Social phobia: When shyness makes you sick



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Social phobia as an illness: When shyness dominates life

According to a scientific study, up to ten percent of children and adolescents in Germany suffer from social phobia. For those affected, the fears mean massive restrictions in everyday training and professional life. “Social phobia” is the most common mental disorder in childhood and adolescence.

According to a study by the Goethe University in Frankfurt am Main, between five and ten percent of children and adolescents in Germany suffer from social phobia. This makes social anxiety the most common mental disorder in adolescence. Researchers from the joint research association Psychotherapy "Sopho.net" are now trying to find out more about causes and treatment options in a multidisciplinary way with the help of a therapy comparison study.

If adolescents or young adults suffer from strong social fears, this disease is known as social phobia. People are afraid to do something embarrassing or shameful or to say when there are other people around them. Because of the palpable fear and accompanying physical complaints, they avoid facing fearful situations. For many, it is unbearable to give a lecture at school, for example, or just to have a "casual conversation" with classmates. Therefore, if not treated, the disease has a chronic character and has manifesting effects on everyday life. Smaller failures or anxiety attacks confirm those affected in their avoidance strategy, they withdraw more and more.

Physical symptoms triggered by fear
"Adults or adolescents who suffer from social phobia experience pronounced physical symptoms in an anxiety situation," says social therapist and educator Gritli Bertram. The "fear of fear" often aggravates the symptoms. During the attacks, visible symptoms such as sweating, rapid heartbeat, tremors, dizziness, derealization, depersonalization, heartache, headache, diarrhea, gag reflex up to vomiting and inner restlessness become apparent. "Many fall silent and freeze," says Bertram.

Different triggers of social phobia
The triggers for the disturbance can be different. “There are a number of risk factors. One of them is an innate inhibition of behavior, ”Lena Krebs, spokeswoman for the“ Sopho.net ”network, told“ dpa ”. The children are remarkably shy when dealing with other people at a young age. If they are exposed to new situations, they withdraw. If there is an anxiety situation, "they react with numbness," says Krebs. A second risk factor is traumatic experiences with other people. Children experience such trauma when, for example, they are teased, humiliated or excluded. "We are talking about one bio-psycho-social model, that means, predisposition, psyche and personal experiences play together. "

When a social phobia is a mental disorder
A distinction should be made between shyness and clinically diagnosable illness. Not everyone who is shy or shy also has a social phobia. It depends on how long the "withdrawing" lasts and how much those affected experience limitations in their everyday life due to their fears. Accordingly, "duration and severity" are decisive. Cancer: "A disorder occurs when the fear is so strong that it creates suffering and affects the quality of life for at least six months." Sometimes social phobias are not discovered in time or perceived as a mental disorder because of reserved and shy children be perceived as “adapted and pleasant”. Children suffering from ADHD syndrome, for example, disrupt teaching and stand out due to their sometimes lively expression. This is not the case with social phobics.

Serious consequences for those affected
However, the consequences of social phobia can be equally serious for those affected. Because the children usually withdraw early, they do not learn important social skills. You break e.g. drop out of school, do not do any vocational training or do not have close ties. This can lead to further illnesses such as depression or other anxiety disorders, the expert emphasizes. Some try to overcome their fears with alcohol or drugs and then quickly become addicted. The later the disease is diagnosed and treated, the more intensely it manifests itself.

Different forms of therapy
Children and adolescents can get help in different forms of therapy. "There are a total of two forms of therapy that are based on different basic assumptions." In cognitive behavioral therapy, therapists assume that "incorrect information processing" maintains the fears. If, for example, the pupil is not heard by the other classmates or teachers, the person concerned can assume that his contributions to the speech are not considered interesting and that his person as such is rejected. Accordingly, he reports less in class or completely stops speaking. In behavioral therapy, the patient reports on the situation he has experienced. In the further course the therapist asks to check his acceptance. Corrective experiences should then be made with exercises so that fear can be overcome in future situations.

Psycho-dynamic therapy explores the basic causes that trigger fear. The therapists assume that "fear is the result of unresolved conflicts in dealing with others". The fear could be triggered by an "unconscious inner conflict between desire and reality". During the therapy period an attempt is made to resolve this conflict. Both therapies can be combined with autogenic training, muscle relaxation and aromatherapy.

Subjects wanted for comparative study
The research group "Sopho.net" now wants to find out in a study which patient group is best suited for which type of therapy. However, the effectiveness of both therapies has been sufficiently demonstrated. Affected parties can contact the research project to participate in the evaluation. (sb)

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