May 23, 2005
I am hoping you can tell me about social phobia. This past year, I have had to visit the emergency room nearly once a month after having attacks. These panic attacks come on whenever I face very crowded and busy social situations, especially weddings or similar large parties. My heart beats fast, I sweat, and I feel dizzy. It’s awful.
My doctor diagnosed me as having social phobia and he offered me medication. I want to avoid medication because I am scared of all the side effects. Also, this is a new problem that started suddenly last year. I tried to get information about social phobia from the net, but it all seems to be advertisements for different pills. What can you tell me about my situation? Is there an alternative to medication for this problem?
I am sorry that you are having difficulty finding information about social phobia online. From the frequency of your emergency room visits, it is clear that this issue is having a significant impact on your life. It also sounds like it is a relatively new problem for you, and I can only imagine how frightening it must be to suddenly in the midst of panic attack symptoms that are so intense.
First of all, please know that you are not alone. Approximately 5.3 million Americans are affected by social phobia.
Social phobia is an anxiety disorder characterized by an overwhelming anxiety and self-consciousness in social situations. People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and of being embarrassed by their own actions. The fear goes beyond mild nervousness or discomfort -- it is so severe that it interferes with work, school, or other activities.
The physical symptoms you described as a panic attack often
accompany the intense anxiety of social phobia. These physical symptoms
may include: blushing, profuse sweating, trembling, and other symptoms
of anxiety, including difficulty talking, a racing heart, and nausea or
other stomach discomfort. It’s a painful cycle -- as you worry
about experiencing the physical symptoms, your chances of developing
-- Fear of one or more social
or performance situations if the person is exposed to unfamiliar
people. And the individual fears that she will behave in a manner that
In your letter, you specifically ask if there is treatment other than medication for social phobia. The answer is a resounding YES! Research has shown that short-term psychotherapy called cognitive behavioral therapy is highly effective in treating social phobia. Cognitive-behavioral therapy works by focusing on two components. The cognitive component helps people change the thinking patterns that keep them from overcoming fear.
A person with social phobia, for example, may think that others are judging them. The behavioral component typically involves exposure, in which a therapist will guide you in confronting your fears while assisting you in managing your anxiety and panic symptoms. While this may sound scary, know that the therapist will work with you to determine the pace and move forward only when you are ready.
Psychotherapy has been proven to be very effective for social phobia. I wish you all the best as you begin your journey to overcome your fears and alleviate your anxiety.
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