Everybody gets a case of “the nerves” or has “butterflies in their stomach” from time to time. These are very normal physiological responses to the kinds of stress we all feel on a somewhat regular basis. When everyday activities cause that level of stress, however, there is the possibility of a social disorder of some kind. When otherwise mundane events, such as going to the grocery store or meeting someone new, cause feelings of fear, crippling self-consciousness or embarrassment, one of these social disorders is likely the cause.
Social anxiety disorder is the most common of the social disorders. It is so common that it is the third-most prevalent mental disorder in the U.S., after depression and alcohol dependence. An estimated 19.2 million Americans have social anxiety disorder, which often makes itself known during adolescence or early adulthood, but can occur at any time, including early childhood. It is more common in women than in men.
Recognizing signs of social disorders
Many of those with social anxiety disorder don’t know they have a disorder at all. Over time, they come to know that their reactions to certain situations are much different than the reactions of their peers. These abnormal reactions generally include some of the signs and symptoms of these social disorders. They typically fall into two groups—Emotional/Behavioral and Physical.
Emotional/behavioral signs usually involve feelings of fear and anxiety that come from social interactions. A fear of embarrassing or humiliating oneself is common. As a result, a person with a social disorder tends to avoid interacting with not only strangers, but also people they know out of fear of saying the wrong thing or drawing attention to themselves.
The physical signs of social disorders are familiar to everyone, but are pronounced in people with the disorder. These include sweating, shaking, upset stomach, clammy hands and a rapid, heavy heartbeat.
Causes and treatments of social disorders
There is not one specific cause of social disorders. Research suggests that multiple factors may play a part, including:
- Biology: Social anxiety disorder may be related to an imbalance of certain chemicals in the brain. This imbalance could slow or alter the way the brain reacts to stressful situations and cause anxiety. It is possible that predispositions for social disorders are passed on through genes.
- Psychological: The development of social anxiety disorder may stem from an embarrassing or humiliating experience in the past.
- Environmental: People may develop their fear through a strong empathetic response to seeing what happened to someone else as a result of their behavior (such as being laughed at or made fun of). Also, children who are sheltered or overprotected by their parents may not learn good social skills as part of their normal development and may struggle in social situations later in life.
The most common treatments for social disorders are cognitive-behavior therapy (CBT) and prescription drugs. The idea behind CBT is to guide the person’s thought process toward a more rational resolution of the situations that trigger their anxiety symptoms. This can include either systematic desensitization or controlled, real-life exposure to the feared situation. Significant practice often resolves social disorders. Sometimes, however, CBT is not enough to manage the symptoms of social disorders. Medications used to treat social disorders such as social anxiety are usually either antidepressants, hypnotics, or beta-blockers. Beta blockers are regularly used to treat heart conditions, but are commonly used to minimize the physical symptoms of social disorders, such as shaking and rapid heartbeat, which are common triggers of worsening social anxiety symptoms and fears. For social disorders, sometimes hypnotics such as clonazepam (Klonopin) or lorazepam (Ativan) are prescribed to be taken just before an anxiety-provoking event, but should be taken with caution as dependency can develop, as can withdrawal when discontinued abruptly. The bottom line is that social disorders can be treated with the help of mental health and medical professionals. There is no need to suffer social disorders alone.
Article content, © Kira Stein, MD, APC. | West Coast Life Center