STORY TO BE TOLD

It's natural to feel self-conscious, nervous, or shy in front of others at times. Anyone can have a racing heart, sweaty palms, or fluttering stomach when trying out for chorus, asking someone on a first date, or giving a class presentation.

Most people manage to get through these moments when they need to. But for some, the anxiety that goes with feeling shy or self-conscious can be extreme. It can seem so unbearable that they might feel too nervous to give answers in class, be unable to make eye contact with classmates in the hallway, or avoid chatting with others at the lunch table.

When people feel so self-conscious and anxious that it prevents them from speaking up or socializing most of the time, it's probably more than shyness. It may be an anxiety condition called social phobia.

What Is Social Phobia?

Social phobia (also sometimes called social anxiety) is a type of anxiety problem. Extreme feelings of shyness and self-consciousness build into a powerful fear. As a result, a person feels uncomfortable participating in everyday social situations.

People with social phobia can usually interact easily with family and a few close friends. But meeting new people, talking in a group, or speaking in public can cause their extreme shyness to kick in.

With social phobia, a person's extreme shyness, self-consciousness, and fears of embarrassment get in the way of life. Instead of enjoying social activities, people with social phobia might dread them — and avoid some of them altogether.

The Fear Reaction

Like other phobias, social phobia is a fear reaction to something that isn't actually dangerous — although the body and mind react as if the danger is real. This means that the person feels physical sensations of fear, like a faster heartbeat and breathing. These are part of the body's fight–flight response. They're caused by a rush of adrenaline and other chemicals that prepare the body to either fight or make a quick getaway.

This biological mechanism kicks in when we feel afraid. It's a built-in nervous system response that alerts people to danger so they can protect themselves. With social phobia, this response gets activated too frequently, too strongly, and in situations where it's out of place. Because the physical sensations that go with the response are real — and sometimes quite strong — the danger seems real, too. So the person will react by freezing up, and will feel unable to interact.

As the body experiences these physical sensations, the mind goes through emotions like feeling afraid or nervous.

People with social phobia tend to interpret these sensations and emotions in a way that leads them to avoid the situation ("Uh-oh, my heart's pounding, this must be dangerous — I'd better not do it!"). Someone else might interpret the same physical sensations of nervousness a different way ("OK, that's just my heart beating fast. It's me getting nervous because it's almost my turn to speak. It happens every time. No big deal.").

What Are People With Social Phobia Afraid Of?

With social phobia, a person's fears and concerns are focused on their social performance — whether it's a major class presentation or small talk at the lockers.

People with social phobia tend to feel self-conscious and uncomfortable about being noticed or judged by others. They're more sensitive to fears that they'll be embarrassed, look foolish, make a mistake, or be criticized or laughed at. No one wants to experience these things. But most people don't really spend much time worrying about it.

How Social Phobia Can Affect Someone's Life

With social phobia, thoughts and fears about what others think get exaggerated in someone's mind. The person starts to focus on the embarrassing things that could happen, instead of the good things. This makes a situation seem much worse than it is, and influences a person to avoid it.

Some of the ways social phobia can affect someone's life include:

• Feeling lonely or disappointed over missed opportunities for friendship and fun. Social phobia might prevent someone from chatting with friends in the lunchroom, joining an after-school club, going to a party, or asking someone on a date.
• Not getting the most out of school. Social phobia might keep a person from volunteering an answer in class, reading aloud, or giving a presentation. Someone with social phobia might feel too nervous to ask a question in class or go to a teacher for help.
• Missing a chance to share their talents and learn new skills. Social phobia might prevent someone from auditioning for the school play, being in the talent show, trying out for a team, or joining in a service project. Social phobia not only prevents people from trying new things. It also prevents them from making the normal, everyday mistakes that help people improve their skills still further.

Selective Mutism

Some kids and teens are so extremely shy and so fearful about talking to others, that they don't speak at all to certain people (such as a teacher or students they don't know) or in certain places (like at someone else's house). This form of social phobia is sometimes called selective mutism.

People with selective mutism can talk. They have completely normal conversations with the people they're comfortable with or in certain places. But other situations cause them such extreme anxiety that they may not be able to bring themselves to talk at all.

Some people might mistake their silence for a stuck-up attitude or rudeness. But with selective mutism and social phobia, silence stems from feeling uncomfortable and afraid, not from being uncooperative, disrespectful, or rude.

Why Do Some People Develop Social Phobia?

Kids, teens, and adults can have social phobia. Most of the time, it starts when a person is young. Like other anxiety-based problems, social phobia develops because of a combination of three factors:

• A person's biological makeup. Social phobia could be partly due to the genes and temperament a person inherits. Inherited genetic traits from parents and other relatives can influence how the brain senses and regulates anxiety, shyness, nervousness, and stress reactions. Likewise, some people are born with a shy temperament and tend to be cautious and sensitive in new situations and prefer what's familiar. Most people who develop social phobia have always had a shy temperament.
  
  Not everyone with a shy temperament develops social phobia (in fact, most don't). It's the same with genes. But people who inherit these traits do have an increased chance of developing social phobia.

