Holidays can fuel social anxiety

November 20, 2006|by TIFFANY ARNOLD

For millions of Americans suffering from social anxiety disorder, the simple thought of attending a holiday party can cause a sufferer to tremble. Long lines at the store checkout counter could have a worse effect. More severe cases might result in loss of bladder or bowel function.

Unlike shyness, social anxiety disorder, which can encompass multiple social phobias, is characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations, such as writing in front of others or interacting with strangers. Physical symptoms range from blushing, profuse sweating and trembling to nausea, fainting and loss of bladder control, according to National Institute of Mental Health, a division of the National Institutes of Health.

While many people might have experienced symptoms of social anxiety at any given time, it becomes a more serious matter when it affects a sufferer's ability to function at work or school or in life, said Dr. William Narrow, associate director for the division of research for the American Psychological Association.


The disorder can be further aggravated during the holiday season, as invitations to social functions and increased public interaction are likely.

"It is not a mental disorder to be shy," Narrow said. "But if you feel your shyness has crossed the line, so that it is not a normal level of shyness, you should seek treatment."

Social anxiety disorder is easily treated through a combination of therapy and medication. Teaching coping mechanisms, such as breathing exercises is helpful, said Hunter Abbott, a clinical social worker for Washington County Behavioral Health Services.

But it has to be diagnosed first. Social anxiety disorder often goes unrecognized and untreated.

"It's something that hides itself in the folds of other diagnoses," Abbott said.

While the disorder itself is common, the term "social anxiety disorder" didn't appear in mental health jargon until the early '80s and had generally been folded into the broader category of anxiety disorders, Narrow said.

During the last 20 years, attempts at determining how many people have the disorder have wielded differing results.

The NIMH estimates 5.3 million people have social anxiety disorder in any given year. The Anxiety Disorders Association of America puts the number at 15 million people. Other psychiatric studies place the disorder third among most common mental disorders in the United States.

"It's not very easily tracked," said Dr. Kenneth Hoffman, a federal Substance Abuse and Mental Health Services Administration medical officer. Hoffman said he's seen the number of people diagnosed with social anxiety disorder range anywhere from 3 percent to 14 percent of the U.S. population.

In 2000, Narrow released a study on the prevalence of mental illnesses. The study, Narrow said, suggested that prior estimates might have overstated the number of people suffering from social phobias. The people surveyed in prior studies, Narrow said, might have suffered the symptoms of a social phobia, but they might not have met the criteria for "clinical significance" - meaning the symptoms weren't severe enough that the individuals sought treatment or experienced serious difficulty in performing day-to-day tasks.

Narrow estimates roughly 3 percent of the population suffers from some form of social phobia.

Hoffman said the best thing for those suffering from social anxiety disorder is to avoid pressure during the holiday season by discussing coping mechanisms with a mental health official before the season hits full swing.

"The natural tendency is to just get through the season, the idea of going on autopilot," Hoffman said. "You don't want to put your needs secondary, making up therapy appointments later. It's good to be proactive about it, thinking of solutions in advance."

If you think you might be suffering from a mental condition contact the Behavioral Health Services of Washington County Health System by calling 301-766-7600.

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