Fears in teenagers: what are they, and how to help cope with them?

Social phobia - how to get rid of it yourself, when is it possible and how? In what cases can you not do without the professional help of a psychotherapist? What are the main psychotherapeutic methods effective in treating social phobia? We asked Chief Medical Officer Vladislav Sipovich, a practicing psychiatrist, psychiatrist-narcologist and psychotherapist, to answer these questions.

Social phobia – is treatment by a specialist necessary or can you manage on your own?

First of all, I want to remind you what social phobia is, why it is dangerous and why its manifestations should not be ignored.

Social phobia, or social phobia, is an anxiety disorder characterized by a fear of communicating and social contacts, performing activities and working while being observed or in the presence of others. The most typical situations that cause fear in a social phobic may be the following: • Speaking in public. • Communication with unfamiliar and unfamiliar people not only through direct contact, but also by telephone. • Conversations with authoritative people, interviews, business contacts. • Eating in public catering establishments - restaurants, cafes, workers' and student canteens. • Personal dates, parties, holidays and other social events. • Being in a crowd, a large flow of people, including at a stadium, concert hall, cinema, supermarket, large office space, etc. • Visiting public toilets. • Participation in team games, dance classes and any other activities that are performed in public and attract the attention of others. Of course, not every uncommunicative or withdrawn person suffers from social phobia. This may simply be a character trait, but an introvert does not experience fear of communication and, if necessary, easily makes contact without any anxiety. A sociophobe is simply horrified by anxiety before an upcoming social contact or going out into the world. Even the most insignificant situation can bring him into this state, for example, a conversation with a seller or another buyer at the checkout, a discussion of some issues in the audience, and even more so, participation in discussions.

A social phobe always thinks that others are much smarter, wittier, more beautiful, more competent and more educated than him. Therefore, he is constantly afraid of ridicule, condemnation, non-recognition and is afraid to express his opinion. Naturally, such a situation not only does not contribute to career advancement, but also hinders the development of a person as an individual, and also significantly worsens the quality of his life.

In addition, the manifestations of a phobia can be so strong that a person prefers to spend most of his time at home, practically not leaving it, working remotely, and ordering groceries and other goods for home delivery. Such a life of a hermit, communication only with a computer or on social networks, a virtual lifestyle deprives a person of a sense of reality and often leads to maladjustment in life. For some time, such a comfortable position for him is quite satisfactory for the social phobic, but sooner or later he begins to realize the futility of such an existence, the lack of communication, the impossibility of starting a family and achieving professional success. Ultimately, such a situation for a person, as a social being, often ends in deep depression with all the ensuing consequences, including suicide. We have found out why fear of society is dangerous, but how to treat social phobia largely depends on its type. It is known that there are two forms of social phobia: • Isolated, single monophobia, when fear arises only in a specific social situation, for example, when eating in public, talking with high-ranking people, doing certain work in the presence of others, even close people. For example, cutting an ordinary salad under the watchful eye of a friend, a picky husband or mother-in-law can turn into a real nightmare - everything will fall out of your hands, the knife will not obey, the oil will overflow, the salt and pepper will spill, and the dish will ultimately earn everyone's disapproval. Naturally, this will only increase the fear and anxiety of strangers in the kitchen. Isolated phobias also include ereytophobia - the fear of appearing awkward, experiencing embarrassment, or, God forbid, blushing in company, especially when there are people of the opposite sex in it. • Generalized social phobia, when the list of situations that frighten a person includes almost all possible contacts and circumstances that require communication with other people at any level. An enhanced avoidance reaction leads to disruption of psychosocial orientation, formation of inadequate adaptation to fears, disruption of social connections, and suffering in all areas of human activity.

It is precisely this kind of extended social phobia that it is no longer possible to fight on your own - you can no longer do without medical intervention, especially when comorbid (combined) mental disorders appear.

What are phobias

The concept of "phobia" comes from the Greek "phybos". This is a mental disorder associated with uncontrollable fear of certain situations or objects. Most often, the factors causing the disorder include insects, people, animals, darkness, etc.

