Most people suffer from shyness or anxiety at some point in their lives, but are such feelings so pervasive as to constitute a diagnosis of social phobia? Here are a few quick questions that can help determine whether or not a person’s fears warrant further review by a primary care physician or mental health professional.
- Have you skipped classes because you were afraid that you would be called upon?
- Does asking someone for a date seem impossible?
- Have you not pursued a job because of the fear of going through the interview?
- Have you turned down promotions because the new position would involve giving presentations in front of people?
- Do you find it necessary to have an alcoholic beverage to lower your anxiety before social engagements?
If you think you might have social phobia, make an appointment with a mental health professional who can evaluate your concerns to determine if treatment is warranted.
Mental Health professionals use a variety of tools to help them assess whether people have social phobia or some other disorder. This can include some or all of the following:
- clinical interview
- self-report questionnaires
- symptom rating scales
- behavioral evaluations
The questionnaires and rating scales give the practitioner an idea of how a person’s experiences and attitudes compare to those expected in the population at large. A person also might be asked to keep a diary or daily log of thoughts and actions as a way to indicate what her life is really like.
Some practitioners also might have people take on a role-playing assignment or give a speech. Those activities can reveal an individual’s response to a social situation, although it is one that has been crafted for evaluation’s sake.
The information gathered will help the health professional compare the person’s characteristics to those described in the Diagnostic and Statistical Manual of Mental Disorders. The fourth edition includes these among its diagnostic criteria:
- A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.
- Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed panic attack.
- The person recognizes that the fear is excessive or unreasonable.
- The feared social or performance situations are avoided or endured with intense anxiety or distress.
- The avoidance, anxious anticipation or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational or academic functioning, social activities or relationships, or there is marked distress about having the phobia.
- The fear or avoidance does not result from the effects of drug or alcohol abuse, a medication or a general medical condition.
- If a general medical condition or another mental disorder is present, the fear is unrelated to it.
For children, there are some additional considerations. These include the following:
- There must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.
- The anxiety may be expressed by crying, tantrums, freezing or shrinking from social situations with unfamiliar people.
- Children may not recognize their fear as excessive or unreasonable.
- In those under 18, the symptoms must have lasted for at least six months.