MENTAL HEALTH
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DR. RAVI SAMUEL
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Social Anxiety Disorder can place many restrictions on one’s life. But, with treatment, it is possible to overcome it.
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Photo: S. Gopakumar
Avoiding people: People with SAD cannot cope with other persons.
What is Social Anxiety Disorder?
In social anxiety disorder (SAD) a person experiences extreme anxiety when they have to interact with known and unknown people irrespective of gender. Patients avoid all types of social functions, get-togethers and parties.
SAD is found among both men and women. These people lead a normal life expect in relation to interacting with people. They take a very long time to relate to other people including colleagues. They form very few close relationships within and outside the family. Invariably the person with whom they form relationships are also socially shy people.
Do people develop this in childhood or as adults?
A person can acquire SAD as a child or develop it during adulthood. Socially shy parents or parent may teach the child to avoid unnecessary interaction, which the child may follow in the initial years. Then it becomes their nature to avoid people. In adults, it can happen when successive relationships result in disappointment, rejection, criticism or being exploited financially or sexually. Similarly people who were subjected to emotional abuse may develop SAD.
Take the case of the college boy befriended by a married woman. She told him about her unhappy life and how he made her very happy. Hearing such sentiments, the boy took it upon himself to keep the woman happy.
After five years, to his shock and disbelief, he saw her getting very intimate with her boss. She also started avoiding him. The boy became very withdrawn and developed a distrustful attitude. He started avoiding people even for official purpose. Whenever he had to meet someone, he would make an excuse. This affected his work to the extent that he lost five jobs. This does not mean all exploitative relationships lead to SAD!
How does it affect a person’s life?
The sense of avoidance is so high that they will not hesitate to resign their jobs if it necessitates interaction with people. Even if the salary is lucrative, they will refuse promotion and remain in a self-defined comfort zone.
In a married couple, if one partner has social anxiety, the other person’s friendliness can be misinterpreted as loss of interest in marriage, or even unfaithfulness. This can lead to enormous strain in the relationship.
If motivated to attend a social gathering, they will be silent spectators and will be thinking of how to leave the place. Seeing their discomfort, people slowly stop inviting them for social gatherings.
What is the treatment for Social Anxiety Disorder?
SAD is 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 along with anxolytic medication. In this, the person is enabled to identify the initial experience, which leads to the formation of thoughts process causing the anxiety.
The CCLD approach — ‘Challenging’ old faulty beliefs and thoughts, ‘Controlling’ the physical manifestation of anxiety that leads to avoiding the situation, ‘Learning’ what to say after saying hello and ‘Doing’ interactive sessions with people initially in role play with the therapist and then slowly moving towards real life situations — is believed to be very helpful. The entire therapy takes about 15 sessions and the progress 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?
There is no definite epidemiological data to answer this question. Around five per cent of people could be suffering from this disorder.
What is the biggest hurdle involved in fighting Social Anxiety Disorder?
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 do they look for treatment.
People 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.
People with social anxiety disorder 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.
