10-09-03 @ 11:25 am EDT

Out of boredom I typed in "shyness" at Google to see what I would get. Of course, I was immediately presented with lots of links on social phobia. I saw a commercial about a disorder named "social anxiety disorder" the other day and wondered what the difference between that and social phobia was. Today I learned that they are in fact the same disorder, but "social anxiety disorder" is the new name. And a more fitting one IMO, as (despite my e-mail address) I've always found that the term "social phobia" just minimizes the situation.

Truly, what do YOU think of when you hear the word "phobia"? "Oh, a silly little fear; a quirk. Something that's easy to avoid, yet still irrational. Quit being so scared of spiders/dogs/the dark/whatever."

What do you say to the person who is afraid of not just one little isolated thing that can easily be avoided, but of SOCIETY in general, of PEOPLE, of EVERYBODY, especially in a society where such a fear is punished every day? (It's not like you can easily AVOID such triggers as society in general, if you wish to get out of your own house. And I'm living proof that even things in the house can be scary enough--witness my trouble responding to simple e-mails, now. The same fear and anxiety are there, just as if the person is standing right in front of me.)

I clicked on a few links anyway, even though I felt there wouldn't be much new that I could learn. When you live being this way every day, it's kind of hard not to know what it's like.

Still, shortly before logging off, I found one website with some articles that gave me some "aha" moments. You know those moments when you learn something that you actually knew all along, but could just never really put into words? The knowledge you had but never really knew you had until someone else said it for you? This is likely to be another long entry because I wish to copy those articles (apologies to the copyright holders--I'm doing this in an attempt to spread the information and understanding), so if you are already bored you can click away from this page now. If you want to learn more about what goes through my head just about every waking moment of every single day, however, please continue...

I will break my habit of posting the articles in bold. They will instead be in regular type, with any points that stand out for me in particular put in a different font color. I may also include some of my own comments in a different color AND [brackets].

All that having been said, here is the main website itself:

http://www.socialanxietyinstitute.org/

And here are the articles which drew my attention...

Social anxiety is the fear of social situations and the interaction with other people that can automatically bring on feelings of self-consciousness, judgment, evaluation, and inferiority.

Put another way, social anxiety is the fear and anxiety of being judged and evaluated negatively by other people, leading to feelings of inadequacy, embarrassment, humiliation, and depression.

If a person usually becomes anxious in social situations, but seems fine when they are alone, then "social anxiety" may be the problem.

Social anxiety disorder (formerly termed "social phobia") is a much more common problem than past estimates have led us to believe. Millions of people all over the world suffer from this devastating and traumatic problem every day, either from a specific social anxiety or from a more generalized social anxiety.

In the United States, epidemiological studies have recently pegged social anxiety disorder as the third largest psychological disorder in the country, after depression and alcoholism. It is estimated that 7-8% of the population suffers from some form of social anxiety at the present time. The lifetime prevalence rate for developing social anxiety disorder is 13-14%.

Specific and Generalized Social Anxieties

A specific social anxiety would be the fear of speaking in front of groups (only), whereas people with generalized social anxiety are anxious, nervous, and uncomfortable in almost all social situations.

It is much more common for people with social anxiety to have a generalized type of this disorder. When anticipatory anxiety, worry, indecision, depression, embarrassment, feelings of inferiority, and self-blame are involved across most life situations, a generalized form of social anxiety is at work.

Symptoms of Social Anxiety Disorder

People with social anxiety disorder usually experience significant emotional distress in the following situations:

This list is certainly not a complete list of symptoms -- other feelings have been associated with social anxiety as well.

The physiological manifestations that accompany social anxiety may include intense fear, racing heart, turning red or blushing, excessive sweating, dry throat and mouth, trembling, swallowing with difficulty, and muscle twitches, particularly about the face and neck.

Constant, intense anxiety that does not go away is the most common feature.

People with social anxiety disorder know that their anxiety is irrational and does not make "head" (i.e., cognitive) sense. Nevertheless, "knowing" something is not the same thing as "believing" and "feeling" something.

Thus, for people with social anxiety, thoughts and feelings of anxiety persist and show no signs of going away -- despite the fact that socially-anxious people "face their fears" every day of their lives.

