Can We Skip the Social Phobia Diagnosis?
One of the most important factors contributing to the underrecognition of social phobia is the perception of social phobia as an exaggerated view of normal shyness and social anxiety. Shyness can be accepted as a normal behavior in different cultures, and even in the presence of a significant disability, this situation may not be seen as a reason for seeking medical attention.
Those suffering from social phobia often develop lifestyle strategies that help them cope with their situation. It has been reported that patients with social phobia have two times more alcohol problems than the general population, and people with alcohol problems have nine times more social phobias than the general population. While these strategies limit their social functions, they result in patients accepting the restriction on their lives and not seeking treatment. Chronic depression may accompany the majority of people with social phobia. Addiction becomes an additional problem that we encounter quite frequently in this group, as people with social phobia begin to rely on alcohol and other substances that they think increase their self-confidence in order to cope with this distress.
It is studied to determine if other conditions are causing the social phobia or if another physical or mental health problem is accompanying the condition. For this purpose; A physical exam is done to help assess whether any medical condition or medication is triggering anxiety symptoms. It is discussed how often and in what situations the symptoms occur. Anxiety level is evaluated with specially prepared tests to determine the degree and level of Social Phobia. The most commonly used of these tests is the social phobia symptoms scale developed by Liebowitz. It consists of 48 questions. There are questions about social situations in which people perform fear or avoidance behavior. The questions answered according to the fear experienced in these social situations in the first 24 questions. In the last 24 questions, the questions answered according to the avoidance of the same social situations. It is a test developed to evaluate social relations and performance status. This test is not medically conclusive. The diagnosis is not made based on the test result, but it provides an idea for people who suspect that they are social phobic.
The social situations determined in the Liebowitz Social Phobia Scale are as follows.
Telephone conversation in public
Take part in a small group activity
Eating in public
Drinking in public
talk to someone in authority
public speaking, role playing
go to party/fun
Working while being watched by others
Writing while being watched by others
Talking on the phone with someone you don’t know very well
Talking face to face with someone you don’t know very well
Using public toilets
Don’t enter someone’s room
be the center of attention
Giving an impromptu speech at a meeting
Being tested for ability, ability or knowledge
Expressing disapproval or disagreement with someone you don’t know well
Don’t look into the eyes of someone you don’t know very well
Presenting a pre-prepared report orally to a group
Trying to pick someone up for romantic or sexual purposes
Returning a purchased item for a refund
Party / invite
Resisting a persistent seller
How to Recognize Social Phobia
The child with the symptoms of social phobia is shy, cannot reveal himself in the lesson, does not ask and does not speak unless he is asked a question, hesitantly responds with short sentences, embarrassed and bored, does not make eye contact, cannot fully reveal his knowledge. For this reason, students who have a great difference between written and oral exam success should be evaluated in this sense. Trembling on the face and sweating in the hands are the most important symptoms. The teacher can notice this situation and inform the family. Children who have low academic achievement, who cannot show their capacity, who have difficulties in friendships, who experience shame in relations with the opposite sex, who are alone in the group and cannot establish and maintain a friendship, but can establish relationships with others by standing by their friends can be noticed immediately. It’s also possible for a social phobic child with social phobia symptoms to be completely alone, which can help the teacher understand.
Physical Symptoms of Social Phobia;
If your professional job requires intense social communication, anything you do to avoid social situations may negatively affect your success. Eating and drinking in front of others, talking on the phone, signing, arguing can cause intense anxiety. The inability to look into the eyes of the person being spoken to is another symptom. Sometimes even the thought of “being the center of attention”, which can be very attractive for many people, can be wearing out. One of the thoughts that increases the anxiety experienced is the fear that “this situation” will be noticed by other people and made ridiculous. The decline in their self-confidence and self-esteem makes people with social phobia hypersensitive and intolerant of rejection and negative evaluation.
Anxiety, fear, irritability
Urgent need to urinate
sweating, hot flashes
Palpitations, dyspnea, dyspnea, tachycardia
Gastrointestinal discomfort, abdominal pain
rapid breathing, difficulty breathing
Dizziness, feeling faint
Psychological Symptoms of Social Phobia;
Feelings of powerlessness and inadequacy
Worrying excessively days, weeks, or even months in advance of social status
Fear of being watched and judged, especially by people you don’t know
Excessive fussiness and anxiety, even in everyday communities
Fear of embarrassing or humiliating yourself
Fear that others will notice that you are nervous
Avoiding social situations that will negatively affect your life
Perception of physical ugliness and dislike
Don’t feel like you don’t deserve the love given
Refrain from making mistakes and the desire to be perfect
Constant anxiety but try not to show it
The state of being and behaving perfectly
The desire to gain the continued appreciation of the society
Inability to enter an environment of fear or shyness
A constant desire to escape and leave the environment
Inability to make and avoid eye contact with people
Sometimes the symptoms can be so extreme that it can become very difficult for people to go about their daily lives. Individuals with this disorder feel powerless, alone, and become isolated from society over time. These people either cannot enter social environments or romantic relationships at all or have limited relationships. Anxiety; It significantly affects their daily routines, professional performance or social life and as a result makes it difficult for these people to finish school, find a job by interviewing, form friendships and romantic relationships. Social phobia, social phobic people feel excited and distressed when they have to meet a new person in the environment they live in. If this person is a student, he/she has difficulty speaking in class due to his/her social phobia and avoids speaking. If he has to speak, his face may become flushed, his voice hoarse, trembling in the hands, blockage in thought, and even a situation such as cessation of speech may occur.
The secondary negative effect of social phobia is also manifested by a tendency to withdraw from society. In the early stages of social phobia, the child cannot tell this problem to anyone because of embarrassment. The severity of social phobia can be overlooked, as shy children in our society even receive praise. If the disease is not known and not intervened in time, the child will have difficulties in the future. The problem worsens during university years. Because if left untreated, the problem gets deeper and deeper.
Symptoms of Social Phobia in Children
May notice a lack of social skills
Perceiving himself as inadequate
He knows he’s missing something because he can’t relate
Can’t stay in a relationship with someone she just met
Can’t start chat
He remains a listener, which lowers his self-confidence.
Depression develops secondarily.
It can be seen as crying, not leaving the parent alone and clinging to him or tantrums.
Does Social Phobia Start in Childhood?
Social phobia symptoms are a disorder that starts in childhood and the first symptoms are seen in preschool ages. For example, when you put 100 children in a new unfamiliar area, 70 percent of them adapt easily, 15 percent take over the environment, another 15 percent remain shy, cry, do not want to leave their mother, and have difficulty adapting to the new environment. Considering the children who have difficulties in starting school, it can be said that this is an important symptom. The symptoms of social phobia are that the child is very shy and shy, wants to return home immediately in new environments, and is clinging to the parents, which is a definite state of alarm. This indicates that the child will have social phobia.
Because parents are overly perfectionist, protective and protective, not being allowed to meet any of their needs, and a very protective and restrictive environment causes the child to become a socially phobic individual in the future. For this reason, children with social phobia symptoms should be brought into different environments from a young age. It is necessary to ensure that he spends a lot of time outside the home, even in open spaces. Today, urbanization, living in an apartment, having little feet on the ground, working of parents, staying at home with a caregiver can be counted among the reasons that prepare social phobia.