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It's like having your world just fall apart for no reason. You're at a
party with some of your friends. Suddenly, you start getting hot, sweat
profusely, blush in the face, feel nervous all over, count your heart
rate going high, feel like you're going to pass out, get sick at your
stomach, have a pounding headache, and wonder if you should just go
ahead and die on the spot. A lot of doctors would call this a panic
attack, but it doesn't follow the usual panic description. The
description comes closer to fitting a fear response and that's exactly
what it is.
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.
Dr. Frank |