[To those people who say, "Just get over it!" or "Just deal with it!" I point out the above paragraphs. We DO deal with it, because society MAKES us deal with it. And see what good it does?--nada. Zip. Zilch. The fear is still ALWAYS there, no matter how easy you may think it is to just "get over it." I tell myself to just get over it all the time--doesn't do a bit of good. I'm still afraid.]

Only the appropriate therapy works to alleviate social anxiety disorder, the largest anxiety disorder, and the one that few people know anything about.

[Omitted section; please see link if you wish to read]

How To Find Help for Social Anxiety Disorder

Social anxiety, as well as the other anxiety disorders, can be successfully treated. In seeking help for this problem, search for a specialist -- someone who (a) understands this problem well and (b) knows from experience how to treat it.

Become an informed client and ask questions. For example, does the therapist understand that you feel very self-conscious and that others are watching and forming a negative evaluation about you? – or do they minimize what you’re saying and just say, "No, No, No, you’re fine ... you're just exaggerating...." or expect you to go out and do unreasonable "exposures"?

It is true that we who have lived through social anxiety do realize our mind is many times irrational and we over-exaggerate, but it still FEELS like others are watching and judging us. Our self-consciousness is a feeling and it is very real.

[More people need to realize this. Just because a feeling makes no sense doesn't mean that that feeling isn't 100% real, and just as disabling as a rational feeling.]

If your psychologist/mental health care worker does not understand this, you know more than they do about social anxiety. Under these circumstances, it is very doubtful they will be able to help you.

Also, remember that the professional should always welcome your questions. If someone seems unfriendly or too clinical, they should not be your choice of a therapist.

[I never particularly "bonded" with my psychiatrist, as she seemed just too cold and clinical for me. She was simply the person who signed the prescriptions, IMO. She seemed to be a good person, but there was just no rapport there. My psychologist was a different story...almost every day I wish I could get back in touch with her. There are so many things I wish I could have told her.]

Those of us who have (or have had) social anxiety need support, encouragement, and a relatively stress-free environment while we are in therapy that will permanently change our thoughts, beliefs, feelings, and our lives.

Does your therapist say, "Face your fears and they’ll go away?"

Sorry, but this therapist does not understand the dynamics of social anxiety. We, as people with social anxiety, have constantly faced our fears ever since birth – we’ve had to – and we feel more fearful now than we did in the past.

In this case, seek another therapist. It is imperative you find a psychologist who understands social anxiety disorder completely – because if they don’t even know what it is – how will they know what to do to help you overcome it?

Getting over social anxiety disorder is not an easy task, nor is it a difficult one. Many thousands of people have already done it.

While you’re in the middle of the social anxiety syndrome, it feels hopeless – it feels that you’ll never get any better. Life is just one gut-wrenching anxiety problem after another.

But this can be stopped, quenched, and killed in a relatively short period of time – by finding a cognitive-behavioral therapist who understands and specializes in the treatment of social anxiety.

[Omitted section; please see link.]

http://www.socialanxietyinstitute.org/define.html

The Diagnostic and Statistical Manual of the American Psychiatric Association currently defines social anxiety disorder in the following way.

Please note that while this definition of social anxiety is the most definitive and clear produced to date, there are several potential problems with this definition that will hopefully be addressed by the task forces, editors, and research coordinators of the association as time progresses.

The Current DSM (Abridged) Definition:

A. A 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 embarrassing and humiliating.

B. Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pre-disposed Panic Attack.

C. The person recognizes that this fear is unreasonable or excessive.

D. The feared situations are avoided or else are endured with intense anxiety and distress.

E. 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.

F. In individuals under age 18 years, the duration is at least 6 months.

G. The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs, medications) or a general medical condition not better accounted for by another mental disorder...

Copyright 1994, The American Psychiatric Association

Problems with the DSM Definition of Social Anxiety

While this definition is clearly the most definitive and precise, "social anxiety disorder" has only been officially recognized since 1980, and the problem did not become adequately explained until the 1987 version of the DSM. Thus, the definition of social anxiety disorder is becoming clearer and more precise with each edition.