• Behaviors learned from role models (especially parents). A person's naturally shy temperament can be influenced by what he or she learns from role models. If parents or others react by overprotecting a child who is shy, the child won't have a chance to get used to new situations and new people. Over time, shyness can build into social phobia.
  
  Shy parents might also unintentionally set an example by avoiding certain social interactions. A shy child who watches this learns that socializing is uncomfortable, distressing, and something to avoid.

• Life events and experiences. If people born with a cautious nature have stressful experiences, it can make them even more cautious and shy. Feeing pressured to interact in ways they don't feel ready for, being criticized or humiliated, or having other fears and worries can make it more likely for a shy or fearful person to develop social anxiety.
  
  People who constantly receive critical or disapproving reactions may grow to expect that others will judge them negatively. Being teased or bullied will make people who are already shy likely to retreat into their shells even more. They'll be scared of making a mistake or disappointing someone, and will be more sensitive to criticism.

The good news is that the effect of these negative experiences can be turned around with some focused slow-but-steady effort. Fear can be learned. And it can also be unlearned, too.

Dealing With Social Phobia

People with social phobia can learn to manage fear, develop confidence and coping skills, and stop avoiding things that make them anxious. But it's not always easy. Overcoming social phobia means getting up the courage it takes to go beyond what's comfortable, little by little.

Here's who can support and guide people in overcoming social phobia:

• Therapists can help people recognize the physical sensations caused by fight–flight and teach them to interpret these sensations more accurately. Therapists can help people create a plan for facing social fears one by one, and help them build the skills and confidence to do it. This includes practicing new behaviors. Sometimes, but not always, medications that reduce anxiety are used as part of the treatment for social phobia.
• Family or friends are especially important for people who are dealing with social phobia. The right support from a few key people can help those with social phobia gather the courage to go outside their comfort zone and try something new.
  
  Putdowns, lectures, criticisms, and demands to change don't help — and just make a person feel bad. Having social phobia isn't a person's fault and isn't something anyone chooses. Instead, friends and family can encourage people with social phobia to pick a small goal to aim for, remind them to go for it, and be there when they might feel discouraged. Good friends and family are there to celebrate each small success along the way.

Overcoming Social Phobia

Dealing with social phobia takes patience, courage to face fears and try new things, and the willingness to practice. It takes a commitment to go forward rather than back away when feeling shy.

Little by little, someone who decides to deal with extreme shyness can learn to be more comfortable. Each small step forward helps build enough confidence to take the next small step. As shyness and fears begin to melt, confidence and positive feelings build. Pretty soon, the person is thinking less about what might feel uncomfortable and more about what might be fun.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: July 2007

source taken from: http://kidshealth.org/

The roller coaster hesitates for a split second at the peak of its steep track after a long, slow climb. You know what's about to happen — and there's no way to avoid it now. It's time to hang onto the handrail, palms sweating, heart racing, and brace yourself for the wild ride down.

What Is Fear?

Fear is one of the most basic human emotions. It is programmed into the nervous system and works like an instinct. From the time we're infants, we are equipped with the survival instincts necessary to respond with fear when we sense danger or feel unsafe.

Fear helps protect us. It makes us alert to danger and prepares us to deal with it. Feeling afraid is very natural — and helpful — in some situations. Fear can be like a warning, a signal that cautions us to be careful.

Like all emotions, fear can be mild, medium, or intense, depending on the situation and the person. A feeing of fear can be brief or it can last longer.

How Fear Works

When we sense danger, the brain reacts instantly, sending signals that activate the nervous system. This causes physical responses, such as a faster heartbeat, rapid breathing, and an increase in blood pressure. Blood pumps to our large muscle groups to prepare the body for physical action (such as running or fighting). Skin sweats to keep the body cool. Some people might notice sensations in the stomach, head, chest, legs, or hands. These physical sensations of fear can be mild or strong.

This response is known as "fight or flight" because that is exactly what the body is preparing itself to do: fight off the danger or run fast to get away. The body stays in this state of fight–flight until the brain receives an "all clear" message and turns off the response.

Sometimes fear is triggered by something that is startling or unexpected (like a loud noise), even if it's not actually dangerous. That's because the fear reaction is activated instantly — a few seconds faster than the thinking part of the brain can process or evaluate what's happening. As soon as the brain gets enough information to realize there's no danger ("Oh, it's just a balloon bursting — whew!"), it turns off the fear reaction. All this can happen in seconds.

Fears People Have

Fear is the word we use to describe our emotional reaction to something that seems dangerous. But the word "fear" is used in another way, too: to name something a person often feels afraid of.

People fear things or situations that make them feel unsafe or unsure. For instance, someone who isn't a strong swimmer might have a fear of deep water. In this case, the fear is helpful because it cautions the person to stay safe. A person could overcome this fear by learning how to swim safely.

A fear can be healthy if it cautions a person to stay safe around something that could be dangerous. But sometimes a fear is unnecessary and causes more caution than the situation calls for.

