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Anxiety Attacks in Social Anxiety Disorder / Social Phobia

Ruy Miranda
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What is Social Anxiety Disorder / Social Phobia

The Social Anxiety Disorder, a.k.a. Social Anxiety, Social Phobia, and Social Phobia Disorder, is a mental disorder that is expressed through anxiety attack symptoms (and signs) during social contacts and performance . The intensity of the anxiety in such situations and the common occurrence over a period of months points to this diagnosis. In some cases it is difficult to differentiate it from intense Shyness.


The anxiety attack symptoms vary and range from sudden and intense anxiety symptoms to those of panic. Between the two extremes, there is a gradation. They also vary from circumscribed situations to generalized social situations. This last one is known as Generalized Social Anxiety Disorder.


-- Sudden and Intense Anxiety – In this extreme, there are physiological symptoms of fear: a fast-beating heart, quick breathing, chest oppression, tremor in the extremities, sweating, dry mouth. In parallel, there are psychological symptoms: difficulty in thinking in an orderly fashion and the expectation of being offended.


-- Panic Attacks – In this extreme, there are more markedly sharp symptoms of fear, especially those of a psychological nature: total incapacity to think, except for the urgency to get away from the location one is in, space and time disorientation, and temporary loss of the notion of self.


The sudden appearance and short duration justify the name attack. The irrational perception of a threat, during the attacks, justifies the name phobia.


The term "symptoms" is improper for what is being described here, but it has been consecrated by use. The descriptions of "symptoms" here include signs, and they are two distinct things. The symptoms are subjective (examples: pain, apprehension). The signs are objective and can be measured (examples: fever, heart beat acceleration). We have signs and symptoms in the so-called Anxiety Attack Symptoms.

Causes of Anxiety Attacks in Social Anxiety

The name Social Phobia/Anxiety suggests that the causes of anxiety attacks are found in social situations. The main causes are :

* being with unfamiliar people;

* being the target or thinking that one is the target of evaluation by others.


-- Being with unfamiliar people – This can be quick, such as when the person is introduced to someone, or longer, as in participating in a drawn-out meeting . The contact with strangers is a decisive factor. Yet, in certain situations, the person may actually be exposed to known acquaintances, or non relatives, such as at a long party.


The term "exposed" is appropriate because the person thinks that she is being exposed and observed. What she thinks goes through other people's minds, upon being introduced or being in a social setting, is very similar to what happens in Shyness: depreciation, criticism, rejection. The attack may also be triggered by closer individuals: when these people play some practical joke on or make fun of the person.

On the other hand, the person wishes to be helped, takes the initiative of searching for a professional, yet hangs up the phone upon hearing an unknown voice.

-- Being the target or thinking that one is the target of evaluation by others– The phobia attack can be triggered by any performance situation. It can be a situation objectively simple, such as filling out a form in front of someone or eating a sandwich in a cafeteria or to urinate in the presence of others. It can also be a more complex situation, such as taking part in a work meeting or explaining a report or being in direct contact with a superior. Performance anxiety can be very high in any of these situations.

The simple anticipation of any of these situations can also trigger the symptoms. "Just the thought" of being in any of these situations is enough to trigger an attack.

You probably have already seen, and if not you will see, some expressions of anxiety in social situations described as forms of Shyness or Social Anxiety. These expressions are known as Fear of Public Speaking, Stage Fright, and Performance Anxiety. Although they are considered as mild forms of anxiety, similar to Shyness, and are not classified as mental disorders, which is to say they do not have the characteristics of Social Anxiety Disorder. They can in fact be mild. However in some individuals they can assume debilitating characteristics and influence the course of people’s lives, and in these cases we have a disorder. In short , Fear of Public Speaking, Stage Fright, and Performance Anxiety may be Shyness or Social Anxiety Disorder.

Example: An actor or actress suffers a strong bout of anxiety prior to walking onto the stage and has diarrhea, among other psychosomatic manifestations; but as soon as he or she begins to perform, the anxiety disappears. In this case, we are looking at an expression that is closer to Shyness than to Social Anxiety. In a different situation, let’s image that the actor or actress continues to feel anxiety during the performance and that this impairs his or her ability to act to the point that he or she abandons an acting career. In this case, we are faced with an expression of Social Anxiety, subtype Stage Fright.

Consequently, the expressions of Fear of Public Speaking, Stage Fright, and Performance Anxiety may be listed as manifestations of Shyness or Social Anxiety; the difference will be in the intensity and duration of the anxiety attack symptoms, as well as in their repercussions on the life of the person.

Social Phobias, Social Anxiety, Social Anxiety Disorder

Denomination – You may have noticed that I use several names, and this is pursuant to defined objectives. One of them is to demonstrate that, in practice, different names are used for the same clinical condition. Thus, this disorder is also known as:
*Social Phobia/Phobias,
*Social Phobia Disorder,
*Social Anxiety/Anxieties
*Social Anxiety Disorder

However, the tendency is to consolidate the expression "Social Anxiety Disorder."

Names for different clinical conditions:
*Specific Social Phobia (reference to crisis-triggering situations – example: public speaking phobia),
*Specific Social Anxiety,
*Generalized Social Phobia (it occurs in many social situations),
*Generalized Social Anxiety,
*Anxiety Attack in Social Situation,
*Social Anxiety Disorders.

As described, in all of them are present the anxiety attack symptoms.

May, 2004.
Last update: 5,31,2005

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This web site, the Social Anxiety Disorder and Shyness Directory and these articles contained on this web site are not solicitations, are not medical advice and are not intended as medical advice. This web site, the Social Anxiety Disorder and Shyness Directory and these articles are intended to provide only general, non-specific medical information and are not intended to cover all the issues related to the topics discussed. This web site, the Social Anxiety Disorder and Shyness Directory and these articles do not create any physician-client relationship between Ruy Miranda and you, and they do not replace the eventual relationship between you and your physician, psychologist, or other healthcare professional. This article�s author recommends no particular medication and does not represent the interests of any person, company or pharmaceutical laboratory.

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You may want to read other articles on Social Anxiety Disorder / Social Phobia and Shyness:

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Self-Concept/Self- Actualization – Shyness Nucleus

Self-concept, Body Image, Self-depreciation and Shyness

Shyness and Social Anxiety Disorder: Neurophysiological Approach

Shyness Articles:

What Is Shyness? Fear, Anxiety, Anguish?

Questions and Answers on Shyness

Humiliation Stories, School Spankings: Examples of Shyness Causes

Social Anxiety Disorder Articles:

Social Anxiety Disorder: What It Is, The Anxiety Attack Symptoms

Social Anxiety Attacks: Incidence, Onset, History, Evolution

Social Phobia / Anxiety Disorder: Treatment

Social Phobia / Anxiety Disorder: Differential Diagnosis

Avoidant Personality Disorder

Medications in Social Phobia: Side Effects - Part 1

Antidepressants Tricyclics: Side Effects - Part 2

Metabolic Pathways Individual Differences and Medications Side Effects - Part 3

Genetic Changes: Medications Side Effects - Part 4

First Line Antidepressants - Side Effects - Part 5

Social Anxiety and Shyness Articles:

Panic Disorder, Shyness, Social Phobia - Differences

Why Self-Help in Shyness and Social Anxiety Disorder / Social Phobia Doesn�t Help You

Shyness and Social Anxiety Disorder:Medication Action

Facial Blushing, Redness of the Face, Ears and Neck

Psychoses, Shyness and Social Phobia

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