SOUND FAMILIAR?
"I skipped a lot of classes because I was so afraid of being called on by the teacher. I was terrified of blushing or shaking in front of my classmates. And dating was impossible. Just the thought of asking someone out would make me break out in a sweat. I began to feel very isolated."

"Going out to eat with collegues and friends seemed so natural for everyone else, but to me it was pure torture. I'd worry about not knowing what to say or of saying something stupid, or of having my hand shake if I tried to pick up a glass. So I avoided going to restaurants...made lots of excuses and hated myself for it."

"I kept turning down promotions at work because I couldn't control my anxiety about presentations. Even when I just had to introduce myself at a table of colleagues, my heart would pound and I could barely talk...I'd feel as if my throat was going to close up. I'd want to bolt from the room."

MORE THAN JUST SHYNESS

Most people feel shy or self-conscious in social situations. Speaking in public, going on a job interview or even asking for a date can make anyone feel shy or anxious. The symptoms are familiar: your heart pounds, your hands tremble or you feel like you have "butterflies" in your stomach. But this type of anxiety is temporary, and once you get through the situation, life goes on as usual.

If your anxiety about social situations is so severe that it disrupts your daly life and relationships to the point where you are sick with worry, you may have social anxiety disorder. Social anxiety disorder is an excessive, persistent fear of social or perfomance situations.

YOU ARE NOT ALONE

Social anxiety disorder is a lot more commmon than you may think. It's actually the third most common psychiatric disorder in the United States---1 out of every 8 Americans suffers from social anxiety disorder. The good news is that it is treatable. Many people recover from social anxiety disorder and enjoy more productive lives.

You, too, can recover from social anxiety disorder. Although recovery doesn't happen overnight, with the right treatment, you can get better. Feel confident that it is possible to live the way you want to, in control of your anxiety.

SIGNS AND SYMPTOMS OF SOCIAL ANXIETY DISORDER

Some of the signs and symptoms include:
An extreme fear of a situation in which you have to meet new people or you may be scrutinized by others
The feared social situations are experienced with intense anxiety or avoided entirely
The anxiety-provoking social situation causes physical symptoms like blushing, sweating, shaking, trembling, tense muscles, shaky voice, dry mouth and a pounding heart.

The basic symptom of social anxiety disorder is of being very anxious in the presence of others. If you suffer from social anxiety disorder, you may think that other people are very confident in public and you are not. Just blushing may feel horribly embarrassing to you, and you may feel like everyone's eyes are always on yoyu. You may feel anxious about giving a speech, talking to a boss or dating.

Some people with social anxiety disorder are afraid of public speaking or parties. Others feel terrible anxiety about using a public restroom, eating out, talking on the phone or writing in front of others.

Almost everyone experiences some social anxiety now and then; it's normal. However, social anxiety disorder consistently limits the lifestyle of those with the illness, in some cases causing them to not participate in school, avoid making friends or miss important opportunities at work. Some people with social anxiety disorder avoid all socially related situations, severely limiting their life, work and social relationships.

WHO SUFFERS FROM SOCIAL ANXIETY DISORDER?

This disorder can start as early as childhood and tends to affect men and women in equal numbers. However, anyone can suffer from social anxiety disorder at any age. Although you may have suffered from social anxiety disorder for a long time, it's never too late to get treatment. With the right treatment, there's a good chance you may get better.

"When I felt anxious around other people I would immediately start sweating. My face turned red...my throat ran dry. My heart would beat out of my chest and I'd shake all over. It felt like everyone was staring at me...I could never think of a thing to say..."

LEARNING MORE

The word "phobia" is used to describe a condition in which someone has an excessive or unreasonable fear reaction to a specific situation or thing. There are three types of phobia: agoraphobia (fear of places or situations from which escape may be difficult), specific phobia (fear of a specific object or situation) and social anxiety disorder (fear of social and/or performance situations).

Some people with social anxiety disorder avoid all social situations, fearing embarrassment or humiliation. But you don't have to be afraid of every social situation to suffer from social anxiety disorder. Some people can go to a party and meet new people with no problem, but still have tremendous anxiety about eating or writing in public. It's not what social situation makes you afraid that's important, it's how your fears affect your life. For example, if someone feels overwhelming anxiety about meeting new people, they may have problems dating, making friends or advancing in their career.