Here is where we believe the current DSM needs to be revised:

1. The descriptive language is generally good, but could be more direct and precise.

2. The reference in "B" to a situationally bound or situationally pre-disposed Panic Attack is confusing, and for the most part, inaccurate. The use of the term "Panic Attack", which is the name of a separate anxiety disorder, is confusing and can prevent a proper diagnosis from being made.

See our article on the differences between Panic Disorder (with and without agoraphobia) and Social Anxiety Disorder for further details.

It is our belief that people with social anxiety disorder may experience "anxiety" attacks that are situationally bound, but they do not experience "panic" attacks, which, by definition, precipitate feelings of a medical emergency (i.e., fear of losing control, heart attack, and dying, to name a few).

[I must agree with this to an extent. I believe I have had a few panic attacks, but usually I just break down and freeze before I can even get that far. If a real panic attack MUST be accompanied by the feelings of dying, then I have NOT actually suffered one, though what else would you call screaming, crying, and shaking like a leaf when confronted with something most people see as a simple task? I suppose "anxiety attack" is a much better term than simply "overreacting."]

There needs to be a clear distinction between these terms, as many people are misdiagnosed as a result of the current language in the DSM.

In addition, people can have both panic disorder and social anxiety disorder. In these cases, which are not common, it is typically the panic disorder that is the most bothersome initially.

http://www.socialanxietyinstitute.org/dsm.html

The distinction between social anxiety and panic disorder is probably the most misunderstood subject concerning anxiety disorders. Many clinicians and therapists have not been adequately trained to understand or diagnose anxiety disorders in general -- and the clear-cut distinction between these two anxiety disorders is often misunderstood.

Even normally reliable and scientific sources fail to make correct distinctions between these anxiety disorders.

Confusing the picture even more is that many people with any type of anxiety disorder are typically misdiagnosed as being "depressed''. This occurs because most people with an anxiety disorder, including panic disorder and social anxiety, are naturally "depressed" over their anxiety and the significant impairment it causes in their daily lives.

Technically, it may be more accurate to diagnose people with anxiety disorders as "dysthymic". The main point, however, is that it is the anxiety that causes the depression (dysthymia) and not the other way around. Once the anxiety shrinks and is overcome, the depression goes away with it.

[I believe this has happened to me. In addition to being diagnosed with OCD and mild ADD, I was diagnosed as mildly depressed. I have ALWAYS believed this depression--or more appropriately, dysthymia, as it's usually a milder feeling hovering in the background, not an all-consuming despair--was caused by the anxiety itself. I KNOW that if I were not so damn anxious about everything, I would not be nearly so depressed all the time, either. Really, how happy can you be when just about everything you do worries you? You would likely be depressed, too. (As a result of the diagnosis I was prescribed Prozac--an anti-anxiety medication which is also used to alleviate depression. It helped with that a bit, but since I got little help for my actual disorder itself, nothing really changed...and I have not been on the medication itself, nor in therapy, for years now. Since coming online, even though the Net has opened up new avenues of interacting with people in ways I never would have been able to before, I have only become worse.)]

PANIC DISORDER

People with panic believe very strongly that the "panic attack" they experienced means that something is physically wrong with them.

For example, many people with panic disorder fear that they are having a heart attack, that they're about to lose control, or that they're going crazy. Other people with panic believe that because they can't catch their breath that they're suffocating, or that the dizziness, lightheadedness, and "unreal" feeling they experience means they have a terrible undiagnosed illness.

For example, the person with a tightness around the head fears they have a brain tumor. The person with muscle spasms fears they're coming down with a muscular disease. Heart palpitations and/or skipped heartbeats "prove" that there's something wrong with the heart.

People with panic disorder can be checked, rechecked, and repeatedly use the hospital emergency rooms before it ever becomes clear to them that they are legitimately suffering from anxiety, and not a physical, medical condition.

[Here is where I have long misunderstood the term "panic attack." I still do use the term to describe what should now be called an "anxiety attack." I have NEVER thought I was suffering a medical emergency, but I have had what the general population could call a panic attack. But it's not a panic attack according to diagnostic terms. I do not suffer from panic disorder, nor have I ever believed I do. I believe with panic disorder there is often no recognizable trigger for the anxiety, whereas in my case, there is--being in social situations.]

