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Understanding Mental Disorder

Social Anxiety Disorder

What is SAD?

Many people may feel anxious about social situations. SAD is not just a feeling of extreme shyness. SAD is characterised by excessive anxiety or fear that is triggered by social or performance situations. This is accompanied by a persistent fear of being judged, observed or scrutinized by others that often leads to the avoidance of many social situations or the endurance of social situations with a high level of distress or discomfort. You may find social situations such as ordering a meal at a restaurant, making eye contract or being introduced to new people very challenging.

Symptoms of social anxiety disorder

Do you excessively worry about or avoid everyday social activities? Do you constantly worry about being criticised or negatively evaluated by others? Do you often worry that you might do something to embarrass yourself (e.g. blushing, sweating) during social interactions or in the presence of others? Do you find it challenging to engage in an activity (e.g. eating a meal) while in the presence of others for fear of being scrutinised, judged or watched? If you experience some of the above symptoms, you may have SAD and should seek professional help.

What causes social anxiety disorder?

Several factors could contribute to the onset of SAD and it is likely the result of a combination of biological, psychological and environmental factors. Having a family member with SAD could increase the risk of developing the disorder. Negative experiences such as bullying, being rejected, experiencing humiliation, family conflict or abuse can also contribute to the development of the disorder. Having a condition that draws attention such as stuttering or tremor due to Parkinson’s disease may increase the risk of developing the disorder. Early symptoms of SAD typically emerge in early adolescence. Having SAD can result in a number of negative consequences including loneliness, social isolation and low self-esteem.

Treating social anxiety disorder

There are a variety of treatments available for those suffering from SAD. Psychological therapy, medication or a combination of the two may be recommended. If psychological therapy is recommended, it may take the form of CBT. CBT has been shown to significantly improve symptoms of SAD. Typical CBT sessions involve talking through one’s problems with a certified clinician, with the aim to understand how one’s own thoughts impact one’s negative emotions and behaviours. Patient and clinician then work together to alter these negative thought patterns and behavioural responses such as avoiding situations that could trigger social anxiety, in order to improve one’s feelings and experiences. Social skills training may also be recommended and involves various exercises such as role-playing, rehearsal and modelling. Treatment often involves exposure whereby the patient and clinician work together to assist the patient to gradually expose themselves to social situations that trigger social anxiety. Therapy may begin with imagining social situations that bring about social anxiety and eventually progress to real life situations. Through practice, the aim is to help patients feel more comfortable in social situations.

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