Finding oneself in the same space as an object of fear causes increased anxiety or a panic attack in a person. In this case, the pathology is accompanied by a variety of painful symptoms. In severe cases, the patient is overcome by such strong fear that he can harm himself or others.

How to overcome social phobia on your own?

If a person suffers from monophobia, then there is a high probability that he will be able to cope with it on his own. But consulting a psychologist or psychotherapist obviously wouldn’t hurt. A specialist will be able to give recommendations taking into account your type of nervous system, the main channel of information perception, specific life circumstances and the severity of symptoms. Of course, I can give some practical advice on how to get rid of social phobia on your own, but I still insist on the need for preliminary consultation. So, first of all, a person with manifestations of social phobia must change his way of thinking: • Completely get rid of negativity towards himself. • Firmly understand that he has something to say and offer to others. • Realize the pointlessness and futility of avoiding the company of other people, and also that they are not monsters and they have something to do other than discuss your qualities and actions. • Convince yourself of your purposefulness and the significance of your own thoughts and actions. You can achieve these results and learn to think positively if you think about it for 10-30 minutes every day.

In addition, if you do not want to seek advice from a psychotherapist, you can find on the Internet people with similar problems who have successfully coped with social phobia. Find out how they managed to do this, and try to find for yourself the most positive and acceptable solution on how to overcome social anxiety in yourself. Positive thoughts are followed by the next stage - getting rid of fear. After all, no matter how positively you set yourself up, anxiety and fear, a feeling of discomfort and awkwardness when communicating with other people still remain. This is what you should do: • At the first sign of panic, start breathing deeply, do not make sudden movements and do not convince yourself that you are not afraid. Violently denying fear can only make it worse. Just try to fix your attention on something else, for example, the rhythm of your breathing. Do not avoid situations that frighten you, even carefully meet them halfway and each time accept the challenge of your own phobias. Believe me, only those who fight win. • You should not start with sudden attempts to immediately plunge fully into your fear; start small and gradually. For example, if you are afraid of crowds, then you should not immediately mix with a large number of people - just stand at a distance and watch what is happening. Then you can start asking questions to strangers, for example, what time is it, how to get somewhere, etc. Subsequently, you can try to talk to a person of the opposite sex. • Establishing business connections and contacts will be the next step in the fight against fear. Make purchases yourself, ask other buyers for their opinions about the product, contact sellers and managers for advice, and in transport, feel free to warn about your stop, and do not wait for someone to demand it before you. Be moderately active in such situations and over time the fear will become less and less. • Try not to depend only on the opinions of others, increase your self-esteem, trust your opinion and intuition. Hear your inner voice and then those around you will hear you. To overcome feelings of insecurity and become convincing to yourself and others, do the following exercises: • Developing beautiful speech by reading poetry aloud. • Coming up and presenting speeches for yourself on any topic. • Tell yourself about the past day's activities and the weather. • Training on close communication skills. • You can even try pantomime in front of a mirror, showing with signs what you want. This will make you feel more relaxed and eliminate the fear of looking ridiculous and funny. And yet, you always need to be internally prepared for communication, for the fact that someone wants to ask you about something or find out your opinion on a certain problem. To avoid getting into an awkward position, first understand the essence of the question and then answer. Understand that your opinion is really important to others if they are interested in it. To summarize, I can give a rough plan on how to treat social phobia yourself: • Recognize your problem, do not deny it and do not put off solving it until later. • Change your lifestyle, get active in a good and careful way, stay alone less and try to go out “in public.” • Don't forget about the above training. • Develop a sense of humor, be able to laugh at yourself and your fears. After all, nothing bad happened because they made fun of you or laughed at you. Remember the old Jewish joke: “It’s not scary when they laugh at you, but when they cry at you.” • Do not use doping in the form of alcohol, much less soft drugs, to increase sociability. • Do not accumulate resentment and do not hold grudges. Rancor and hatred are bad advisers in establishing communication with other people and are destructive to the psyche. If all your attempts have not brought significant results, seek professional help from a psychotherapist who will competently assess the depth of your problem and prescribe adequate psychotherapeutic and, if necessary, medication treatment.