The central point is that people with panic fear that they have a physical, medical disease. Otherwise, what else could explain the suddenness and awfulness of that first panic attack? How could the mind have something to do with the horrible swirling emotions and feelings that overload the person during this traumatic and emotional attack?

A great many people who experience their first panic attack find their way to the hospital emergency room or go directly to their physician's office. They feel their life is in danger and they legitimately want a diagnosis to explain it.

When doctors report that they can find nothing wrong with the person medically, it only heightens the person's anxiety. After all, something must be wrong or else how do you explain the horrific sensations and emotions they went through during the panic attack?

Unfortunately, many people are never told that they are experiencing anxiety, and that a panic attack could be the culprit.

Sometimes, especially when the panic attacks occur frequently and in many diverse places, the person feels more and more restricted as to where they can go and still be safe. When a person feels their "safety zone" is a limited area around their house, and they fear they’ll have panic attacks as a result of getting too far away from this protection and safety, they may become agoraphobic. That is, they will typically stay in their homes, avoiding the outside world, for fear of having a panic attack.

[Once in a while I will sort of half-jokingly "misuse" the term agoraphobia to describe myself, particularly lately. I rarely get out of the house, as getting out of the house puts me in social situations I'm not equipped to handle. I DO have fears of messing up in public, but I'm not really agoraphobic. I just sought a term to describe how I've become practically housebound; "agoraphobic" was the most understandable term. But no, I am not truly agoraphobic. Agoraphobia, as it says here, is usually a SYMPTOM of panic disorder--not a disorder itself. It's what panic disorder can TURN INTO if it gets worse. Surprisingly...I learned that there IS a term for my particular situation, and it's a term I've been using to describe myself for a long time. Please keep reading...]

People with panic disorder are generally sociable people, and they do not avoid social encounters or social relationships because of fear. The reason for avoidance is fear of having a panic attack in public, where they feel vulnerable and unsafe.

[This was news to me. I had always assumed agoraphobics and those with panic disorder were as "unsociable" as "social phobes" are, but as panic disorder is more of a random, untriggered type of anxiety, why SHOULD they be afraid of interacting with people, since people are not the real trigger? The attack itself is the trigger--it usually has no real cause that they can see (at least, this is what I'm assuming based on what I've read--sorry if I'm wrong). Whereas with socially anxious people, we know what our trigger is, and we avoid it because of that very reason--because it IS the trigger--not because we might have a random attack in its presence. We are pretty much assured we will have some kind of attack if we set foot out in public! (In a way, it must be even harder for those with panic disorder, as they don't have a particular situation they can avoid, short of becoming agoraphobic. It must feel awful not to know exactly where your fear is coming from.)]

SOCIAL ANXIETY DISORDER (Social Phobia)

People with social anxiety disorder do not believe that their anxiety is related to a medical or physical illness or disease. This type of anxiety occurs in most social situations, especially when the person feels on display or is the center of attention.

The socially-anxious person has extremely high anxiety when they're put into a position to make small talk with others or interact in a group. The anxiety becomes worse when the person fears that they are going to be singled out, ridiculed, criticized, embarrassed, or belittled.

People with social anxiety find it to be a terrifying experience to interact with unfamiliar people, give any type of public presentation, or even be publicly noticed. For example, the office may be planning a birthday party for the socially-anxious person -- and instead of this being a pleasant and happy experience -- it will cause great anticipatory fear and dread -- because they will be on display.....in front of all those people...and then they fear they will do something to make a fool of themselves.

[I was feeling this way quite recently...stated it in my private offsite journal, in fact. What if I get a present I don't like? I will have to lie and pretend to like it. What if they see right through me? Will they think I'm a total jerk? What do I do...? Needless to say, I have not enjoyed any of the major holidays for years now. This INCLUDES giving gifts to OTHER people--what if they don't like it? Will they be angry with me?--etc.--and this is also a reason that replying to reviews, notes, e-mails, etc. is so damned hard for me--what if I say the wrong thing? What if they see through my "form letter" thank you? What if I miss replying to the part they want me to reply to the most? What if I have nothing to say?...]