Unfortunately, many people with social anxiety disorder cope by changing their lives to avoid the situations that provoke their anxiety, such as turning down a job promotion to avoid presentations.

"I thought there was something terrible wrong with me. I never knew what social anxiety disorder was, let alone that there were treatments for it..."

WHAT CAUSES SOCIAL ANXIETY DISORDER?

Although no one has discovered a single cause of social anxiety disorder, studies suggest that both biological and psychological factors may play a role.

One theory is that social anxiety disorder may be related to an imbalance of a chemical called serotonin that transports signals between nerve cells in the brain. Interestingly, this is the same chemical imbalance linked to other mood and anxiety disorders.

Another theory is that social anxiety disorder may run in families---especially among close relatives like parents and their children. Or it may stem from an embarrassing social event in the past.

It's important to know that the anxiety you may feel in social situations in not neccessarily "just the way you are." No matter how long you've lived with it, social anxiety doesn't have to be part of your personality or your life. Social anxiety disorder can be treated, no matter how or why it develops. Several therapies already exist to help people suffering from social anxiety disorder, and researchers are working hard to find even more treatments.

OTHER CONDITIONS

The first time someone with social anxiety disorder seeks help is often for another disorder entirely. Depression and panic disorder are examples of disorders that may first make people wih social anxiety disorder go to their doctor.

Individuals who suffer from depression have a persistent feeling of sadness and loss of enjoyment that interferes with daily life. People with panic disorder have repeated attacks of intense fear, sometimes for no apparent reason. Their heart races, they have chest pain, they can't seem to catch their breath and they feel like something terrible is going to happen.

Depression and panic disorder are treatable conditions frequently found with social anxiety disorder. If any of the symptoms sound familiar to you, tell your doctor immediately so he or she can make any necessary changes to your treatment plan.

ALCOHOL AND DRUGS MAKE MATTERS WORSE

Some people with social anxiety disorder may use alcohol or drugs as a way to self-medicate to help them get through social situations. In fact, about one quarter of all people with social anxiety disorder abuse alcohol. Although alcohol or drugs may seem to help initially, they eventually become another problem in the life of the person with social anxiety disorder.

Appropriate treatment for social anxiety disorder may reduce alcohol and drug dependence in those who suffer from this disorder.

"I thought alcohol would help me be more social...and in a way, it did. But it wasn't really me...I wanted to know what was happening to me and what I could do to feel better. I didn't want to hide behind alcohol."

TREATMENT FOR SOCIAL ANXIETY DISORDER Hearing how disabling social anxiety disorder is, you can understand the critical importance of finding an appropriate treatment. Getting help as early as possible can lessen the emotional damage social anxiety disorder causes, stop harmful coping tactics from forming (like alcohol abuse) and prevent the development of other conditions often seen with social anxiety disorder (like depression). The right treatment can free you to pursue the social activities you've always wanted to be involved with and help you feel more comfortable at work and in relationships.

Fortunately, therapies already exist for social anxiety disorder, and there are more on the way. Effective treatments consist of medicationis, the "talk" therapies or a combinations of both.

WHAT ARE SOME TYPES OF "TALK" THERAPY? Cognitive-behavioral therapy (CBT) is a type of "talk" therapy that may be helpful in the treatment of social anxiety disorder. It teaches people with social anxiety disorder to react differently to the situations that trigger their anxiety symptoms.

The therapist helps the patient confront the negative feelings about social situations and the fear about being judged by others. Patients learn how their thinking patters add to the symptoms of social anxiety disorder and how to change their thinking so the symptoms begin to lessen. All this is combined with other behavioral techniques, such as gradual, controlled exposure to an anxiety-provoking situation until the patient learns to identify and modify behavior that contributes to his or her social anxiety.

Social skills training is a component of "talk" therapy. Not to be confused with "etiquette" (teaching people to act and behave properly), cosial skills training involves meeting with a professional therapist to discuss and rehearse problematic social situations. Patients are shown how to make eye contact, talk louder and slower, greet people and say good-bye, ask for favors, respond to requests and criticism. They monitor themselves with diaries and practice the new skills with the therapist and then in real life. The hope is that knowing exactly what to say and do in social situations will ease the patient's anxiety.

