Social Phobia: Symptoms and Diagnosis
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Social Phobia: Symptoms and Diagnosis
Diagnosis
Diagnosis of social phobia can be very difficult, because it often goes hand in hand with other disorders (see below). Thus, a great deal of effort has been put into creating accurate diagnostic methods. The Social Phobia Inventory, a questionnaire recently developed to assist in the diagnosis of social phobia, asks these questions:
- True/False: Being embarrassed or looking stupid are among my worst fears.
- True/False: Fear of embarrassment causes me to avoid doing things or speaking to people.
- True/False: I avoid activities in which I am the center of attention.
If a patient answers ‘true’ to all three of these questions, chances are high that they suffer from social phobia.
Additional Symptoms
Sufferers are likely to have a number of anxieties and several inaccurate beliefs about the world. Most express a fear of conversation with strangers, but it is small talk that really terrifies sufferers. They fear that the conversation could grind to a halt at any time, and that they will be left with nothing to say, looking foolish.
Many sufferers report that they lack assertiveness. Even when they have a strong opinion on a topic, they will not voice it. Some fear that they will falter for words when asked to defend their position. Others even suddenly doubt the certainty of their own belief.
A distressing symptom is the conviction, “Everyone else is more confident than me”. Sufferers are often convinced that they are the only ones who struggle to find something to say or who feel awkward with strangers. Furthermore, there is a strange self-centeredness that characterizes the sufferers of any anxiety disorder. Social phobics often feel that the entire attention of the room is focused on them, and that everyone is just waiting for them to make a mistake. In reality, of course, people are mostly too involved in their own lives to watch anyone else that closely.
Frequently, social phobia goes along with other phobias, such as a fear of riding in buses. Like sufferers of generalized panic disorder, social phobics tend to be anxious most of the time. Compounded sets of anxieties may be difficult to tease apart, making it difficult to plan adequate therapy.
Many sufferers, particularly men, engage in heavy social drinking to ease social interaction. This can turn to alcoholism. Other forms of substance abuse are also reasonably common. Sufferers report relief at being able to shut off their anxiety chemically. Of course, most drugs do little but mask the problem for a time. After a night of heavy drinking, for instance, a sufferer will tend to agonize about the social ‘mistakes’ that they made while drunk.
Patients may also suffer from chronic depression, as their social anxiety causes strong feelings of general inadequacy. Some become suicidal.
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