The person with social anxiety is sometimes viewed as "quiet", "shy", "introverted", or "backward". They are continually concerned that other people will notice their anxiety and they will be humiliated and embarrassed as a result.

Most people with social anxiety disorder hold down jobs that are well beneath their capabilities and capacities because they fear job interviews, working in a position where there is too much public contact, and being promoted to a position where they would have to supervise other people.

[Or they do not hold down jobs, period.]

When socially-anxious people isolate themselves as much as possible and are somehow enabled to stay at home and not work, their social contact can drift down to the immediate family or to absolutely no one at all.

[This is the stage I have been at...ever since graduating high school in 1995, I believe. After college graduation in 1997, until coming online in 2000, I had practically no real contact with outsiders short of shopping for groceries with parents. I still have practically no contact with real-life people.]

Once a person avoids almost all social and public interactions we say the person has a severe case of social anxiety disorder, or an avoidant type of social anxiety disorder. As you would expect, people with social anxiety disorder have an elevated rate of relationship, occupational, and academic difficulties, as well as potential substance abuse problems.

[This was the biggest "aha" moment I had all this morning. I have long wondered what the exact difference is between social phobia/social anxiety disorder, and avoidant personality disorder. I assumed it was a matter of degree, and to an extent that's true. Seeing this description, however, makes a LOT of sense. Just as panic disorder can evolve into agoraphobia, social anxiety can evolve into what is known as avoidant personality disorder. I have always been "shy," so I assumed I was avoidant to begin with, and this manifested itself as social anxiety; personality disorders are so difficult to treat as they are so ingrained. Could it be, however, that they can sometimes be learned? Did I actually just have this whole thing backwards? After being so anxious all of my life, I've finally "learned" to just avoid everybody and everything COMPLETELY. I've become avoidant. Could that really be what's been happening all along? Instead of having one disorder or the other, or being avoidant and then becoming anxious, was I anxious to begin with and I merely...progressed into the next stage? It makes an awful lot of sense to me...]

To escape the constant anxiety, many people with an anxiety disorder (both panic and social anxiety) turn to alcohol and substance/drug abuse.

SYNOPSIS: DIFFERENCES

People with panic disorder experience a horrible anxiety attack accompanied by many physical symptoms that are originally interpreted as a physical, medical problem. Socially-anxious people experience horrible anxiety in social situations that lead them to stay away from other people because of the anxiety it causes. They see anxiety as a "fear" and do not believe it is caused by a physical, medical condition.

Panic and agoraphobic people are many times very social. In fact, the majority of panic people enjoy the company of talking and being with other people. This is nowhere more apparent than in a therapy group with other people who have panic and/or agoraphobia. The room is alive, active, open, friendly, and sometimes even noisy.

Contrast this picture with the life of socially-anxious people. Even though they are lonely and would like to be with other people and enjoy their company, the heightened anxiety this would cause overpowers the loneliness. Thus, the socially-anxious person stays alone. In a therapy group meeting of socially-anxious people, the room is fairly subdued, particularly during the first few sessions. Individuals are afraid of talking, drawing attention to themselves, and risking anticipated embarrassment.

Contrary to popular conception, people with social anxiety disorder do not develop agoraphobia. Agoraphobia results from the fear of panic attacks, not from the fear of social interactions. Likewise, people with panic disorder do not develop avoidant personality disorder. Avoidant personality disorder results from social anxiety as people continue to cut themselves off from most of the world because of the fear of social interactions and other people, not from the fear and dread of having a panic attack.

(Note: We, as a therapeutic and research community, are light years behind where we should be concerning the anxiety disorders. It is still prevalent within our own professional communities to dismiss the anxiety disorders as unimportant and not be able to make the clear-cut clinical distinctions that are apparent to those who specialize in this area.)

[This was my exact problem in figuring out the difference between avoidant personality disorder and social anxiety. Nobody seemed to really know the answer! And I was NEVER diagnosed with EITHER!]

Also, contrary to current psychiatric/psychological nomenclature, people with social anxiety do not have "panic attacks". They experience extreme anxiety in social settings where they fear they will have to perform or be on display. It is not uncommon for socially-anxious people to use the terminology "I panicked". Again, however, the distinction here is that the person is not talking about the sensations leading to a physical pain or condition. They are referring to a very high level of anxiety and the adrenaline rush that accompanies it.

