SPOTLIGHT
Living With Social Anxiety Disorder

Emily Ford knew something was wrong. She hadn’t made any friends since she started college. She was so uncomfortable around people that she avoided them as often as possible, choosing to eat lunch in the library.

That’s where Ford picked up a book by ADAA President and CEO Jerilyn Ross and learned that despite her solitude, she wasn’t really alone. There was a name for what was troubling her, and it could be treated.

Ford has social anxiety disorder, a type of anxiety disorder characterized by an intense fear of being scrutinized and negatively evaluated by others in social or performance situations. The 15 million people with social anxiety disorder, also known as social phobia, often literally feel sick from fear in seemingly non-threatening situations, such as ordering food in a restaurant or making a phone call.

Relationships Suffer

“While many of us have experienced some shyness or anxiety in novel social situations, it typically tends to fade as we get more familiar with these situations,” says Mark H. Pollack, MD, director of the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital and a professor at Harvard Medical School.

“However, for individuals with social anxiety disorder,” Dr. Pollack continues, “the anxiety is persistent and markedly distressing and causes significant dysfunction in their ability to establish and maintain satisfying social and family relationships and to live up to their potential in work and educational domains.” In a recent national survey commissioned by ADAA, nearly 90 percent of people said their social anxiety disorder negatively affects their personal relationships, and 75 percent said the disorder affects their ability to carry out normal daily activities. Most of the people surveyed also said they feel as if they are alone.

“I never talked about anything personal with anybody, and I never went to doctors. I couldn’t imagine doing it,” Ford says. But after she transferred colleges in search of a clean start, her fear and anxiety did not go away, and she found she still couldn’t interact with other students or her professors. “I knew it was either be depressed or go to the doctor. I wouldn’t talk on the telephone, so I asked my mother if she would make an appointment for me with a psychiatrist.”

Waiting to Get Help

More than a third of those surveyed reported that they experienced symptoms of social anxiety disorder for 10 or more years before seeking help. Now 29 and an editor in Washington, D.C., Ford remembers sensing something was wrong as early as fourth grade.

“I remember all of a sudden being surprised that I was nervous reading aloud or nervous talking to friends,” she says. “I started worrying about how I was sitting, how I was dressed.”

Ford became so self-conscious around her peers that she stopped seeing them on the weekends and declined invitations to social events. By high school she avoided all extracurricular activities and even refused to go on class field trips.

She didn’t know there was a name for what she was feeling until that day in the library. But she didn’t check out the book, fearing that others would judge her if they saw a self-help book in her hands. She was relieved that her intense fear of social situations had a name. Yet it took her another year to get help.

Treatment Takes Effect

Her first visit to a psychiatrist started Ford on the road to recovery. She began taking medication for depression and anxiety, and noticed improvement within a few weeks. But she also experienced side effects. Too afraid to tell her doctor and ask if another medication or dosage level might work better, she took the medication off and on for seven years. Then her depression worsened, and she stayed in bed for more than a month before getting the courage to go back to the doctor. Following a successful trial of a new medication and inspired by the results, Ford traveled to Washington, D.C., for a five-day intensive cognitive-behavioral treatment program for social anxiety disorder.

Exposure-based cognitive-behavioral therapy and medications like antidepressants and benzodiazepines are both effective treatments for social anxiety disorder, Dr. Pollack says. A combination of these treatments may also be prescribed.

Ford now goes to therapy sessions every three weeks and no longer takes medication. Before therapy, she couldn’t hold a job and wouldn’t even call her landlord if her heat went out, preferring to live in a cold apartment instead of talking to another person. Today she has been at her job a year and has entertained friends in her home.

“I used to not put myself in any opportunity where I would meet people, but now it’s changing,” Ford says. “I find out that as I open myself up to people, they’re receptive.” Now that Ford is in recovery, she can look forward to a full and productive life surrounded by friends and colleagues, rather than just books.

Learn more about social anxiety disorder, including its symptoms and treatments; or take a self-test.

Resources

Social Anxiety Disorder – National Institute of Mental Health
Social Anxiety Disorder – Mayo Clinic
Social Anxiety Disorder Symptoms – Psych Central
Social Phobia’s Traumas and Treatments – FDA Consumer magazine

News Articles

More Than Shy: How to Cope with Social Anxiety – U.S. News and World Report
15 Million Americans Suffer from Social Anxiety Disorder – HealthDay News
The Child Who Would Not Speak a Word – New York Times

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