Articles from prior issues of The Advocate

September/October, 2001

Understanding Social Phobia
by Jodi Boucher and Trish Dothage, Missouri DDS

BARBARA MARKWAY, PH.D. IS A LICENSED clinical psychologist who works at Capital Region Medical Center in Jefferson City. She is a nationally recognized expert in the area of social anxiety disorder. She has coauthored two books for the general public on the subject including Dying of Embarrassment and Painfully Shy. Dr. Markway has been interviewed on the radio programs nationwide, has been featured in national print publications such as The New York Times, and she has also appeared on Good Morning America. Dr. Markway has been performing consultative examinations for Disability Determinations for the past year. Markway spoke at the MADE Conference held at the Lake of the Ozarks in August. She spoke on understanding social anxiety disorder otherwise known as “social phobia.”

Social anxiety disorder was first recognized as a disorder in 1980. This disorder effects children as well as adults, with the age of onset in the teenage years from 15 to 16 years old. Ninety percent of all cases are diagnosed before the age of 25. Onset after the age of 25 is rare. Ten million people have this disorder and it is the third most common disorder in the United States. It is the most common among anxiety disorders.

There are three subtypes of social anxiety; generalized, non-generalized, and public speaking. Generalized involves a multitude of social situations. Non-generalized involves at the most one or two social situations. The third subtype involves anxiety with public speaking alone.

The physical symptoms of social anxiety include tachycardia, trembling, blushing, shortness-of-breath, sweating, and abdominal stress. The cognitive symptoms include maladaptive thoughts and beliefs about social situations. The behavioral symptoms involve freezing and avoidance.

Social anxiety is a chronic disorder with only 27 percent recovery and quality of life is greatly affected. Complications from this disorder include depression, truancy, alcohol and substance abuse. The characteristics of a person who suffer from this disorder include less than 11th grade education, low income, never marry, no occupation, live with parents and are under employed.

Over two million sufferers go untreated or are under-treated because of lack of information that it is a treatable disorder. Effective medications include beta-blockers, anti-seizure medication, and psycho- therapy. Social anxiety is a real and serious disorder, but there is treatment available.