It is possible for a person to have concurrent symptoms from both of these anxiety disorders, although one or the other will usually be more prevalent. For example, a person with panic may also be socially-anxious concerning several different life situations, such as fear of public speaking and fear of being assertive. It is also possible for a person with one of the anxiety disorders to develop another disorder at a different period during the lifespan. People may also simultaneously suffer from several of the other anxiety problems, such as obsessive-compulsive disorder, post-traumatic stress, and/or generalized anxiety disorder.

[I think this was the biggest problem in my therapy--as the OCD was the disorder which attracted the most attention, it was the one which was diagnosed. I cherish my psychologist, but I have to wonder if she believed my difficulty opening up and socializing was because of mere shyness, or because of the OCD, rather than because of a greater underlying problem...social anxiety. I fail to see why I was not diagnosed with this problem, unless I was seen as "merely shy." All of my life people have called me "shy"--they've never really understood what a hell is going on in my head all the time. To this day, I HATE the word "shy"--it minimizes everything I feel.]

It appears from the latest epidemiological data that social anxiety disorder is the most common of the anxiety disorders.

Lending credence to this data is that many socially-anxious people find it extremely difficult to seek help – going to therapy is a social event where the person is dealing with an authority figure on a 1:1 basis. Just the thought of this can create high levels of anxiety, and hold the person back from seeking help (even though they want it desperately).

[By now I am so desperate I would not even care. But I WOULD much prefer my old psychologist...I don't know if I would even be able to bond with another total stranger. It takes so long. Before being diagnosed, I was shuttled around the mental health circuit so much that I could not get close to anyone. It's a wonder I did get close to anyone at all...but then it was just taken away from me, anyway. No more insurance.]

Panic disorder with and without agoraphobia seems to be the second most common anxiety disorder.

The anxiety disorders as a whole continue to be the disorders that plague and afflict the largest number of people on the planet.....

The anxiety disorders as a whole continue to be the area in which the LEAST amount of research and clinical experience is available.....

The general public continues to hear more about the obscure psychological disorders that seem bizarre and strange, thus commanding a greater deal of media attention.....

And because of this misfocus, people with anxiety disorders continue to be the losers.....

[Rest of article omitted--please see link.]

http://www.socialanxietyinstitute.org/diff.html

1. Most people, even professional organizations, have a difficult time understanding the definition of "social phobia".

For example, the largest anxiety association in the world many times misuses the term. When it tries to give a case study or tell a story about a person with "social phobia", the story invariably turns into a story about a person with agoraphobia, an entirely different anxiety disorder.

2. The people, organizations, and sites that lump "the phobias" together are doing a real disservice not only to this problem (which, by itself is the largest anxiety disorder), but to the "true" phobias, such as specific phobias (i.e., fear of snakes, blood, insects, etc.)

3. Social anxiety permeates all of a person's life. It is all-encompassing.

[This is what pisses me off the most! It's not like it's a dinky little phobia you can just get rid of with a little positive thinking or confrontation. We DO confront it--EVERY DAY! Like I said--a lot of good it does! Just yesterday I had to get my ID picture retaken...I handled it well, but as soon as we exited the building, I started babbling, "She must have thought I was a total jerk--I should have said, 'No thank you,' instead of just 'No,' when she told me to smile...she must think I'm a horribly annoying person...I ruined her day...I'm such a jerk..."

[Take that attitude, magnify it ten times, and apply it to EVERY SINGLE SOCIAL SITUATION you've ever been in. Now see why it can hardly be compared to somebody avoiding dogs or spiders? It's kind of hard to avoid SOCIETY!]

People with social anxiety fear social situations and events, they do not fear having panic attacks. They fear the high amount of anxiety and the negative self-appraisal experienced before, during, and after a social event.

4. Social anxiety and agoraphobia are light years apart in terms of operational definitions.

Social anxiety is a fear of social activities, events, and the people associated with them, which leads to high levels of anxiety, and, therefore, motivates the socially-anxious person to avoid them.

