The disorder, which is called social anxiety disorder, social anxiety disorder or social phobia, is defined as a state of unreasonable fear, embarrassment, distress in one or more situations that may be evaluated by others. Individuals with social anxiety disorder experience intense anxiety and distress in situations that require performance such as making presentations, speaking in public, or in social parts of daily life such as meeting new people. Individuals intensely experience the anxiety of being judged by others in society. They have a constant and distinct fear of being embarrassed and disgraced. These intense distresses they experience can encourage individuals to avoid situations in which they are uncomfortable and cause individuals to become lonely and alienate from society. Individuals are able to work in jobs that are below their abilities due to the social fears and anxiety they experience intensely, and they can continue their lives in jobs that are less satisfied but require less social demand by avoiding social situations rather than coping with them.
When an individual with social anxiety disorder enters an environment where he feels uncomfortable, the most obvious symptoms are palpitations, tremors, sweating, tension, stomach discomfort, dry mouth, crying, and redness of the face. Individuals experience these feelings in their own bodies and think that these symptoms will be seen and noticed from the outside, and they focus intensely on this. According to DSM-V diagnostic criteria, fear, anxiety or avoidance is a continuous state and can last for 6 months or longer than 6 months. Individuals pay more attention to their internal symptoms than external cues. For example, a person who goes out to give a presentation to a class of 50 people focuses on his own physical symptoms (tremor, blushing, anxiety, fear, etc.) rather than what the other people think.
The mean age of onset of social anxiety disorder varies between 13-20 years (Karamustafalıoğlu & Yumrukçal, 2011). The age to apply for treatment is usually 15-20 years after the onset of the problem. The reason for this delay may be that it is not known that social phobia is a treatable disorder and individuals with social anxiety disorder see this disorder as a part of their personality (Dilbaz, 1997).
Low education level, unemployment, low socioeconomic level, being never married, lack of social support in the early stages of the disease, genetic predisposition and trauma are among the main risk factors for the disorder (Wittchen & Fehm, 2001). The incidence in women is more frequent than in men (Ohayon & Schatzberg, 2010).
The incidence of social anxiety disorder and another pathological disorder is quite high. Social anxiety disorder can be seen together with many pathological disorders such as mood disorders (major depression, bipolar disorder), agarophobia, specific phobia, obsessive-compulsive disorder (OCD), alcohol addiction and avoidant personality disorder (Ohayon & Schatzberg, 2010; Acarturk, et al. Graaf, van Straten, Have, and Cuijpers, 2008; Schneier, Johnson, Hornig, Liebowitz, and Weissman, 1992).
Can Social Anxiety Disorder Be Treated?
Medication can be used in the treatment of social anxiety disorder, but it is not sufficient. A treatment program with clinical interviews is very effective for individuals. At this point, individual or group therapies come into play. Among our long-term goals; It should be to ensure that the individual interacts socially without anxiety and unnecessary fear, to participate in tasks that require social performance without fear and anxiety, to enable the individual to develop social skills that will increase the quality of his relationships, to develop skills that will increase the recovery and support system and structure relationships (Jongsma, Jr, Peterson & Bruce, 2014).
In individual therapies, negative thoughts of people with social anxiety disorder are determined first. These negative thoughts are often distorted and inaccurate. At this stage, cognitive distorted thoughts are organized. The individual is already aware that his fear is excessive or unreasonable. In the beginning, basic beliefs such as ‘I am incompetent’, ‘I am stupid’, ‘I am incompetent’, ‘I am weak’ and automatic thoughts such as ‘he will understand when I am excited/fry’, ‘he must think I am stupid’, ‘everyone will laugh at me’, and these thoughts will be resolved. it is rationalized, that is, it becomes logical. Then, as the second step, the behavior of the individuals in the process is studied. Behavioral goals are determined with the cooperation of the client and the therapist, and homework is given to ensure the behavioral activation of the individual. For the individual with social anxiety disorder, these assignments are usually assignments that include more social activities such as meeting new people, making presentations in the community, eating out alone.