LIVING WITH SOCIAL PHOBIA Brought to you by Mediheip SOCIAL PHOBIA Despite the fact that social phobia often goes undiagnosed, it responds very well to treatment. The following approaches are used, often in combination, to treat the disorder.
1. MEDICATION Social phobia responds well to medication, but it is a chronic condition that requires long-term treatment. Medication should be taken for a minimum of six months, and withdrawn gradually under a doctor's supervision, periodically lowering the dosage. There may be side effects during the first few weeks of treatment, however these will usually disappear with time. The most common side effects include headaches, nausea, nervousness, dizziness and sleep problems, as well as impaired sexual function. It is important to get through the side effects, so that the medication can take full effect and integrate with your body. It is also important to continue treatment, as relapse is very common when medication is stopped too soon or too suddenly.
2. PSYCHOTHERAPY Almost 80 per cent of people suffering from social phobia find relief from their symptoms when treated with a combination of medication and psychotherapy. Psychotherapy encourages the sufferer to confront negative beliefs and feelings, which are thought to be the root cause of their social anxiety. There are three basic forms of psychological treatment: Social skills training: Many people with social phobia have never learnt basic social skills, such as how to initiate a conversation. This form of therapy can help individuals to feel more relaxed and confident in the company of others by teaching them the fundumental skills they need.
The emphasis is on practice and feedback, which will allow the person to monitor their social interactions. Exposure therapy: Exposure therapy helps the person to relax in a situation they find frightening. It is usually conducted in stages, bringing about gradual desensitisation to the feared situation or location. Real-life desensitisation: This is the single most effective treatment available for the treatment of social phobia. Also called 'exposure' or 'in vivo' desensitisation, it treats phobias through direct exposure, where the person must learn to tolerate the unpleasantness of the situations they fear. At the outset of this process, goals must be clearly defined.
Broad goals, such as shopping in a mall, are broken into smaller intermediary goals, such as travelling to the mall, walking around outside the mall, and then eventually going inside. Cognitive behavioural therapy: CBT helps people living with social phobia to change the way they think about themselves, their surroundings and other individuals, bringing about a more realistic way of thinking about fearful situations. CBT focuses on identifying negative and automatic thoughts and then confronting and testing these assumptions against reality.
Group therapy sessions are particularly appropriate in treating certain forms of social anxiety. The group provides appropriate exposure in a controlled and safe environment, and people with social phobia can practise and test their new skills.
3. SELF-HELP Social phobia is best treated professionally, but you might also try the following in conjunction with therapy, should you be afraid of speaking in public: • Present a short talk on any subject - to your cat or dog. • In any group situation, make a one-sentence comment. • Make another comment three to five minutes later. • Make a comment at any meeting you attend. • Join Toastmasters, an organisation that helps people to improve their public-speaking skills. For more information, visit www.toast-masters.org.za NOT SURE IF YOU HAVE SOCIAL PHOBIA? Ask yourself if the following situations cause you anxiety: • Working while being observed. • Telephoning someone you don't know very well. • Urinating in a public bathroom. • Being graded on your ability, skill or knowledge. • Expressing disagreement or disapproval to someone you don't know very well. • Hosting a party. • Entering a room where others are already seated. Consult your doctor or the South African Depression and Anxiety Group (SADAG) on 011262 6396 if any of the above apply to you, and you suspect you may be suffering from social phobia. Having the support of family and friends is a crucial part of recovering from social phobia. The following are some of the guidelines you can follow to help a friend or loved one who may be suffering from social phobia:
1 ' Learn more about the disorder. Acknowledge that there is a real problem. Social phobia is not merely a severe form of shyness, it is a medical condition that should be taken seriously. : Be understanding. Recognise that by allowing a sufferer to explain their problems you will help them feel less isolated and less ashamed of their condition. Social phobia is not anyone's fault. Neither you nor the person living with social phobia is to blame for the condition. Gently encourage the person to seek professional help. Acknowledge that this may be a difficult decision, keeping in mind that the very nature of social phobia often means that sufferers are afraid to seek help from strangers. Once treatment has been initiated, encourage the person to persist and continue with treatment. Recognise and show your appreciation for any improvement, no matter how slight. As treatment takes effect, the sufferer will be encouraged to begin facing up to fearful situations and locations. Your support and understanding in this regard is vital. While at home, persons living with social phobia should be encouraged to maintain as normal a lifestyle as possible. Do not adapt your lifestyle to fit in with their fears and anxieties.