Sociophobia: what it is in simple words, symptoms, causes, how to get rid of

practicing psychologist, member of the Association for Cognitive Behavioral Psychotherapy, Psychedemia expert

“It’s hard to imagine a person who doesn’t worry at all before an important meeting or at least once didn’t refuse a date because he didn’t look good enough (by his own standards) that day.

But what if the whole life begins to be built around such fears and feelings of inferiority? And what if the necessity of public speaking or some other social interaction causes insurmountable terror?

Let’s find out what causes such difficulties. Today we will talk about social anxiety disorder or, to put it more simply, sociophobia.

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What is sociophobia?

Social Anxiety Disorder (SAD) is characterized by a marked and excessive experience of fear and anxiety that consistently occurs in the same or multiple public situations. This can range from interactions (e.g., in the midst of a conversation) to being in public or giving a speech. The person worries that by his behavior (manifestation of anxiety) he will cause negative evaluation of others.

He tries to avoid such situations. If they are tolerated, it is with intense feelings of fear or anxiety. The symptoms persist for at least several months and are quite severe. They cause marked distress or significant impairment in personal, family, social, academic, occupational and other important areas of life.

Studies say that this disorder presents in 5-10% of the world’s population, and the numbers have been increasing over the past decades. This may be due to the ever-increasing standards of society, which demands to be even more beautiful, successful, rich, etc. Another reason could be because people today have become more willing to seek help from psychologists and psychiatrists, so social anxiety disorder has become more commonly diagnosed.

There are also studies that say that the prevalence of STR is lower in lower income countries and higher in high income countries. That is, the better the conditions in which people live, the more among them are those who fear the judgment of others for who they are.

How does sociophobia arise?

If we talk about the causes of occurrence and factors that can affect the course of social anxiety disorder, we can distinguish the following components.

Biological – possible genetic and hereditary conditioning, as well as neurophysiological and physiological causes.
Social – societal and environmental conditions, social status, and events and situations that have happened to the person in society. For example, one of my clients could not eat lunch with everyone at work because once in her childhood her grandmother told her that she ate like a pig, and later a classmate at university laughed at the fact that she left a lot of crumbs behind. These two incidents overlapped and led to the woman eating in the janitor’s back room, holding her food over the urn. She was afraid of leaving trash behind and didn’t want anyone to think she was the piglet from Grandma’s message.
Psychological – cognitive attitudes and habits of thinking, patterns of emotional response and behavioral coping peculiar to a person.

If we talk about biological factors in more detail, we cannot but recall one interesting study on monkeys. In the course of laboratory observations, subordinate and dominant individuals were identified among them. The former spent more time alone, cautiously studying their social environment, as if analyzing how they should be, so that the pack would not expel them.

Biological studies of subordinate individuals revealed signs of hypothalamic-pituitary-adrenal axis hyperactivity, impaired functioning of the serotoninergic system and dopaminergic neurotransmission. It turns out that the distribution of roles in the primate social hierarchy may be regulated by neurophysiological mechanisms. It is logical to assume that in humans the feeling that they are worse than others (that there is a risk of being rejected) is partly caused by biological processes in the organism.

Social factors of influence include both traumatic events in early childhood (bullying, family violence, public humiliation), as well as role-model training and a hyper-pedagogic parenting style – children learn to fear and avoid by the example of their parents.

As for psychological factors, people with STR are prone to automatic thoughts, most of which are related to self-deprecation. They believe that they behave foolishly and absurdly in social situations, and yet they tend to evaluate their behavior much more harshly than objective observers.

People with STR also tend to hold negative beliefs about other people and social relationships. Believing that those around them are critical of them, they are certain in advance that they will be negatively evaluated. They are also characterized by a heightened attention to the specifics of the social situation. Their importance is often overestimated. For example, a barely noticeable stutter may be perceived as an insurmountable obstacle to communication with others, condemning them to loneliness and social isolation.

Symptoms of sociophobia

What are the symptoms that may suggest possible sociophobia and the need to consult a specialist?

Symptom #1. Expressed fear of being in the center of attention or behaving in a way that will cause embarrassment or humiliation. The person avoids situations in which this scenario could materialize

These fears manifest themselves in social situations such as eating or socializing in public places, casually meeting acquaintances, being in small groups (e.g., parties, meetings, meeting room).

People with sociophobia may literally lose their speech when they have to give a presentation, fall into a stupor at the fleeting glance of a neighbor, or try not to leave the house during the day to minimize encounters with people.

Symptom #2. Expressed emotional anxiety over symptoms or avoidance of situations and realizing that the reaction is excessive and there is no reason for it.

