A clinical psychologist’s book addresses a largely ignored problem: social anxiety | UCR News

We all suffer from social anxiety. The nervousness we feel before giving a speech is one example. However, some people suffer from social anxiety more severely than others and limit their social engagement due to excessive chronic fear of embarrassment or humiliation. Although this social anxiety is common in both adolescents and adults, it is rarely diagnosed and treated.

In a new book titled Social Anxiety: Hidden Fears and Shame in Teens and Adults, Thomas E. Brown, clinical professor of psychiatry and neuroscience at the School of Medicine at the University of California, Riverside, explains how social anxiety can limit friendships and lead to loneliness and depression. The book, which he co-wrote with a colleague and just published by American Psychiatric Association Publishing, contains 22 case vignettes that highlight 11 adults and 11 teens who suffer from various forms of social anxiety as well as related conditions such as attention deficit hyperactivity disorder (ADHD), depression or autism.

“Social anxiety is a constant part of many people’s thoughts about what others would think of them,” Brown said. “For example, what would my mother, father, spouse, best friend, pastor or other people in the community think of me if they knew what I’ve done or what I think or want to do? Sometimes it has to do with specific fears about information that might be revealed. Sometimes I worry about what my parents would have thought about my actions if they were alive and could know about them.”

According to available data, the lifetime prevalence of social anxiety in the United States among adults ages 13 to 17 in 2012 was 11% among women and 6% among men. Among American adults ages 18 to 64, the lifetime prevalence was 11% among women and 14% among men.

“Social anxiety disorder is too often unrecognized by doctors, psychologists and other mental health professionals,” Brown said. “Currently, some people talk and write about it. But there just isn’t a lot of empirical research on it. Moreover, many people never talk to other people about their social anxiety issues, including their therapists.”

Brown explained that according to the Diagnostic and Statistical Manual of Mental Disorders, a manual that guides U.S. and other medical professionals in diagnosing mental disorders, social anxiety negatively affects people in several ways:

higher school dropout rates, higher unemployment, lower socioeconomic status, and higher likelihood of remaining single or getting divorced.

“Despite these difficulties, only about half of people with social anxiety ever seek treatment for it,” Brown said. “Many people are ashamed of having such fears. Typically, those who seek treatment for social anxiety do so only after experiencing their symptoms for 15 or 20 years. Some social anxieties are inherited. They can run in families. They can also be learned in a family that is overprotective.”

Brown added that adolescent girls, who develop breasts much earlier than their peers, are often self-conscious and worried about what people will think of them. For adolescent boys, it’s more a question of height and when they’ll have to undress in a dressing room.

“Such fears often get in the way of dating and romantic relationships,” he said. “For example, college students with social anxiety report less contact with the opposite sex. Some people have great anxiety about their sexual performance. They think, ‘Can I turn on my sexual partner? Am I attractive to him?'”

According to Brown, fears associated with social phobia are usually unfounded.

“Some people are just very anxious and easily become nervous in any situation where there is even a little bit of uncertainty,” he said. “Psychotherapy, interventions and prescription medications are some ways to alleviate social anxiety.”

Brown, an expert in ADHD, grew up in Chicago. He completed his undergraduate studies at Knox College in Illinois and his doctorate at Yale University. He was invited to join the clinical faculty at Yale Medical School, where he taught and treated patients for 20 years. After his wife died in 2014, he moved to California three years later to open his own clinic and be near his adult children and grandchildren. In February 2022, he was appointed clinical professor in the Department of Psychiatry and Neuroscience at UCR.

Brown has published seven books on various aspects of ADHD, many of which have been translated into foreign languages. Aimed at a lay audience, “Social Anxiety: Hidden Fears and Shame in Teens and Adults” is his first book on social anxiety.

“I hope that readers of this book and their family and friends who struggle with social anxiety understand that they can get help right away, rather than waiting 15 or 20 years before seeking help, as many people do,” he said.