Social Phobia

Published in Perpectives Magazine - January 2000 by arah Chana Radcliffe, M.Ed., C.Psych.

Many people suffer silently with a devastating disorder – social phobia. Indeed, one out of twelve people – 8.2% of the population – are afflicted but almost none of them seek or receive treatment! The reason for this is two-fold: 1) this common disorder is rarely asked about during routine interviews in doctors’ offices or even in psychiatric facilities and 2) sufferers tend to think of it as a “personality” thing rather than a mental health problem and they therefore don’t come forward for treatment. The result is high costs for both individuals and society.


What is Social Phobia?

Social phobia is an intense anxiety that occurs in situations of public performance in which a person feels he may be observed, judged or scrutinized or otherwise exposed to strangers. It can manifest, for example, as fear of public speaking (standing up in front of an audience), of speaking in public situations (as a member of a class or business meeting, for instance), initiating conversations, speaking to authority figures, or of eating or writing in public. Finding oneself in a socially threatening situation may result in panic attacks. Many people with this disorder understandably attempt to avoid their distress by avoiding social or performance situations altogether.

The severity of this disorder is quite high, causing sufficient distress to sufferers that its suicide rate is similar to that of the depressed population. Social phobia tends to begin in childhood and is a chronic, life-time disorder when left untreated. It often coexists with other mental health problems such as anxiety disorders and depression. People with social phobia have twice as much work absenteeism as others and signficantly lessened productivity. They utilize the health care system more often, posing a social expense. Educational and occupational progress is strongly affected, with an average earning of 15% less in wages than they would otherwise be expected to achieve. Often people cannot advance in their careers because they cannot handle the increasing social demands of their professions. For example, a salesperson may not be able to handle the meetings involved at higher levels of staff functioning and therefore does not advance to those levels. Students with social phobia consistently underfunction and demonstrate enormous test score differences on measures of academic function such as the SAT.


Drug Solutions

The tragedy is that social phobia is a highly treatable disorder! There are both pharmaceutical and psychological interventions that are highly effective. For example, there are specific medications such as betablockers that can be taken for performance anxiety during oral examinations or public speaking. These can eliminate blushing, rapid hearbeat, sweating and other highly unpleasant symptoms, allowing a person to perform smoothly and comfortably. The SSRI’s (peroxatine, for example) have been used successfully to reduce the more chronic forms of social phobia (as opposed to providing relief for a particular performance occasion). These have a long “onset” for effectiveness with this disorder – 6 weeks or longer before the drug begins to take effect in the system. However, the results are worth waiting for! People who have suffered unbearable discomfort may feel relaxed around people for the first time in their lives. Other medications have also been found to be effective in the treatment of this disorder such as nardil, parnate, clonazapan and clonapin. It is best to see a psychiatrist about the correct medication since psychiatrists are highly trained to titrate medications – that is, find the correct medication in the correct dosage for a particular individual.

There are some people who prefer not to use psychotropic medications or who have tried them without success. The alternative health field also offers effective treatments for anxiety reduction. The professions of herbology, homeopathy, biofeedback, acupuncture and other naturopathic sciences all have treatment solutions for anxiety processes and may be helpful in the treatment of social phobia.

Cognitive-behavioural therapy has also been found to be very effective in the treatment of social phobia. Particulary beneficial are the group treatments of cognitive-behavioural therapy which provide needed exposure that ultimately reduces or cures anxiety. Similarly, non-therapeutic groups such as the Toastmaster’s organization (a group which supports people in learning how to speak up in public situations) are also quite effective. Some of the newer psychological treatments for anxiety such as EMDR or Thought Field Therapy can also provide relief.



Parents who note that their children are showing symptoms of social phobia would be wise to initiate treatment as soon as possible in order to prevent a life of unnecessary suffering. Speech and Drama Teachers are specially trained and licenced to teach children to overcome the fear of public perform. Thought Field Therapy can also be very helpful for children. For adults already afflicted, don’t give up! Try several different approaches and consult different practitioners as needed. If you’ve never pursued even one treatment, now’s the time to begin. If you’ve tried one without success, try another! New advances are being made daily in the mental health field, so give yourself the chance you deserve – the chance to live a fuller, happier life!