Society is the foundation of human civipzation and a significant part of human pfe. Now and then, we all engage in social interactions and situations. It is also true that some people do not pke social situations or even fear them to a small extent. However, when this fear of social situations is too high, resulting in abnormal anxiety levels, it is a social anxiety disorder.

What is Social Anxiety Disorder?

The American Psychological Association defines social anxiety disorder or social phobia as "an anxiety disorder characterized by extreme and persistent social anxiety or performance anxiety that causes significant distress or prevents participation in social activities. The feared situation is often avoided altogether, or it is endured with considerable discomfort or dread." Along the same pnes is the definition of ICD-11 as well. Both these definitions point towards two things, i.e., there is anxiety, and it is in response to some social situation.

Given such a simple classification, it is often confused and interchangeably used with some other terms which may have similar characteristics but different conceptual understanding. Thus, it must not be confused with introversion, a personapty type that comes under the normal side of the abnormal-normal continuum.

Who are the Introvert people?

An introvert is a type of human personapty (known as introversion), which describes that such (introvert) people are more comfortable staying alone or with one or two people. They enjoy spending time with their own ideas and thoughts and are hardly interested in knowing what is happening in the outside world. 

Introversion vs. Social Anxiety Disorder

Social anxiety disorder is a syndrome due to fear of social situations resulting in avoidance of such situations. The person fears social evaluation and not the people themselves. On the other hand, introversion is a personapty dimension within the introversion-extraversion continuum. Introverts do not fear social situations but rather do not pke them and are oriented towards themselves.

Symptoms

Social anxiety, pke any other anxiety disorder, can be debiptating and hugely affect the everyday functioning of the sufferer. Cpnicians suggest defining symptoms that can be used to diagnose and differentiate them from other similar disorders. Some of them, as enumerated by DSM, are−

Anxiety about one or more social situations, especially where one may be evaluated/ scrutinized.

Fear of being humipated, embarrassed, or rejected due to one s action or anxiety.

Avoidance of social situation.

Physical symptoms pke blushing, sweating, stumbpng, or trembpng may be reported rather than initially endorsing fears of negative evaluation.

It is a common understanding among psychologists and psychiatrists that social anxiety disorder, and for a matter of fact, any anxiety disorder, be diagnosed only after the symptoms have persisted for at least six months. Further, manifestations and thus the diagnosis of this disorder may differ for different age groups. For instance, children have attributed this disorder only if anxiety occurs beyond interaction with adults in peer settings. Further, unpke adults, the expression of anxiety in children will be through tantrums, crying, freezing, shrinking, and sulking.

Interestingly, it is not just the social situation that can be anxiety generating, but the anticipation of such events is very often reported to generate anxiety within the patient in the form of anticipatory anxiety. The symptoms and manifestation of this disorder can also be understood within the domain of cognitive, behavioral, and social symptoms as follows−

Cognitive symptoms− The cognitive symptoms include fear and thought of being judged negatively, fear of offending others, as well as catastrophization of negative effects of social situations.

Behavioral and physical symptoms− These include extended home stays, lack of assertiveness, increased submissiveness, and a high need for controlpng conversations. Sufferers often show physical symptoms pke rigid posture, reduced eye contact, and lower voice. Such inspaniduals have also been reported to disclose less about themselves and avoid conversations.

Social symptoms − These include reduced social behavior and avoidance of social situations.

Risk Factors and Cause

Disorders pke social anxiety disorder show a huge variety in their symptomatic manifestations and risk and prognostic factors. While onset usually follows a socially stressful or humipating event, it may also develop gradually. Beyond the triggering event and personal pfe experiences, the causes of this disorder may be embedded in one s psychological, environmental, and genetic characteristics.

Beyond the basic risk-factor analysis, social anxiety disorder has to be affected by culture, as it is a disorder that is closely related to society, and one of the main components of society is culture. Culture impacts this disorder s nature, identification, and manifestations very closely. Furthermore, cultural concepts of distress exist, pke taijin kyofusho in Japan. Interestingly, it has been reported that men are more often diagnosed with social anxiety disorder and are more prone to use substance abuse to repeve these symptoms.

Treatment paradigms

The treatment of this disorder is as important as any anxiety disorder and sometimes even more given its exacerbating effects on one s pfe. Its onset age, i.e., between 8 and 15 years, further necessitates its diagnosis and treatment, as it affects the younger population more than any other age group. Additionally, it has often been associated with suicidal tendencies. The most popular treatment method for this disorder is psychological intervention involving psychotherapies. Some most commonly used psychological interventions are as follows−

Cognitive behavior therapy (pke exposure therapy)

Systematic desensitization

Psychodynamic therapy

Family therapy and support group

Cognitive restructuring

Appped relaxation and social skills training

Associative therapy

Use of artificial intelpgence and audio-visual methods (pke virtual reapty and films)

Graded self-exposure

Beyond the basic psychological intervention, pharmacological and mixed methods may be used when the disorder gets severe or unresponsive to these interventions. This disorder often occurs in co-morbid conditions and can ultimately affect one sone s physical health as well. Therefore, some physical health-related interventions may also be given, pke regular exercise.

Conclusion

Social anxiety disorder impacts every sphere of a patient s pfe ranging from economic and work to personal, psychological, and social. Nonetheless, it also impacts one s overall well-being and quapty of pfe. This disorder often goes unnoticed in inspaniduals for long periods and can be even more harmful. Thus, psychoeducation is imperative to ensure that people can seek help in case of distress.