Agoraphobia results as a reaction to panic attacks that occur frequently and in many places, thus making people with agoraphobia feel unsafe when leaving their "zone of safety". The fear is of having a panic attack, not a fear of social situations and other people.

5. When an organization or group lists social anxiety as a part of the "phobias" it is a strong clue that they probably do not understand social anxiety, its complications, and its distinctiveness from the other anxiety disorders.

This is particularly sad, given the huge numbers of people who live with social anxiety.

[Ditto my thoughts above. Not to malign people with "simple" phobias--I know how terrifying they can be, what with my acrophobia and hydrophobia--but it is MUCH easier to avoid heights and water than it is to avoid EVERYTHING and EVERYBODY, especially when you are so incredibly lonely!]

6. The word "phobia" is inappropriate to this condition, and brings to the imagination a type of chronic knee-jerk avoidance that is permanent.

Social anxiety, on the other hand, is successfully treatable, providing that cognitive-behavioral therapy is a part of the program.

7. Why should the largest anxiety disorder, one that affects 7-8% of the population at any given time, be lumped together indiscriminately with other anxiety disorders, thus diluting its already misunderstood status?

This lack of diagnostic precision is a direct hindrance to people who are in great need of help for a specific, clearly definable, anxiety disorder.

8. The term "social anxiety" (social anxiety disorder) is more precise, clear, and understandable than "social phobia".

[I agree--henceforth my e-mail address of "social_phobe" shall be seen as a jokey name and nothing more. Though that's pretty much all it was to begin with. O_o ]

http://www.socialanxietyinstitute.org/prefer.html

And last but not least...

The biggest barrier to overcoming social anxiety disorder (social phobia) is to know what problem you have -- and then be able to define it.

Because social anxiety disorder is a relatively new diagnosis, many professionals in the field are not aware or have incorrect conceptions of this problem. For example, many professionals confuse panic disorder with social anxiety disorder -- please see the article on how to differentiate between these two anxiety disorders.

It is not uncommon for the socially anxious person to seek help and be misdiagnosed. At The Social Anxiety Institute, we see socially-anxious people on a regular basis that come to us after being misdiagnosed as having:

among others. Receiving an incorrect diagnosis like this, the socially-anxious person many times accepts this "label" as fact and begins taking medication that is not appropriate.

Even worse than this, people still do not know what really is troubling them. Thus they may spend many more years and thousands of dollars to find out...if they ever do.

[It bothers me greatly to this day that I was never diagnosed as socially anxious...because even before I knew what OCD was, I always KNEW I was more than just "shy." I didn't know the name of it back then, however, so I could not speak up on my own behalf...thus, the diagnosis was missed. I am still officially nothing more than "just shy."]

If you are socially anxious, it is very important that you seek treatment from a professional who thoroughly understands your problem and the depth of pain you endure every day. It is also important that your therapy be cognitive-behavioral in nature, because research has been clear that this form of therapy is the only effective method of reducing and eliminating social anxiety once and for all.

Socially-anxious people who are misdiagnosed are often prescribed medication that is inappropriate. The appropriate medication, as a tool to reduce anxiety and continue with cognitive-behavioral therapy, is very beneficial when needed.

But, please be aware that medication does not change brain patterns or brain chemistry forever. That is why you need to take the medication every day. If you stop taking it, your brain reverts to its old "patterns".

Only by learning and acting on new behaviors do your neural pathways and brain chemistry change permanently.

This can only be done through an active "learning" therapy, not through analysis or medication.

-Thomas A. Richards, Ph.D., Psychologist
Director, Social Anxiety Institute

http://www.socialanxietyinstitute.org/misdiagnosis.html

In addition I ask that you please visit the following link to see why I keep insisting I am so stupid, ugly, hateful, untalented, useless, and everything else--even now--even if there is by any chance somebody who does not agree with me. (Of course, I think everybody secretly believes I AM each of these things, but they are too polite to say so.)

http://www.socialanxietyinstitute.org/dysmorphia.html

Apologies, once more, for the length of this...this will go a good way toward freezing this journal due to entry size. :/ Oh well. Not like I've been typing anything else up for the past week.

I hope somebody read through all of this and learned something, like I did...tar.