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Social phobia is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as parties and other social events.

People with social phobias fear and avoid situations in which they may be subject to the scrutiny of others. It may begin in adolescence and may be associated with overprotective parents or limited social opportunities. Males and females are affected equally with this disorder.

People with social phobia are at high risk for alcohol or other drug dependence, because they may come to rely on drinks or drugs to relax in social situations.

Social phobia is different from shyness. Shy people are able to participate in social functions. People with social phobia are constrained by their condition to the point that it affects their ability to function in work and relationships.

Some of the most common fears of people with social phobia include:

• Attending parties and other social occasions
• Eating, drinking, and writing in public
• Meeting new people
• Speaking in public
• Using public restrooms

The health care provider will look at your history of phobia, and will get a description of the behavior from you, your family, and friends.

Signs include:

• Elevated blood pressure
• Rapid heart rate

The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of the phobia.

Systematic desensitization is a technique used to treat phobias. You are asked to relax, then imagine the components of the phobia, working from the least fearful to the most fearful. Gradual exposure to real-life situations has also been used with success to help people overcome their fears.

Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation.

Anti-anxiety and antidepressant medications are sometimes used to help relieve the symptoms associated with phobias.

The outcome is generally good with treatment, and antidepressant medications have been shown to be very effective.

• Alcohol use to combat anxiety
• Alcohol or other drug dependence
• Loneliness and social isolation

Call your health care provider or mental health professional if fear is affecting your work and relationships with others.

Taking measures to improve your self-esteem and getting training in social skills may be helpful.

Phobia - social

Moore DP, Jefferson JW. Social phobia. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier;2004: chap 86.

Katon W, Geyman JP. Anxiety disorders. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 57.

Updated by: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.