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Forum Name: Psychiatric Topics

Question: Social Anxiety Diagnosis Question

 wikitiki10 - Tue Aug 03, 2010 12:35 pm

Hi, I'm Sean and I'm 15.
I think I have social anxiety disorder but I'm too afraid to go to the doctor's office to get a diagnosis for fear that he might tell me that I don't have it. I think he might say that because I am in my teenage years and my hormones are raging. What should I do and can you tell me about the diagnosing process?
 Faye Lang, RN, MSW - Thu Aug 05, 2010 11:02 pm

Hi Sean,

The key feature of Social Phobia is a pronounced and persistent fear of social or performance situations in which embarrassment might occur. Being exposed to the social or performance situation causes an immediate anxiety response. The person knows their fear isn't reasonable or is excessive, but they are unable to control it. The fear or anxiety significantly interferes with their daily routine or social function, or the person is extremely distressed about having the phobia. The criteria for diagnosing Social Phobia are established by the American Psychiatric Association and are described in the Diagnostic and Statistical Manual of Mental Disorders which is maintained, updated and published by that organization. I'll paraphrase the criteria:

A pronounced and persistent fear of one or more social or performance situations, where the person fears that the exposure to unfamiliar or to scrutiny by others will be humiliating or embarrassing. The person knows the fear is excessive or unreasonable, and avoids such situations or endure them but have extreme anxiety and stress. The fear, anxiety, and/or avoidance interferes with the person's normal routine, or with social activities or relationships, or there is severe distress over having the phobia. In persons under 18 years, the phobia must have been present for at least 6 months. The fear or avoidance can not be due to substance abuse, medication, or a medical condition, or by another mental disorder.

A certain amount of such anxiety and fears really is a normal occurrence in the teen years, so the issue for you is the intensity of the fears. It's never pleasant to be embarrassed or humiliated, and unfortunately, teenagers often enjoy inflicting those feelings onto others with great humor. Wishing to avoid being the object of such actions is not abnormal - unless it's to the degree I described above. You didn't mention the reasons why you think you have a Social Phobia Disorder, but if it involves bullying or excessive teasing by others in a school situation, please involve your parents and your school counselor and/or your teachers. If you are worried about how you'll appear in front of those you find attractive, that too is an uncomfortable norm. If you think you meet the criteria for the disorder, make a list of why you think so, and take it with you to see your doctor. If you'd like, write a little more about why you think you have the disorder and I'll review it for you and give some guidance about the next best step for you to take.

I hope this is helpful to you. Good luck.

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