Many people have a fear of public speaking. Whether it's giving a report in class, speaking at an assembly, or reciting lines in the school play, speaking in front of others is one of the most common fears people have.

People tend to avoid the situations or things they fear. But this doesn't help them overcome fear — in fact, it can be the reverse. Avoiding something scary reinforces a fear and keeps it strong.

People can overcome unnecessary fears by giving themselves the chance to learn about and gradually get used to the thing or situation they're afraid of. For example, people who fly despite a fear of flying can become used to unfamiliar sensations like takeoff or turbulence. They learn what to expect and have a chance to watch what others do to relax and enjoy the flight. Gradually (and safely) facing fear helps a person to overcome it.

Fears During Childhood

Certain fears are normal during childhood. That's because fear can be a natural reaction to feeling unsure and vulnerable — and much of what children experience is new and unfamiliar.

Young kids often have fears of the dark, being alone, strangers, monsters, or other scary imaginary creatures. School-aged children might be afraid when it's stormy or at a first sleepover. As they grow and learn, with the support of adults, most kids are able to slowly conquer these fears and outgrow them.

Some kids are more sensitive to fears and may have a tough time overcoming them. When fears last beyond the expected age, it might be a sign that someone is overly fearful, worried, or anxious. People whose fears are too intense or last too long might need help and support to overcome them.

Phobias

A phobia is an intense fear reaction to a particular thing or a situation. With a phobia, the fear is out of proportion to the potential danger. But to the person with the phobia, the danger feels real because the fear is so very strong.

Phobias cause people to worry about, dread, feel upset by, and avoid the things or situations they fear because the physical sensations of fear can be so intense. So having a phobia can interfere with someone's normal activities. A person with a phobia of dogs might feel afraid to walk to school in case he or she sees a dog on the way. Someone with an elevator phobia might avoid a field trip if it involves going on an elevator.

A girl with a phobia of thunderstorms might be afraid to go to school if the weather forecast predicts a storm. She might feel terrible distress and fear when the sky turns cloudy. A guy with social phobia experiences intense fear of public speaking or interacting, and may be afraid to answer questions in class, give a report, or speak to classmates in the lunchroom.

It can be exhausting and upsetting to feel the intense fear that goes with having a phobia. It can be disappointing to miss out on opportunities because fear is holding you back. And it can be confusing and embarrassing to feel afraid of things that others seem to have no problem with.

Sometimes, people get teased about their fears. Even if the person doing the teasing doesn't mean to be unkind and unfair, teasing only makes the situation worse.

What Causes Phobias?

Some phobias develop when a person has a scary experience with a particular thing or situation. A tiny brain structure called the amygdala (pronounced: uh-mig-duh-luh), keeps track of experiences that trigger strong emotions. Once a certain thing or situation triggers a strong fear reaction, the amygdala warns the person by triggering a fear reaction every time he or she encounters (or even thinks about) that thing or situation.

Someone might develop a bee phobia after being stung during a particularly scary situation. For that person, looking at a photograph of a bee, seeing a bee from a distance, or even walking near flowers where there could be a bee can all trigger the phobia.

Sometimes, though, there may be no single event that causes a particular phobia. Some people may be more sensitive to fears because of personality traits they are born with, certain genes they've inherited, or situations they've experienced. People who have had strong childhood fears or anxiety may be more likely to have one or more phobias.

Having a phobia isn't a sign of weakness or immaturity. It's a response the brain has learned in an attempt to protect the person. It's as if the brain's alert system triggers a false alarm, generating intense fear that is out of proportion to the situation. Because the fear signal is so intense, the person is convinced the danger is greater than it actually is.

Overcoming Phobias

People can learn to overcome phobias by gradually facing their fears. This is not easy at first. It takes willingness and bravery. Sometimes people need the help of a therapist to guide them through the process.

Overcoming a phobia usually starts with making a long list of the person's fears in least-to-worst order. For example, with a dog phobia, the list might start with the things the person is least afraid of, such as looking at a photo of a dog. It will then work all the way up to worst fears, such as standing next to a person who's petting a dog, petting a dog on a leash, and walking a dog.

Gradually, and with support, the person tries each fear situation on the list — one at a time, starting with the least fear. The person works on each fear until he or she is comfortable. The person takes as long as needed to feel comfortable and isn't forced to do anything.

A therapist could also show a person with a dog phobia how to approach, pet, and walk a dog, and help the person to try it, too. The person may expect terrible things to happen when near a dog. Talking about this can help, too. When people find that what they fear doesn't actually turn out to be true, it can be a great relief.

A therapist might also teach relaxation practices such as specific ways of breathing, muscle relaxation training, or soothing self-talk. These can help people feel comfortable and bold enough to face the fears on their list.

As a person gets used to a feared object or situation, the brain adjusts how it responds and the phobia is overcome.

Often, the hardest part of overcoming a phobia is getting started. Once a person decides to go for it — and gets the right coaching and support — it can be surprising how quickly fear can melt away.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: August 2007

source taken from: http://kidshealth.org/