Social Anxiety Disorder (ADAA)

Social anxiety disorder is the extreme fear of being judged and scrutinized by others. It is also termed, social phobia. It is common that social anxiety can be specific to certain situations such as speaking in public, meeting a stranger, performing an interview, or going to a party, but in rare occasions it can be a severe fear of every social situation. Generalized social anxiety disorder is the most debilitating form of social anxiety and it can majorly affect the quality of life for people who suffer from it. It is estimated that around 15 million adults have the disorder (ADAA).

Recorded instances of social anxiety date back to 400A B.C. in which Hippocrates conceptualized it, but it didn’t surface again until the 1900s (about health).

It was initially viewed as an extreme form of shyness and was only recognized as a phobia in 1968 when the DSM-II developed a definition for social anxiety that described it as an excessive fear of being observed by others (about health.com). After a series of more DSM releases, the definition of social anxiety was broadened and refined. In the present, it is treated more seriously as a condition and research is now being focused to find causes and cures. So far, that research has developed relief and treatment in the form of medication and clinical methods.
The specific cause of social anxiety is unknown to researches as of yet. Some theories exist, that causes could be biological or environmental. Supposedly the disorder has been recorded to run in families which supports a genetic cause (NIMH). Some scientists believe that an overactive amygdala is responsible for causing the disorder because it is associated with the activation of fear. Yet, it could also be attributed to learned behavior after watching the anxious behavior of other people. Environmentally, it can potentially be caused by parenting techniques. Especially if the parents are overbearing and overprotective. (NIMH).
Social anxiety has been around for a long time, but only recently is it being recognized. It remains as a disorder that is also underdiagnosed and not taken as seriously as it should be. Having such a disorder can mean having few friends and relationships, an inability to find a job, and have a normal life. It can also lead to other mental health issues such as depression (NIMH). In a world that is growing ever more social, people with social anxiety are finding it increasingly difficult to thrive. An important component to reducing this issue is by diagnosing early and by knowing and being able to recognize the symptoms.
Physiological symptoms include profuse sweating, trembling, loss of self-control, nausea, distress, and loss of breath when faced with a social situation (ADAA). Behavioral signs include avoidance of social situations, extreme nervousness days or weeks prior to a social event, and a prevalent fear of judgment (NIMH). Symptoms strongly resemble those of other anxiety disorders.
The major treatments for social anxiety disorder include medication and cognitive behavioral therapy. The medication used to treat it is usually anti-depressant or anti-anxiety medication (NIMH). The therapy works on developing different ways of thinking and reacting to situations that would normally incite a problematic response. It focuses on thoughts, feelings, and behavior and how they all link up. By instructing a patient to analyze the patterns and thinking that leads up to an undesired behavior, they can learn to modify the thinking process and in turn learn to cope with issues. This therapy is proven to change brain activity, and in many cases it has been as effective/more effective as medication as a treatment for mental disorders. Both medication and cognitive behavioral therapy have been found to be the most effective in treating social phobia.
A new medication was tested called Fluvoxamine, that was developed specifically to treat social anxiety patients.

The study conducted was a 12 week study on participants 18 years old to 65, and they all rated 20 or above on the Brief Social Phobia Scale. The researchers used a double blind method to ensure accurate results and a placebo was used for the control. The drug acted as a selective serotonin uptake inhibitor and would ideally decrease the impairment that the disorder presented in everyday life. Therefore, success of the drug was measured by psychological impairment ratings given by the participant throughout the time that Fluvoxamine was being given. Initially participants were given 50mg of Fluvoxamine per day, and after a week the dosage could be increased by 50mg per week with 300mg per day being the maximum dosage. The dosages were planned so that they could be reduced immediately in case any prominent side effects began to occur. The result was that “there was a significantly higher proportion of responders in the Fluvoxamine group (42.9%, N=18) than in the placebo group (22.7%, N=10)” which meant that the drug was an effective way to treat social

anxiety.
Another study done was to find a correlation between social anxiety disorder and the development of mood disorders afterward. The data gathered came from a longitudinal study on people from 14 to 24 years of age. The results showed that social anxiety disorder could be an indicator for the development of mood disorders, and that it is a factor that would greatly increase the odds of developing further disorders. It was also found that if social anxiety is found in adolescents, it is a strong indicator that a mood disorder would follow. This would mean diagnosing the anxiety early could mean a decreased chance of the development of deep depression later in life.
Studies like the one conducted on Fluvoxamine are great milestones to the progress that social anxiety disorder in going through in order to make it into the mainstream medical field.

The more treatments are developed the closer people will get to controlling the issue, and the more it can be understood and accepted as a true disorder. It is also important to continue research on this disorder to uncover more information on disorders and health problems associated with it. Longitudinal studies such as the study done to investigate the correlation between depression and social anxiety disorder displays the importance of fully understanding social phobia, how to treat it, and how to diagnose it early in order to reduce effects that could develop over the course of

time.
Over time and the development of psychology, social anxiety disorder has become a realized issue that impacts the daily lives of many. It has developed from an extreme shyness to an actual cognitive impairment, and as more information is becoming accessible it is coming into the mainstream as a notable issue to address. In modern times, scientists seem more focused on investigating the disorder, as well as causes and treatments. Yet, it still is one of the most misunderstood disorders that exists. As the public and the medical fields become more informed about the symptoms and the general information about the disorder, it can begin to come into the mainstream as a serious mental issue that needs to be addressed.