Performance anxiety and social phobia are the most common anxiety disorders in the general population. Research indicates that 12% of the population will suffer from social phobia at some point in their life. We all know someone who appears shy but social phobia goes well beyond shyness. Those who suffer from social phobia experience extreme shyness in almost all social situations. People with social phobia dread being exposed to new social situations. And they may experience an irrational fear that they will appear to act in a way that will be humiliating or embarrassing in social situations.

Social phobia normally begins during adolescence and with a peak stage onset of around 13 years. Social phobia is more prevalent in young people (aged between 18 and 29 years), and amongst undereducated, single and lower socioeconomic background people. As we age there is a decline in the prevalence of social phobia. There is a noted decline in social phobia in adults over 60 years of age. Because people with social phobia have difficulty meeting others they are often single. Research indicates that men are more likely to suffer from social phobia then women. And social phobia can be found equally among different ethnic groups.

The most common form of performance anxiety is public speaking. Other forms of performance anxiety can be eating in public, signing papers in front of a clerk or for males urinating in a public toilet (bashful bladder). If a man experiences bashful bladder they must wait until a toilet cubicle becomes vacant to urinate. What do all these performance anxieties have in common? It’s the anxiety of being publicly evaluated by those presumed to be looking on. This can be truly classified as a social phobia because individuals have no problems performing these different tasks in private.

What may be the cause of social phobia? There are currently several different theories. Research indicates that some infants are born with a temperament or trait of inhibition or shyness. This trait of inhibition is often noticeable by four months. These infants cry more frequently when presented with toys. Other research has indicated that people may inherit a generalised vulnerability to develop anxiety. And there are environmental factors such as stress. Those with a propensity to develop anxiety may experience stressful situations inhibiting performance. This may lead to escalating levels of self-consciousness. It is also possible that under high levels of stress a person may experience a panic attack in a social situation. This may lead to an association between the panic attack and social situations generally. Another possible cause for social phobia may be a real social trauma. This often occurs during early adolescence between 12 and 15 years. This is a time when children are often brutally taunted by their peers who attempt to assert their own dominance. This may then lead to panic in future social situations.

Treatment for social phobia may include a program in which groups of patients rehearse or role-play their socially phobic situation in front of each other. Members of the group act as an audience and witness to the social phobia and participate to assist the sufferer. Alternatively, slow exposure therapy has also shown to be effective in assisting those with social phobia. Drug treatment has also been shown to assist. Medication like tricyclic antidepressants and in particular monoamine oxidase (MAO inhibitors) have proven to be effective with individuals suffering from severe social phobia. The optimum treatment for social phobia appears to be a combination of medication and psychotherapy. Medication may assist sufferers with the short term relief from anxiety. While psychotherapy assists with the long term treatment of the condition.

Christopher Swane - Depression and Anxiety Psychotherapy - Wellington New Zealand