- For a person to be scientifically diagnosed with social anxiety disorders he or she should meet the below mentioned criteria:
- There is clearly foreseeable and marked fear of situations in which the person has to interact with totally unrelated and unknown individuals
- Any chance of a public or social response provokes a severe anxiety attack
- The involved person is totally aware that the fear is totally irrational.
- Although a social situation is always avoided, if endured is totally in dread.
- The avoidance, fear or anticipation of such a situation severely affects person's normal routine in daily life.
- For individuals under the age of 18 it should persist for more than 6 months.
- Irrational fear should not be a physiological effect of any drugs or medicine and should not be diagnosed under any other medical condition.
The symptoms of this disorder can be categorized into mainly three aspects; Cognitive aspects, Behavioral aspect, Physiological aspect. We will discuss them one by one.
Cognitive aspects: In this aspect the sufferer consistently fears dread over how he represented himself to others, due to this they become overly self conscious. They always pay high attention to what ever they are doing and set very high standards for themselves. The sufferer constantly tries to put a good impression on others, but after every encounter he feels he has not been able to succeed in doing so. They constantly over analyze the situation and look for the slightest possibility of where they may have been embarrassed or humiliated.
Behavioral aspects: The fear of any situation social or public leads to the sufferer undergoing many behavioral changes which exceed the boundaries of shyness and enter into the realm of constant social avoidance and occupational impairment. This also leads to the surfacing of many physical symptoms such as stomach pain, dry mouth, sweating and various others. The sufferer also constantly tries to avoid any eye contact and you will also be able to see constant shaking.
Erythrophobia: Facial blushing or erythrophobia is a sudden reddening of the face that occurs spontaneously or in response to stressful stimuli. Even though Erythrophobia isn't one of the most widely recognized phobias in our society, it is fairly common among people who exhibit social anxiety symptoms and is just starting to become more and more accepted as a real phobia and certainly an overlooked, but more and more common in todays patients. Ask anyone with Social Anxiety if they suffer from facial blushing, and most definitely all of them will tell you Yes. I believe if we start treating more patients with blushing problems, as a special group of individuals who need different treatment than those who don't suffer from blushing problems, we would see a lot more different characteristics between the two groups that must each be treated differently. I believe by getting to the root cause of blushing, and treating those issues specially rather than just categorizing them in to a group who have social anxiety - the success rate of treatment would skyrocket. Patients who have constant blushing problems from shyness, embarrassment, or other stressful situations should not be put on medication for social anxiety. Their blushing problems may physically worsen, thus contradicting the entire purpose of treating the anxiety in the first place.
Physiological aspects: These are essentially the same that we encounter during an anxiety attack. In children there is a constant weeping and throwing tantrums and also shutting themselves out. In adults it may lead to tears, nausea, palpitations, chest pain and other symptoms.
Although there are no definite theories about the cause of social disorders, with advancement of neurosciences several theories have been put up into the air. Some of them have been summarized below
Some scientists believe that if social awkwardness is present in your family tree, it's most probable that you will also inherit it. It has been linked to the working of some kind of genes.
Family factors also play an important role in the advent of social disorders; it is much more likely for a person coming from a highly disturbed childhood to develop such kind of social awkwardness. Also children who have had a bad bonding with their mothers are twice as likely to develop social disorders
A previous negative social experience involving the person being humiliated or embarrassed may put the person totally in fear of social gatherings and occasions
Some substances like drugs, benzodiazepines, alcohol when used in excess also play an important part in inducing social awkwardness, especially when someone who is addicted tries to dry himself from all these substances.
Most of the successful treatments are totally depended on the early diagnosis of that disorder. As social disorders are not given due importance during primary care, they are usually diagnosed after they set of complications such as clinical depression and also substance abuse. Some of the major and common treatment methods involve Psychotherapy, involving group sessions with other people who suffer from the same kind of disorders. You share your experiences with them try to speak among those people and get your confidence back online. There also a technique that involves gradual public exposure that sometimes can be really unpleasant but if used properly can be highly successful.
Pharmacological treatments involve intake of a specific class of drugs called as SSRI's, Selective Serotonin reuptake Inhibitors, this the first choice when it comes to drugs for the treatment of generalized social phobias. Other drugs that can be used are selective benzodiazepines, and RIMA's Reverse Inhibitors of Monoamine oxidase subtype A.
Ultimately it depends on the individual and their symptoms. I believe that symptoms must really be taken in to consideration before looking to treat or diagnose Social Anxiety in any form. Sometimes, if you take away the symptoms, you will take away the anxiety. However, people are so narrow minded these days on looking at it vice versa that medication is the first thing that comes to mind when looking to treat any disorder for that matter. However, if we start looking more carefully at the actual symptoms and diagnosing and treating the symptoms one by one, you may find that cause for medication may not be in check after all.