shaking all over or acting as if freezing.

SAD responds very poorly to self-help therapies or treatments using medications only. Herbal medicines have shown no benefit in the treatment of SAD. SAD has been successfully treated with a combination of medications such as SSRI type antidepressants (Paxil, Zoloft, Effexor) and cognitive behavior therapy. CBT involves using psychologists, psychiatrists, and counselors in a team fashion to help a SAD sufferer learn behavior and social skills that allow him or her to interact with their world with out the fear and dread of social occasions. It is important to start treatment as soon as the disorder is suspected, since a large number of those affected will fail in their life's endeavors not reaching their fullest social and economic potential.