Social Anxiety in Adults What is it? The generalized type of social anxiety (social phobia disorder) is a severe and often disabling form of shyness that affects approximately 5% of the general population. Social anxiety disorder is characterized by the fear of being observed or evaluated by others. Individuals with social anxiety fear that they will say or do something to embarrass of humiliate themselves or that others will notice that they are anxious.

Consequently, people with social anxiety often avoid situations where such scrutiny might take place or they endure them with intense distress. Not surprisingly, this can result in impaired functioning and reduced quality of life. Patients with social anxiety may have few friendships, experience trouble dating, drop out of school, reject promotions at work, become demoralized and depressed, abuse alcohol, and develop other psychiatric symptoms.

Are you experiencing Social Anxiety?

Please consider the following statements:

1. Fear of embarrassment causes me to avoid doing things or speaking to people.
2. I avoid activities in which I am the center of attention.
3. Being embarrassed or looking stupid are among my worst fears.

If the above statements describe you, then you may have social anxiety disorder.

Is there help?

Yes. Currently both medication and psychotherapy have been shown to be effective in reducing social anxiety symptoms.

The FDA has approved three medications for the treatment of social anxiety disorder; paroxetine (Paxil), sertraline (Zoloft) and venlafaxine extended release (Effexor XR). Nevertheless, there are several other medications that appear promising.

At the UCSD Anxiety and Traumatic Stress Disorders Clinic, we are conducting two research studies for treatment of social anxiety using investigational medications.

• One study offers a proven treatment (sertraline [Zoloft]) for social anxiety disorder. For those participants who continue to experience social anxiety symptoms after initial treatment, an adjunctive or secondary treatment is offered.
• The second study involves assignment to the investigational medication group or to placebo (a sugar pill or non-active study drug).

Participants in both studies will receive:

• A comprehensive evaluation to determine if they have social anxiety disorder.
• A physical examination with blood and urine tests.
• Visits to our UCSD clinic to monitor your social anxiety symptoms and study the effects of treatment.

Clinical care and medication during the study will be provided at no charge to you. All visits take place at our clinic in La Jolla. For more detailed info about the studies, please call 1-877-UCSD-SHY (1-877-827-3749).

Psychotherapy is also an effective option for some individuals. The type of therapy that has received the most research support is called cognitive behavior therapy. This therapy focuses on helping the person understand their anxiety patterns, helping the individual gradually confront their fears, and changing unhelpful thinking patterns in anxiety provoking situations. You can contact a mental health professional or check out a self-help manual to find out more about this treatment.

If you have mostly public speaking fears you may want to search out organizations where individuals have the opportunity to practice their speaking skills (e.g., introducing themselves, brief presentations, speeches, etc.) in a supportive atmosphere. One of these groups is called Toastmasters International. For more information please visit their website at www.toastmasters.org or check your telephone directory.

Informational Resources

Organization Websites

• Freedom from Fear is a national non-profit mental health advocacy association for anxiety and depressive illnesses.
• Anxiety Disorders Association of America
• For People with Shy Bladder Syndrome (A Form of Social Phobia): This site is provided as a resource for people who find it difficult or impossible to urinate in the presence of others, either in their own home or in public facilities. Also, for people who have difficulty under the stress of time pressure, when being observed, when others are close by and might hear you, or when on moving vehicles.
• Toastmasters provides a non-judgmental atmosphere to become comfortable speaking to groups.

• Antony, Martin M., Swinson R. P. (2000). The shyness and social anxiety workbook, Oakland, CA, New Harbinger Publications
• Dayhoff, S. A. (2000). Diagonally-parked in a parallel universe: Working through social anxiety. Placitas, NM: Effectiveness-Plus Publications.
• Garner A. (1991). Conversationally Speaking: Tested new ways to increase your personal and social effectiveness, New York, NY McGraw Hill
• Markway, B. G., Carmin, C. N., Pollard, C. A., Flynn, T. (1992). Dying of embarrassment: Help for social anxiety and phobia. Oakland, CA: Harbinger Publications, Inc.
• Schneier, F., Welkowitz, L. (1996). The hidden face of shyness: Understanding and overcoming social anxiety. New York, NY: Avon Books.
• Stein, M.B., Walker, John R. (2002). Triumph over shyness: conquering shyness and social anxiety. New York, NY: McGraw-Hill.

Publications

• Social phobia : clinical and research perspectives / edited by Murray B. Stein
• Dayhoff, S. A. (2000). Diagonally-parked in a parallel universe: Working through social anxiety. Placitas, NM: Effectiveness-Plus Publications.
• Heimberg, R. G. Liebowitz, M. R., Hope, D. A., Schneier, F. R. (Eds.). (1995). Social Phobia: Diagnosis, assessment, and treatment. New York, NY: Guilford Press.
• Markway, B. G., Carmin, C. N., Pollard, C. A., Flynn, T. (1992). Dying of embarrassment: Help for social anxiety and phobia. Oakland, CA: Harbinger Publications, Inc.
• Schneier, F. & Welkowitz, L. (1996). The hidden face of shyness: Understanding and overcoming social anxiety. New York, NY: Avon Books.
• Stein, M. B. (Ed.) (1996). Social Phobia: Clinical and research perspectives. Washington, D. C., American Psychiatric Press Inc.
• Stein, M.B., Walker, John R. (2002). Triumph over shyness: conquering shyness and social anxiety. New York, NY: McGraw-Hill.