Understanding the Unique Barriers for People with Social Anxiety Disorder

Today we begin a series from the Anxiety and Depression Association of America, a national organization of researchers and clinicians focusing on science, treatment, prevention, and cure of these disorders. In the coming weeks we will share posts from members of this organization shedding light on the disorder, by creating awareness about symptoms, treatment and support.

Mark Pollack, M.D.
Grainger Professor and Chairman, Department of Psychiatry,Rush University Medical Center, and President, Anxiety and Depression Association of America

People with social anxiety disorder (SAD) face unique challenges when it comes to accessing mental health care, and many struggle for years before seeking any type of treatment. For family members supporting an individual with SAD, gaining a deeper understanding of the disorder can help you guide your loved one toward appropriate care and an improved quality of life.

About social anxiety disorder
Social anxiety disorder(SAD), also called social phobia, causes extreme self-consciousness in everyday social situations. (http://www.adaa.org/understanding-anxiety/social-anxiety-disorder) People with SAD have a strong fear of embarrassing themselves or being judged by others. It interferes with an individual’s ability to form relationships, succeed at school or work, and complete everyday tasks that involve interacting with others in person or even on the phone. SAD can have a significant impact on nearly every aspect of a person’s life.

Three barriers to care
People with SAD face internal and external barriers in accessing mental health care. The primary barrier results from the disorder itself. Like many people with mental health problems, individuals with SAD tend to experience a sense of personal failing that can interfere with their willingness to seek treatment. This is magnified in SAD because, by its definition, people have more anxiety in social or interactive settings. If a person is already feeling anxious or stigmatized about seeking mental health treatment, generally, heightened concerns about doing or saying something embarrassing will make the barriers to care even greater.

The second barrier is the lack of awareness of the disorder among people who experience SAD. Further complicating people’s path to treatment is the fact that many sufferers tend to feel that social discomfort is an inherent part of who they are, rather than a disorder, especially if they have felt this way since a young age. This can further inhibit people with SAD from seeking care because it makes it hard for them to present the difficulties they’re having.

Finally, the lack of awareness of the disorder among medical providers and the general public reduces the likelihood of a potentially supportive environment for recognizing and addressing the disorder. Although there is increased understanding of SAD today, much of the general public and even some in the medical profession still fail to recognize social phobia as a diagnosable disorder that requires treatment. In part, this stems from the fact that almost everyone has experienced some level of anxiety in a social situation. Many people get nervous speaking in front of a crowd, for example.

However, for most of us, these feelings are transient and we are able to move ahead, despite our nervousness; but for people with SAD, something as seemingly insignificant as attending a staff meeting can cause paralyzing anxiety for weeks. And while most of us experience less anxiety with every social interaction we attend, people with SAD never acclimate to these kinds of social situations, and the anxiety doesn’t lessen with familiarity. Each time they encounter such a situation, it causes marked distress and impairment.

This is not the way it has to be
The number one lesson for anyone who suffers extreme self-consciousness is this is not the way it has to be. This is a condition for which effective treatment is available and seeking treatment can have a positive life-altering effect. And if you are a family member supporting a loved one with social phobia, if you see this kind of anxiety making a difference in their life—interfering with their ability to socialize, get the kind of job they want and have a fulfilling life—encourage them to get treatment and support their need to seek care. It will make a huge difference in their life.

Your Turn

  • What might be done to alleviate the internal barriers to seeking treatment?
  • What role might education—of medical professionals and of the general public—take in addressing these barriers?
  • What should society’s policy be about providing help to people like those with social phobia who are not seeking treatment, especially if they are not harming anyone?

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