Types of phobias

The disease is of two types - primary or secondary. The first category includes fears associated with one object or a specific situation. Secondary pathology is characterized by the addition of other disorders. For example, if a person is only afraid of spiders, this is a primary species. If, over time, a second, third and subsequent phobias appear, we can already talk about a secondary pathology.

In total, there are about 40 thousand phobias in the world, so it is impossible to consider everything within the scope of this article. The table shows the main types of violations that occur most often.

Tell us in more detail about psychotherapeutic and medicinal methods of treating social phobia.

The most effective and promising direction of psychotherapy in the treatment of social phobias is cognitive behavioral therapy (CBT), especially group sessions and the exposure method. The patient is gradually taught to treat previously disturbing situations without fear or anxiety. By acting in a group, participating in role-playing games and trainings, a person restores previously lost communication skills and acquires new ones, develops an adequate line of behavior in society in various situations, forms new mental attitudes based on a sense of dignity and awareness of his significance and uniqueness as an individual. For example, with assertive training, a person learns to defend his opinion, not to depend on external circumstances and assessments, to independently choose a line of behavior, control and be responsible for it. Self-respect and respect for others, the desire to reach a reasonable compromise, the ability to hear and understand another person, and also to make someone listen to oneself is the goal of such group classes. The patient also learns to control his physical responses to fear and anxiety. For example, a patient whose hands begin to tremble when communicating is asked to write on the board in a group or pour tea for everyone.

Ultimately, a person must understand his rights, which boil down to the following postulates: • I have the right to evaluate my own behavior, thoughts, feelings and I bear full responsibility for this. • I am not obliged to explain, justify or justify my behavior to anyone. • I myself decide to answer or not answer for the problems of others, and if I answer, then how deeply I go into it. • I have the right to make mistakes, illogical actions and decisions, change of views and am ready to be responsible for this. • I have the right to say: “No,” “I don’t know,” “I don’t care,” “I don’t understand you.” • I should not depend on the opinions of others and their goodwill. Of course, it is important not to overdo it, so as not to turn a social phobe into an inveterate egocentric and individualist. What is important here is a sense of proportion and the correct balance between one’s own and others’ interests. You need to be free and independent, but not ignore the interests and desires of others.

Social phobia, treatment of which by purely psychotherapeutic methods has not been sufficiently effective, can be symptomatically mitigated or eliminated with the additional use of medications aimed at eliminating symptoms of anxiety, fear and depression. These include: • Antidepressants, including SSRIs - selective serotonin reuptake inhibitors, norepinephrine and serotonin reuptake inhibitors (SRIs), and a monoamine oxidase inhibitor (MAO) called moclobemide. • Benzodiazepines (clonazepam), which may be used although effective only as a short-term treatment option due to the risk of dependence and withdrawal symptoms. In conclusion, I want to say that the sooner a person admits that he has social phobia and turns to specialists, the more effective and less radical the treatment will be, the safer the consequences for the psyche and the less significant the disruption of social ties. And this will minimize negative changes in all areas of activity of each individual patient.

Symptoms of phobias and their diagnosis

Symptoms directly depend on the type of disease. If a person is afraid of snakes, then when he gets into the same space with the “aggressor factor,” panic may begin. The same goes for other types of phobias. There are also common symptoms that unite all types of pathology. These include:

• Difficulty swallowing and a feeling of a “lump” in the throat.
• Dry mouth.
• Frequent urge to urinate.
• Diarrhea.
• Cardiopalmus.
• Breathing problems, shortness of breath
• Pain in the chest area.
• Dizziness, nausea.
• Noise in ears.
• Deterioration of vision.
• Trembling in limbs.
• Impaired concentration.
• Memory impairment.
• Increased sensitivity to noise.
• Excessive worry.
• Cramps.
• Pre-fainting state.
• A sharp increase in blood pressure.

Often the disease is accompanied by depression, depression and an obsession that something will happen soon.