Social Anxiety Disorder Prevents Millions of Americans from Having Fulfilling Relationships

New Survey Finds Despite Having Symptoms, People Delay Getting Help for More than a Decade

Silver Spring, MD, April 9, 2008 – Social anxiety disorder can wreak havoc on the social and romantic lives of the 15 million American adults who suffer from the disorder, leaving them isolated, ashamed and in some cases, misdiagnosed, according to a new survey commissioned by the Anxiety Disorders Association of America (ADAA) and conducted by Harris Interactive. One of the most troubling findings is that 36% of people with the disorder, which is also known as social phobia, report experiencing symptoms for 10 or more years before seeking help.

“Social anxiety disorder can have a profound effect on social interactions that most people take for granted,” said ADAA President & CEO Jerilyn Ross, MA, LICSW.  “In extreme cases, the disorder can disrupt social lives to the point that people may have few or no relationships at all, making them feel powerless and alone.” 

Social anxiety disorder, also known as social phobia, is an intense, persistent fear of being scrutinized and negatively evaluated by others in social or performance situations. Social anxiety disorder can cause people to avoid such situations or other people for fear of humiliating or embarrassing themselves. People with social anxiety disorder have excessive, irrational fear of seemingly routine situations, according to the National Institute of Mental Health.

The study found that of the people surveyed:

• 34% said their disorder led to serious fights with their significant others. Ross says this may be because their disorder caused them to have difficulty coping with activities that, to people without social anxiety disorder, seem normal and unthreatening. For example, someone with the disorder may be afraid to attend social functions or family events, which their significant other may find irrational and annoying. 
• 77% said their untreated social anxiety disorder has a negative impact on their romantic relationships. For example, experts say, they may have difficulty discussing their disorder with their partner or feel that their partner does not understand what they are going through, which can lead to difficulty trusting one another.
• 35% said their disorder caused them to avoid intimacy, which Ross says may happen since their experiences dealing with people – or the fear of doing so – cause them to struggle with unbearable anxiety.
• 24% said they felt their disorder caused their significant other to not respect them. Experts say this may be because they fear their disorder is considered a weakness or character flaw.

“The results of this survey highlight the need to effectively diagnose and treat people with social anxiety disorder in a timely manner, before their symptoms worsen and dominate their lives,” says Mark H. Pollack, MD, Director of the Center for Anxiety and Traumatic Stress Disorders, Professor of Psychiatry at Harvard Medical School, and chair of the ADAA Scientific Advisory Board. “And the fact that 36% have symptoms for a decade or more before getting treatment suggests that millions more are suffering.”

Pollack says these symptoms can be triggered by anxiety with relationships or by stress over daily routines; of those surveyed, 75% reported that social anxiety disorder has had a negative impact on their ability to carry out normal activities. The consequences of these symptoms are even more severe when they lead to misdiagnosis, which can happen due to their similarities to other health problems, Pollack says. Furthermore, 69% said they do not want people to think they are crazy, and 58% said they are embarrassed by their disorder. Also, experts say people suffering from social anxiety disorder can become even more anxious and isolated because they are preoccupied with keeping their anxiety from others.

Ross agrees, adding that this likely makes them reluctant to seek help, therefore exacerbating their condition. They may also be unlikely to seek treatment because social anxiety disorder is also characterized by a morbid fear of authority figures, including doctors. Furthermore, people with the disorder often suffer substance-abuse problems including alcoholism, and they may also experience depression, which makes their disorder even more difficult to deal with.

In contrast, 59% who received treatment said it had a major positive impact on their ability to have a romantic relationship, and 39% of those who are currently being treated or have ever been treated said knowing that others have been successfully treated would make them more comfortable with the treatment they receive or have received.

Ross says previous studies suggest that people with social anxiety disorder who do not seek treatment say they are afraid someone will find out about their disorder, they do not know where to go for help, they think they cannot afford help, and they are often ashamed. Unfortunately, the incidence and symptoms of the disorder seem to increase the longer someone with social anxiety disorder goes untreated.

Ross adds that the difficulty of social anxiety disorder is compounded by skepticism that it is a real and serious condition. The disorder is often incorrectly confused with shyness. In fact, it is not uncommon for someone who is not shy at all to have social anxiety disorder. While people who are merely shy may not relish giving a presentation or attending a party alone, Ross notes that people with the disorder find these situations seemingly impossible. They will turn down opportunities involving social interactions, rather than suffer the discomfort. People who are forced into a situation they find anxiety-provoking are likely to become even more anxious and will try to avoid it.

Anxiety is a normal reaction to stressful situations and can even help motivate people in some cases. For example, being anxious about giving a speech can make someone more conscientious about preparing for it. But people who suffer from social anxiety disorder experience terror, not motivation. They suffer symptoms similar to what people experiencing other phobias suffer from. For example, some people suffer intense, persistent fear of heights, flying, animals, elevators, or dental or medical procedures. Even though they know their fear is illogical, they feel powerless to stop it. The fears suffered by people with social anxiety disorder are similar, and are likely more frequent since they have to – or are expected to – deal with people each and every day in one capacity or another.  

In addition to excessive anxiety about being judged, people with social anxiety disorder often suffer physical symptoms, including heart palpitations, sensations that their throat will close up, sweating, blushing, faintness, trembling and stammering. They suffer such extreme physical and psychological discomfort that they will do anything in their power to avoid an anxiety-provoking situation.

Ross says the finding that 47% of those surveyed were not in a committed relationship at all further illustrates how alienating social anxiety disorder can be. “Unfortunately, some people feel safer being alone than engaging in healthy relationships that might help them cope,” Ross says. “When people with social anxiety disorder cannot connect with others, their isolation worsens and makes nearly all areas of life harder to handle.”

The survey findings of the effects of social anxiety disorder on relationships with friends and family were consistent with the findings on romantic relationships:

• 55% of the respondents have no close friends;
• 78% said their disorder resulted in missed opportunities with friends and family;
• 66% reported misunderstandings with friends, family and coworkers; half have kept their symptoms a secret from friends; and
• 65% lose touch and 17% get into arguments with friends, and 62% do not return or answer calls from friends.

“This survey emphasizes the importance of increasing the availability of effective treatments for social anxiety disorder,” says John R. Walker, Ph.D., a clinical psychologist with the Anxiety Disorders Program at the University of Manitoba in Winnipeg, Canada. Fortunately many forms of treatment are available to help people deal with this disorder, including:

• Cognitive-behavioral therapy involves people in their own recovery and provides a sense of control.
• Cognitive therapy helps people identify and change unwanted and disturbing thought patterns. The individual examines his or her feelings and learns to separate realistic from unrealistic thoughts.
• Behavior therapy helps people modify and gain control over unwanted behaviors. The individual learns to cope with difficult situations, often through controlled exposure to them.
• Relaxation techniques help individuals develop the ability to more effectively cope with the stresses that contribute to anxiety, as well as with some of the physical symptoms of anxiety.
• Medication, including serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, benzodiazepines, beta blockers and monoamine oxidase inhibitors, is a proven treatment.  
• Combination therapy, which includes behavioral therapy and medications, is also a proven treatment for many.