If you suffer from social anxiety, it can weaken your ability to relax and make new friends.

A lot of us dread speaking in public or get nervous before we go to a party where we won’t know anyone. Still, we’re able to make it through those situations successfully.

But when such anxiety becomes extreme—when someone is unable to eat or drink in public, speak up in a meeting, attend a social gathering, or talk with people in authority—it’s likely they have social anxiety disorder or social phobia.

Approximately 15 million American adults suffer from social anxiety, according to the National Institutes of Mental Health. They often lead lives of isolation, shame, and fear of interaction with strangers.

Learning about this condition can help you tell whether you need to seek help for yourself or a loved one.

What are the signs or symptoms of social phobia?
A: People with social phobia are often unable to function at work or in social situations due to their chronic, intense fear of being watched and judged. Psychological signs of this condition can include:

• Avoiding social situations
• Experiencing days or even months of persistent fear prior to a scheduled social event
• Fearing they’ll humiliate themselves by how they act or what they say
• Experiencing extreme anxiety in everyday social interactions

  Physical symptoms can include:

  • Excessive sweating
  • Rapid heartbeat
  • Shaky voice and rapid breathing
  • Muscle tension or shaking

Normal social interactions can trigger these symptoms. Meeting new people at work, eating at a restaurant, using public restrooms, interviewing for a job or promotion, going on a date, or being called on to speak in a meeting might lead to an episode.

What causes social phobia?
A: The cause is unclear. Psychologists believe it often begins in childhood or adolescence and may be triggered by overprotective parents or limited social interactions. Some experts believe the behavior may have biological or environmental roots, as it appears to run in families.

How is social phobia treated?
A: No one treatment works for everyone. However, a variety of treatments can help people function more fully in their work and home lives. Successful approaches include:

• Cognitive behavioral therapy. This treatment aims to help people face the social situations they fear and learn relaxation techniques to help control the physical symptoms of social anxiety. Therapy helps them challenge negative thoughts and irrational fears that fuel dread of social interactions.
• Medication. Three types of prescription medications—beta blockers, antidepressants, and anti-anxiety drugs—are used to relieve social anxiety. However, medications are less effective when used without other therapies. Symptoms are likely to return if a person stops taking medication.
• Other treatments include group therapy, role-playing, and social skills training. In systematic desensitization, people are taught relaxation skills to use as they are gradually exposed to situations they fear.

Left untreated, social anxiety can cause a diminished social, home, and professional life. However, the outcome is generally positive when the right treatment is provided.

By Barbara Floria, senior writer for Vitality. For more information, visit the National Institute of Mental Health at www.nimh.nih.gov.

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