That is, if you don’t like parties and refuse to go to them without regret, then there is nothing to worry about. However, if you don’t go to corporate events just because everyone will know (and judge you for it) that you chew funny or you might say something stupid (and in fact you would really like to have fun with your colleagues), then there is a reason to think about it.

On a physical level, the symptoms of sociophobia can manifest as “standard” indicators of anxiety: flushing, trembling, rapid heartbeat, sweating, dry mouth. There may be difficulty breathing, chest discomfort or pain, nausea, burning in the stomach, and feelings of dizziness and unsteadiness.

Sometimes there may be a feeling that objects are unreal, or that one’s own self is distant or “truly is not here” (depersonalization). The person fears losing control or even dying. Common companions of anxiety disorder may include hot flashes or feelings of chills, numbness or tingling sensations.

Specific specifically to social anxiety disorder are fear of vomiting and urges or fear of urination or defecation. It is these symptoms that are often the most unbearable for people with STR, because if it does happen, it seems that there is definitely no strength to bear such shame.

It is important to mention that the onset of anxiety symptoms should occur only or predominantly in or thinking about fearful situations. If they appear at other times, it is likely that we may already be talking about other disorders.

How is sociophobia diagnosed?

What should you do if you suspect sociophobia in yourself or someone close to you? Now there is a large number of questionnaires, tests and scales, by which you can see whether a person has any manifestations of STR.

Sociophobia questionnaire SAQ-A30 (Social Anxiety Questionnaire for Adults).
BFNE-S (Brief Fear of Negative Evaluation Scale).
Social Phobia Inventory SPIN (Social Phobia Inventory).
Liebowitz LSAS (Libowitz Sociophobia Symptom Assessment Scale).
Negative Self-Portrayal Scale NSPS (Negative Self-Portrayal Scale).
SIAS (Social Interaction Anxiety Scale).

However, only a specialist can interpret the results as correctly as possible, so if you have taken the test and found symptoms of STR, consult a psychiatrist or psychologist. They will talk to you and conduct the necessary diagnostics. The psychiatrist will also be able to prescribe medication if necessary.

It is also important to contact specialists because sociophobia is often comorbid with other disorders (that is, coexists with them). Depression, dysmorphophobia, obsessive-compulsive disorder, or another anxiety disorder may be involved. Sometimes it’s even difficult to determine which one is the root cause, but it’s important because it affects treatment.

If a comorbid disorder goes undetected, the person may not get the therapy they need. Then the results will also be unsatisfactory. Therefore, it is better not to engage in self-treatment, but to turn to professionals.

It is believed that STR usually begins in early adolescence and most often persists until it is effectively treated. However, seeking help is usually infrequent, delayed, and often accompanied by another mental disorder.

For example, a person complains of a depressive state, lack of strength and lack of desire to communicate with close (and even less familiar) people. And at the appointment with a psychologist it turns out that this reluctance is not caused by depression, but by social anxiety, which does not allow to build a normal life, communicate and develop in society. And this eventually leads to depressive symptoms.

Treatment of social anxiety disorder can include drug therapy if necessary (for example, drugs containing selective serotonin reuptake inhibitors), psychotherapy. Group sessions are also effective. Moreover, the very fact that a person attends them, interacts with society – is already a powerful factor contributing to recovery.

How does sociophobia affect a person’s life?

It is obvious that social anxiety disorder worsens the quality of life, because the fear of being in the center of attention often leads to social isolation, problems in the professional sphere, and can also provoke various psychological problems and disorders.

Agree, if your work is connected with communication with people, but you are afraid to talk to them, it will not be so easy to succeed in your career.

In my practice I had a client who spent a lot of money on cabs because of sociophobia. She had to move around the city a lot because of her work, she did not drive a car herself, and she could not be in public transportation, because the symptoms of sociophobia made themselves known. She felt nauseous, dizzy, and terrified. She was afraid that people around her would do something to her because she did not fit into the standard she had invented of how a person should look and behave in the subway.

Needless to say, getting rid of sociophobia freed up not only psychological resources, but also considerable sums of money?

Separately, it should be said about what happens if sociophobia is not treated. Our brain is so organized that if it does not receive refutation of information by experience, it believes in the original belief more and more strongly. That is, the person will become more and more immersed in his thoughts that he is something he is not, that society condemns and rejects him. The symptoms of the disorder will begin to manifest themselves more and more vividly. This can even lead to the onset of another mental disorder. For example, depression.

This is why it is so important to seek help as early as possible. Especially modern evidence-based psychotherapy approaches show very high efficacy in treating STR. You should also not be afraid of psychiatrists and taking medications to relieve anxiety. Properly selected medications will definitely benefit mental and psychological health. Competent specialists, correctly selected therapy regimen and a person’s desire to improve his or her life will definitely bear fruit.