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Expert Speak

Social Anxiety Disorder

Do you Avoid People?
Know more about Social Anxiety Disorder.

Ravi Samuel MA, MPhil, PGCARM (Lond)
Cognitive Behaviour Psychotherapist.

What is Social Anxiety Disorder?

Social anxiety is a disorder found in both men and women who are otherwise very normal people, except when they have to interact with another person outside their immediate family whether they are colleagues, classmates, people living in the same apartment etc. The anxiety that is provoked in such situations is both with members of the opposite sex and same sex. They form close relationships with very few people within and outside the family. They take a very long time to form such relationships. Invariably the person with whom they form relationships would also be socially shy people.

Do people develop this in childhood or as adults?

A person can acquire SAD as a child or develop it as an adult. Socially shy parents or parent may teach the child to avoid unnecessary interaction, which the child may follow in the initial years, and then it becomes their nature to avoid people. In case of adults it can happen when successive relationships result in disappointment, rejection, criticism or being exploited financially or sexually.

How does it affect a person’s life?

The sense of AVOIDANCE will be so high that they will not hesitate to resign their jobs if their job profile necessitates interacting with people, they will drop out of a relationship if their partner starts getting friendly with others. Even if the salary is lucrative they will refuse promotion and remain in a self-defined comfort zone.
If one married partner has social anxiety then when the other partner gets friendly with a third person even if it is with a person of the same gender it can be misinterpreted as loss of interest in marriage, or even as being unfaithful. This can lead to enormous strain in the relationship and the partner may have to stay away from all relationships which may be realistically possible in the initial years but after few years it can lead to enormous frustration.
Patients with SAD will avoid parties and will find a good excuse to stay away. If someone manages to motivate them to attend a social gathering they will be silent spectators during the event and even while they are there they will be thinking of how to leave the place. So seeing their discomfort and silent participation people slowly stop inviting them for social gatherings.

What is the treatment for Social Anxiety Disorder?

SAD has to be treated with Medicines and Psychotherapy. Social anxiety manifests due to faulty thought processing, dysfunctional beliefs and consequent anxious physical reactions. This can be either secondary to a traumatic real life experience or totally imagined.
Cognitive Behaviour therapy is very effective in treating this disorder along with anxolytic medication. In this therapy the person is enabled to identify the initial experience, which leads to the formation of thoughts process causing the anxiety.

Formation of Social Anxiety

Cognitive Behaviour Therapy, which is aimed basically towards overcoming the anxiety of socialisation and developing social skills, is an effective treatment for Social Anxiety Disorder. The CCLD approach, ‘Challenging’ old faulty beliefs and thoughts, ‘Controlling’ the physical manifestation of anxiety which leads to the person avoiding the situation, ‘Learning’ what to say after saying hello and ‘Doing’ interactive sessions with people initially in role plays with the therapist and then slowly moving towards real life situations is believed to be very helpful.

The entire therapy would last for about 15 sessions and the progress of the therapy directly depends on the efforts of the person to perform the physical and cognitive homework.

On an average, what is the percentage of people suffering from Social Anxiety Disorder?

We do not have definite epidemiological data to answer this question. My rough estimate would be about 8 to 10 per cent of people could be suffering from this disorder. Due to cultural restrictions women are more vulnerable towards developing this condition.

What is the biggest hurdle involved in fighting Social Anxiety Disorder?

  1. People do not consider this as a problem and so they just learn to live with it. Only if it grossly disturbs their vocation or marital relationship they look for some kind of treatment.

  2. Indians have a tendency to expect medicines or their birthstone to solve their problems. Instead if they put in efforts on physical and cognitive exercises they can easily overcome this embarrassing and socially paralysing disorder.

  3. People with social anxiety disorder avoid situations, consequently they live a very restricted life, which they find to be comfortable and compromise on many aspects of life. The comfort feeling they have is another hurdle that prevents them from seeking help.

Ravi Samuel has done MPhil in Social Work specialising in Medicine and Psychiatry. He has undergone training in Counselling and Cognitive Behaviour Psychotherapy at the National Hospital, UK. He has over 16 years of experience in treating people with emotional,behavioural, psychological, psychiatric problems,marital problems and Interpersonal conflicts at the workplace. He has expertise in treating people with Anxiety Disorders, Depressive Disorders, Obsessive Compulsive Disorder, Social Anxiety Disorder and Conversion Disorder (Hysteria). He also provides Cognitive Rehabilitation for patients with brain damage. He also has specialised software to provide cognitive stimulation to students with poor memory and for those with concentration problems. He has been certified by the Rehabilitation Council of India. He has presented many papers in International Conferences and has written many articles in many International Scientific Journals.

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