Social Anxiety Disorder (Social Phobia)
According to the Social Phobia/Social Anxiety Association of the States, Social Anxiety Disorder (Social Phobia) is the third largest mental health problem in the world. Latest government data show that Social Anxiety Disorder affects over 7% of the population at any given time. The life time prevalence rate (i.e. the chances of developing Social Anxiety Disorder at any time during the lifespan) stands at above 13%.

Social Anxiety Disorder is a relatively new psychiatric diagnosis. It becomes more specifically described in the Diagnostic Statistical Manual in 1987. Thus, not only is the public ignorant of this major anxiety disorder, the majority of professionals are not aware of it either.

This disorder comes in two forms:

1. Social Phobia - people fear for specific situations such as in front of crowds.
2. Generalized Social Anxiety - people are anxious and nervous in almost all social situations.

People with social anxiety are often seen by others as shy, quiet, backward, withdrawn, inhibited, unfriendly, nervous, aloof and disinterested. Yet they longed to be "normal" socially, they want to make friends and engage in social interactions. They suffer in agony.

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

• Being introduced to other people
• Expressing own ideas or discontent
• Being the centre of attention
• Performing publicly, e.g. entering competition, making a speech, playing musical instruments etc.
• Participating or leading social events
• Meeting people in authority, e.g. important people or authority figures
• Feeling insecure and out of place in social situations, don't know what to say
• Getting embarrassed easily, e.g. blushing
• Making eye contacts with others
• Eating, making phone calls, talking or writing in public

Three levels of responses
Under such social situations, people with social anxiety usually respond in three different levels:

1. Negative thoughts
   They always carry negative thoughts. They feel being rejected and misinterpret others' attention to them as a sign of humiliation. Yet the more they worry, the more they feel being perceived as "abnormal" or having mental health problems. They feel anxious and difficult to adjust in social situations.

2. Psycho-physical responses
   When people are occupied with the negative thoughts, the following signs will be noticed: anxiety, intense fear, nervous, racing heart, blushing, excessive sweating, dry mouth, trembling, muscle twitches and rapid breathing. Constant and intense anxiety is the most common feature.

3. Behaviour
   People with social anxiety know that their anxiety is excessive and irrational, yet these thoughts and feelings are so persistent and real that they feel under constant threat. In these situations, they either try to escape or if with no choice, they just tolerate silently. Their struggles are reflected in their daily behaviour.

Treatment
Anxiety symptoms and behaviour would persist if not receiving proper treatment. Research indicated that the most effective treatment method is the combined use of drug treatment (e.g. anti-anxiety or anti-depression medication) and cognitive-behaviour therapy. Early intervention is the best solution.

社交焦慮症
根據美國社交焦慮症協會指出，社交焦慮症是現時世界排行第三位的精神健康問題。專家指出全球約有7%的人患有這病，而平均每100個人當中就有13個人有發病的機會。

社交焦慮症是一項較新的臨床診斷，於1987年的精神科診斷統計手冊(Diagnostic Statistical Manual)才有較詳細的界定，故此不單市民對這病症不太認識，甚至專業人士亦不易察覺病徵。

社交焦慮症可分為特定性(Social Phobia)及廣泛性(Generalized Social Anxiety)。前者指患者對特定或個別的社交場合感到害怕，而後者則代表患者廣泛地害怕不同的社交場合。

在別人的目光中，社交焦慮症患者是一群害羞、安靜、退縮、隱藏自己、不友善、緊張、迴避別人或對其他人和事不感興趣的人。但其實他們十分渴望可以擁有「正常」的社交生活和與別人溝通，他們內心的痛苦是不能言諭的。

常見的社交焦慮情境
社交焦慮症患者害怕在以下的場合出現：

• 被介紹給別人認識
• 表達不同的意見或不滿
• 成為別人的目光焦點
• 在公開場合表演；例如比賽、演講、演奏樂器等
• 參加或主持社交活動
• 與有權位的人會面；例如與重要人物交談
• 在社交場合中不知所措，不懂得如何應對或表達自己
• 容易「臉紅」及感到「難為情」
• 接觸別人的目光
• 在公眾場所吃東西、打電話、傾談，甚至寫字

三種層面的反應
面對以上的情況時，患者常有下列三類的反應：

1. 負面思想
   社交焦慮症患者常帶負面的想法。他們覺得自己不被人接納，常誤會別人的目光或注視是輕視他們的表現。當他們越擔心別人因察覺到他們的緊張而被現為「行為不正常」時，他們便越加緊張及難以適應社交場合。

2. 生理反應
   當患者的腦海中充滿著重覆的負面思想時，身體會出現以下的徵狀，包括：焦慮、極度恐懼、緊張、心跳加速、臉紅、大量出汗、口乾、手震、肌肉抽搐、呼吸急促等。而持續明顯的害怕感是最常見的情緒反應。

3. 行為表現
   雖然患者均知道自己的焦慮是過度及不合理的，但那種置身於受威脅情境下的感覺令他們不其然會逃避；或若沒有選擇下，只好勉強忍受。這種內心掙扎亦會表現於日常行為中。

治療
若得不到合適的治療，這些焦慮的思想及感覺只會持續而不會自動消失的。研究顯示最有效的治療方法是同時進行藥物治療(如服用抗焦慮或抗憂鬱藥物)及認知行為治療法(Cognitive-behavioural therapy)。而最重要的還是及早向醫生尋求協助。