"I finally went to the doctor for help...who sent me to a therapist who told me about social anxiety disorder. I was so relieved when she told me that she knew what was wrong. It was incredible to hear that it wasn't 'just in my head,' and that there were others like me."

MORE ABOUT THERAPY

What about medicaitons?
There are several types of medication used for social anxiety disorder, including monoamine oxidase inhibitors (MAOIs), benzodiazepines, beta-blockers (B-blockers) and selective serotonin reuptake inhibitors (SSRIs).

Although all of these medications can help social anxiety disorder, certain ones are better for certain people. MAOIs and benzodiazepines may require more monitoring than other medicaitons. B-blockers control only specific symptoms of anxiety, like heart pounding, durning performance situations.

Doctors are starting to use SSRIs more often because, for most patients, they have fewer side effects compared to other medications. Although SSRIs are still being studied in social anxiety disorder, they seem to be a very promising treatment.

Working with your doctor
Work with your doctor and follow the program he or she recommends. Use your doctor as a resource--ask questions and ask for information. Take your medication exactly as your doctor prescribes. Always let your doctor know about any side effects you are feeling or if you're unhappy with your therapy, so it can be changed if necessary. Following these tips will help you communicate with your doctor--an important part of any recovery.

"With the help of what the doctor called 'CBT' and medicaiton, I started to feel more comfortable in social situations."

THE ROAD TO RECOVERY

By learning about social anxiety disorder, you've taken the first step on the road to recovery. Next, seek help from a doctor, or if you've already seen a doctor, stick with your treatment plan and take one day at a time. These points may help you on your way:
Don't let others discourage you or tell you to "snap out of it." There's no need to be ashamed: you should take social anxiety disorder as seriously as you would any other illness.
Learn as much as you can about social anxiety disorder. Visit the library or various Interent Web sites. Ask your doctor for more information.
"It took a lot of hard work and patience to get through my social anxiety disorder. At times I thouight I'd never make it. It's not that I never feel anxiety anymore...but I feel it less and less. And I know how to control the anxiety when it does happen...and how to stop it from preventing me from doing the things I want to do."
Seek support from others. Because of the very nature of social anxiety disorder, this may be difficult for you. However, many people who have joined social anxiety disorder support groups, or have spoken to others with sociial anxiety disorder, find it a very helpful and positive experience.
Take an active role in your recovery. If you haven't felt any improvement after a few months of therapy, feel free to discuss a change in your treatment program with your doctor.

Most importantly, know that you can overcome social anxiety disorder. Keep a goal in mind, whether it's to speak to a group of people, ask someone for a date, go to a party or make new friends. Recovery may take work, but it's well worth the effort.

WHERE TO GO, WHOM TO TALK TO

The following organizations can give you more information on a social anxiety disorder, other anxiety disorders and their treatment.
American Psychiatric Association
Box SP98
1400 K. Street, NW
Washington, DC 20005
(202)-682-6000
www.psych.org

Anxiety Disorders Association of America
11900 Parklawn Drive
Suite 100
Rockville, MD 20852-2624
(301)-231-9350
www.adaa.org

Freedom From Fear
308 Seaview Avenue
Staten Island, NY 10305
(718)-351-1717
FFFNADSD@aol.com

National Institute of Mental Health
Toll-free anxiety disorders information services:
(800)-647-2642
www.nimh.nih.gov/anxiety

What to Read?

Triump Over Fear:
A Book of Help and Hope for People With Anxiety, Panic Attacks, and Phobias.
By Jerilyn Ross, MA, LICSW, 1994

Dying of Embarrassment:
Help for Social Anxiety and Phobia
By Barbara Markway, PhD, Cheryl Carmin, PhD, C. Alec Pollard, PhD, and Teresa Flynn, PhD. 1995

Social Phobia:
From Shyness to Stage Fright
by John R. Marshall, MD 1994

It's Not All in Your Head
By Susan Swedo, MD and Henrietta Leonard, MD 1996

Feel the Fear and Do It Anyway
by Susan Jeffers, PhD 1987

I hope this has helped you somewhat. I got this information from a pamplet I picked up while in my doctors waiting room. I suffer from Social Phobia. But I am currently on medication and have read a few of those books and I am getting better every day.
You Can To!! God Bless