Social anxiety disorder (SAD), alternatively known as social phobia, is a recognized psychological condition affecting millions of people. While many of us may feel anxious at the thought of delivering a speech or undergoing a job interview, those with this disorder may suffer crippling feelings of inadequacy and public rejection. This is not to be confused with a panic attack disorder, although some of the physical symptoms may be similar. Sufferers understand intellectually that their fears are largely unfounded, but they cannot use the coping mechanisms others have mastered. It's as if they live their entire public lives under a harsh and critical microscope.
This condition is one of five anxiety disorders recognized in the DSM-IV, a classification manual used by psychiatrists and psychologists. Many patients who seek treatment for it may have already been misdiagnosed as schizophrenic, bi-polar, clinically depressed or agoraphobic. The difference is that many social anxiety disorder sufferers exhibit normal social skills when alone or in small groups under private conditions. It is only when confronted with large groups or unfamiliar surroundings that the symptoms of SAD are most noticeable. The person may feel others are constantly judging his or her appearance, or a perceived authority figure will punish him or her in some way.
Shyness in public is not the same as true social anxiety disorder. In fact, it is not even considered a criteria for diagnosis. What matters more is a definite physical and emotional reaction to social circumstances. A SAD sufferer may feel nauseous at a company mixer, or sweat profusely when asked to speak in public. For the afflicted, relief isn't simply a matter of coming out of one's shell or becoming more animated in public. Many actors and other performers with this condition can function perfectly well on stage, but feel severely uncomfortable around large crowds when not performing.
Treatment is generally a combination of cognitive-behavioral therapy and various drug regimens. Cognitive-behavioral therapy is generally an individual or small group technique in which the counselor and patient discuss the anxiety objectively. Over a number of sessions, the patient experiences more and more social interaction and analyzes his or her reactions. Eventually, many sufferers learn to recognize triggering mechanisms and develop the means to cope with them. Mood-altering drugs may also keep patients from experiencing the unnatural highs and lows which often complicate their condition. Social anxiety disorder may not always be curable, but it can be controlled through cognitive-behavioral therapy and personal determination.