What is situational anxiety

Social phobia

When fear rules life (page 7/11)

Fear of observation and evaluation

Social anxiety disorder is a "situation anxiety". It relates to activities in which those affected feel that they are being critically observed and assessed by third parties.

People with a social phobia fear situations where they will be the center of attention or where they fear they will behave in an embarrassing manner. The fear can relate, for example, to giving a lecture or participating in a larger social gathering. Other sufferers are afraid to eat or write in the presence of other people:

Markus G. was a successful civil engineer up until six months ago. He has been working for a large construction company for six years and reports that he actually enjoys his work and that he feels up to the task at hand. His superiors are also satisfied with him and offered him the position of manager six months ago.

But that was when the problems began for Markus G. He now often has to attend meetings with other departments or with external companies. Whenever Markus G. is the center of attention at such meetings, for example when he is supposed to give a short lecture or want to bring his own point of view into the discussion, he starts to sweat a lot and gets shaky hands.

He then suddenly has the feeling that everyone is staring at him, that he can no longer express himself clearly and that his voice is trembling. Markus G. is convinced that others notice the sweating and tremors in his voice and think that he is unable to exercise his position.

Lately Markus G. has therefore been silent in meetings or only said the bare essentials. His boss had already noticed this negatively. Sometimes he also lets his wife call him at an agreed time so that he can "disappear" from the meeting without being noticed. On the other hand, when Markus G. is with many people on private occasions, for example at family get-togethers or celebrations with friends, he feels comfortable and has no such fears.


The anxiety is often associated with severe physical symptoms such as palpitations, shortness of breath, sweating, tremors, nausea or the urge to urinate. People are very afraid that these signs of anxiety, such as blushing or tremors, will be noticed by others.

If the person concerned can carry out certain activities or activities without company, but feel fear in the presence of others, this is a sure sign of a social phobia.

Because of these fears, people with a social phobia avoid many social situations. In addition, they suffer from low self-esteem, believe they are inferior to others, or feel like they are failing completely in many situations.


In the case of social phobia, too, various factors such as traumatic and other stressful life experiences, incorrect conditioning, neurobiological and genetic influences are assumed to be the causes for their development.

In people with social phobia, there are indications of irregularities in the serotonin and dopamine system and abnormalities in various areas of the brain as well as cognitive peculiarities that favor a false self-perception.

Overcoming social phobia with psychotherapy

Without timely professional treatment, social anxiety disorder is usually chronic. Cognitive behavioral therapy is best suited for treatment. Anxiety-relieving medication can support therapy.

Psychotherapy can demonstrably and effectively help those affected. It aims to ensure that those affected completely overcome their phobia or at least become so controllable for them that it no longer negatively influences or restricts their life.

Frequency and course

The information on the frequency of social phobia in European studies is between four and 12 percent of the population. The disease usually begins in adolescence or young adulthood. Unlike most other anxiety disorders, men are just as likely to experience social phobia as women.

Without therapy, fear or the avoidance of social situations usually remains chronic and can even increase over time.