Social Anxiety Disorder (SAD)

SAD is characterized by a persistent fear of social or performance related situations in which embarrassment could occur. People with SAD experience so much social anxiety in these situations that they commonly avoid them, leading to interference in their daily lives. SAD can lead to high levels of academic and occupational impairment. Situations commonly feared or avoided by individuals with SAD include public speaking (the number one fear in the U.S.), conversations with others, interacting with authority figures, using the telephone, being introduced, reading aloud, participating in class, eating or drinking in front of others, writing in front of others, dating, and social events. SAD may also cause difficulty in using public restrooms due to paruresis or shy bladder (i.e., can not urinate while others present despite a strong urge to).

There are two subtypes of SAD. The first is called specific. In specific SAD, individuals tend to be relatively comfortable in most social situations, but dread one or a limited number of them. Generalized SAD sufferers fear and avoid a wide range of social situations. Individuals with generalized SAD tend to have a greater level of interference caused by their condition.

SAD affects 13.5% of the U.S. population. It is unclear whether SAD affects more men than women. Research has shown it to be more common in women, however, clinically it may be more common in men. The average age of onset is roughly 15, however, signs of SAD maybe present even in toddlers. Due to these early warning signs many believe that SAD is caused by some, at the present, unknown biological abnormality. There is also evidence that this biological factor may be influenced by environmental factors.

SAD is also very treatable in most cases. Certain anti-anxiety and anti-depressant medications have been found to be helpful in reducing the symptoms of SAD. These medications themselves are rarely enough, and in most cases should be used in combination with therapy.

Cognitive-Behavioral Therapy (CBT) has been found to be effective in reducing SAD symptoms as well. This teaching model trains individuals in skills found to be effective in managing social anxiety and avoidance behaviors. For SAD these skills may include social anxiety monitoring, respiratory control (i.e., slow, controlled breathing), cognitive restructuring (i.e., identify and correct errors in thought), and invivo exposure (i.e., exposure to feared situations). Social skills training may also be necessary. Success rates of roughly 75% have been found using these methods. For some SAD sufferers the most effective and efficient form of treatment may be a combination of medication and CBT.