Wednesday, 27 February 2019

What The DSM-5 Doesn't Tell You About Social Anxiety Disorder

The Diagnostic and Statistical Manual of the American Psychiatric Association (APA) currently defines social anxiety disorder as follows:

The Current DSM-5  Definition:

  1. A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.
  2. Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack.  
  3. The person recognizes that this fear is unreasonable or excessive.
  4. The feared situations are avoided or else are endured with intense anxiety and distress.
  5. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
  6. The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.
  7. The fear or avoidance is not due to the direct physiological effects of a substance (e.g., drugs, medications) or a general medical condition not better accounted for by another mental disorder.
What They Don't Tell You:

  1. You have no sense of self. Quite simply, your sense of self is the identity you carry around all day every day – it is your sense of “this is me” and “this is not me.” The sense of self, also known as the ego, is an image we carry around in our minds about who we are. When we have a strong sense of self, we are able to differentiate ourselves from other people. It is the biological, psychological, emotional, and spiritual destiny of all human beings to create a strong sense of self. It feels like you have no personality or soul or that your body and soul are detached from each other. You don't know who you are or how to act around other people. You keep changing your mind about what you want to do with your life. It's almost like being constantly dissociated. People with no sense of self will often mimic other peoples personalities so that they can seem normal. They associate no sense of self with borderline personality disorder but in reality, it is more often seen in social anxiety disorder.
  2. You are likely to develop depression later on in life due to financial difficulties and loneliness. I know this all too well. I'm turning 40 this year and I am semi-agoraphobic because I am struggling with depression as well as social anxiety disorder. 
  3. You have difficulties forming relationships with other people and to maintain relationships. 
  4. You feel intimidated by everyone no matter how old or young they are. 
  5. You blush constantly when you're out in public and it's not something you can control.
  6. You have memory problems. Our memories can be affected when we are under periods of stress or experience some sort of disturbance in our mood. Having a significant anxiety disorder like SAD can create some of these problems routinely, leaving people operating below their normal level of memory functioning. 
  7. You struggle to maintain eye contact when speaking to people. You feel unable to look directly into other people's eyes when talking or feel like you are being judged or scrutinized when making eye contact.
  8. You can't concentrate for long periods when speaking to other people and tend to get distracted by your own thoughts.
  9. You are so nervous when you speak to strangers that you stutter or stumble your words.


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