Social Anxiety disorder treatment center - Miami, FL
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What is Social Anxiety Disorder?
In order to discuss what social anxiety is, I believe it is crucial to distinguish it from the typical day to day anxiety. The typical anxiety can arise in many scenarios, including social situations, and can lead to physical symptoms; physical symptoms can include a racing heart, sweating, clammy hands, racing thoughts, trembling, and many other symptoms. I would say, in my personal and professional experience, it is common to feel nervous in a new social setting – whether it be a new social connection or a new physical setting. Being presented with new information can be overwhelming and the body, as well as the mind, need time to adapt to all of the information being presented. This form of anxiety is usually short lasting, can waver in intensity, and usually does not cause severe distress for the person.
Just as I mention in my Generalized Anxiety Disorder (GAD) blog, anxiety can be a healthy mechanism because it lets us know that we are not comfortable. It may also signal to us that we might be in danger by sending surges of adrenaline through the body. Or, it could just come from a place of not knowing what to do or what to expect from a new situation. Regardless of the reason, typical anxiety is common and not indicative of a social anxiety diagnosis.
Social Anxiety Disorder, also known as social phobia, has certain characteristics that distinguish it from the typical day-to-day anxiety. According to Bourne (2020):
It involves fear of embarrassment or humiliation in situations where you are exposed to the scrutiny of others or you must perform. This fear is much stronger than the normal anxiety most nonphobic people experience in social or performance situations. Usually, it’s so strong that it causes you to avoid the situation altogether, although some people with social phobia endure social situations, albeit with considerable anxiety. Typically, your concern is that you will say or do something that will cause others to judge you as being anxious, weak, “crazy”, or stupid (p. 13).
Diagnosing Social Anxiety Disorder
The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association [APA], 2013) specifies that there are certain criteria a person who is diagnosed with Social Anxiety Disorder must meet. Besides the previously mentioned characteristics, the fear associated with Social Anxiety Disorder is disproportionate to the situation the individual is facing (American Psychiatric Association, 2013). Furthermore, symptoms must be present for at least six months and “causes clinically significant distress or impairment in social, occupational, or other important areas of functioning” (American Psychiatric Association, 2013, p. 203). Lastly, the symptoms cannot be better explained by any substance, other medical condition, or other mental condition (American Psychiatric Association, 2013).
Social phobia can be specific to certain situations that may arise – such as fear of crowds, fear of public speaking, fear of using public restrooms, fear of talking to new people, or of public speaking - or it may be a generalized phobia towards any social situation in which an individual thinks they might be judged (Bourne, 2020). As a result, “social anxiety disorder is associated with increased likelihood of dropping out of school, decreased satisfaction and productivity in the workplace, lower socioeconomic status, and generally poorer quality of life” (Bourne, 2020, p. 13-14). Social phobia is also found to be co-morbid with other diagnoses such as panic disorder or generalized anxiety disorder (Bourne, 2020).
Who is Affected By Social Anxiety Disorder?
Bourne states that Social Anxiety Disorder can develop sometime between late childhood and adolescence. The symptoms arise during these formative years due to a stressful event such as being bullied or it may develop over time without a triggering event (American Psychiatric Association, 2013). “They often develop in shy children around the time they are faced with increased peer pressure at school” (Bourne, 2020, p. 14). Without proper treatment, the symptoms can increase and intensify through early adulthood; however, the symptoms may decrease in severity over time (Bourne, 2020).
Social Anxiety Disorder can present itself in different ways, depending on the age group. The DSM-5 highlights:
Adolescents endorse a broader pattern of fear and avoidance, including of dating, compared with younger children. Older adults express social anxiety at lower levels but across a broader range of situations, whereas younger adults express higher levels of social anxiety for specific situations. In older adults, social anxiety may concern disability due to declining sensory functioning (hearing, vision) or embarrassment about one’s appearance (e.g., tremor as a symptom of Parkinson’s disease) or functioning due to medical conditions, incontinence, or cognitive impairment (e.g., forgetting people’s names) (American Psychiatric Association, 2013, p. 205).
The pervasive theme among all age groups experiencing symptoms of social phobia is the intense fear associated with specific or general social situations
Social Anxiety Disorder Treatment Options
Cognitive Behavioral Therapy
There are various treatment options available for individuals experiencing Social Anxiety Disorder. Firstly, cognitive behavioral therapy (CBT) has shown to be effective when working with symptoms of social phobia (Neufeld, Palma, Caetano, Brust-Renck, Curtiss, & Hofmann, 2020). In order to change the unhealthy thought patterns a person may experience, the CBT therapist works with the client in order to challenge unrealistic thought patterns and core beliefs (Neufeld et al., 2020). “To accomplish this, therapy is delivered in cognitive restructuring sessions, self-guided exposition sessions, and in vivo exposure sessions” (Neufeld et al., 2020, p. 30).
Exposure is a fundamental component of CBT when working with symptoms of social phobia (Bourne, 2020). Exposure involves the client being exposed to certain situations or triggering stimuli in a step-by-step manner (Bourne, 2020). The CBT therapist guides the client through imaginary as well as in vivo experiences that encourage the client to challenge their unrealistic beliefs (Bourne, 2020). This can be accomplished in an individual or group setting. According to Neufeld et al. (2020), “Group intervention is effective due to the continuous exposure to a social situation inherent in being part of a group” (p. 30).
Another treatment for Social Anxiety Disorder is medication (Bourne, 2020). Medications including SSRI’s - such as Zoloft or Lexapro - or low dosages of benzodiazepines - such as Xanax - have been shown to be effective in treating symptoms of social phobia when combined with cognitive behavioral therapy (Bourne, 2020). In order to make sure the medication treatment you are thinking of receiving is right for you, be sure to speak with a physician before starting any new medications.
Getting Treatment for Social Anxiety Disorder in Miami, Florida
If you or someone you know is experiencing symptoms of Social Anxiety Disorder, reach out to a qualified mental health therapist. Together, you can decide which course of treatment will work best for you.
Galen Hope, a mental health treatment center in Miami, Florida, provides comprehensive services for a wide range of diagnoses and related conditions, including: Eating Disorders, Anxiety Disorders, Borderline Personality Disorder, Dependent Personality Disorder, Mood Disorders, PTSD/Trauma, Psychosis, Thought Disorders, and Schizoid Personality Disorder. Our treatment integrates the best concepts of residential programs, partial hospitalization programs, and community psychology in order to provide an experience that not only feels uniquely meaningful to the client, but also breaks the cycle of repeated hospitalizations, over-institutionalization, and isolation from community and family.
To learn more, or to join our community, contact us below.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Bourne, Edmund J. (2020). The Anxiety & Phobia Workbook. New Harbinger Publications.
Neufeld, C. B., Palma, P. C., Caetano, K. A. S., Brust-Renck, P. G., Curtiss, J., & Hofmann, S. G. (2020). A randomized clinical trial of group and individual Cognitive-Behavioral Therapy approaches for Social Anxiety Disorder. International Journal of Clinical and Health Psychology, 20(1), 29–37. https://doi.org/10.1016/j.ijchp.2019.11.004