- A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.
Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults. - Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.
- The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
- The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
- The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
- In individuals under age 18 years, the duration is at least 6 months.
- The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g., Panic Disorder With or Without Agoraphobia, Separation Anxiety Disorder, Body Dysmorphic Disorder, a Pervasive Developmental Disorder, or Schizoid Personality Disorder).
- If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa.
All fun and games until someone ends up hiding in their wardrobe hyperventilating, huh?
In hindsight, I started experiencing symptoms of social phobia when I reached Intermediate school. This anxiety was still fairly generalised, but it increased again when I started high school. It was not until I was probably 16 that the specific nature of my anxiety really began to make itself known, that it began to be noticeable to me, and that it began to seriously hamper my ability to live my life. At 19 I was a wreck, completely housebound, terrified of the phone ringing, perpetually fearful, having multiple anxiety attacks on any given day, heavily self-medicating with alcohol and cannabis, and hooked on the diazepam that the psychiatrist had prescribed me for my anxiety attacks.
But let's not get ahead of ourselves. I'll end this post by making note of the main features I experienced. The most obvious was a fear of social or performance situations, this was what I began to notice first when I was at high school. I became convinced that I would humiliate myself in some way if I were in public, and I also formed the irrational thought that other people, even strangers, could see what I was thinking or feeling in some way, and that they would mock and judge me for it. The next was a fear of eating in public, or in front of others, even my own family. I developed this idea that I would vomit if I ate in front of others. Initially I would not actually experience nausea, but later I did, as if my anxiety was trying to create some form of self-fulfilling prophecy. The third was the anxiety attacks. Those were frequent, distressing, and entirely out of my control for some time. The combination of these main elements left me avoidant, in constant fear, and unable to manage even the most basic tasks, like hanging out washing, or getting my mail. It left me feeling continually guilty and ashamed.
In my next post, I'll discuss how social phobia progressed for me, and the impact it had upon my life.
In my next post, I'll discuss how social phobia progressed for me, and the impact it had upon my life.
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