Table of Contents
Social anxiety is a common problem among individuals in the society. People experiencing social anxiety feel uncomfortable at social places and have a low self-esteem (Hedman, Ström, Stünkel, & Mörtberg, 2013). Social anxiety is influenced by various factors such as one’s genetics, cognitive abilities and the coordination of the brain and the nervous system. Treatment should be offered to the individuals so that they can actively engage with other members of the society. This paper explains a case of social anxiety disorder, the causes and the treatment of the problem.
Presenting Problems
Mary experiences a social anxiety disorder. It is common to find her avoiding social institutions as she prefers to spend time on her own. She has developed a low self-esteem that limits her belief in her capabilities. Her condition is one of the more common social phobias that are present among people. Research indicates that, for example, in the United States of America, the condition is prevalent in around 18% of the total population and is most common among young adults and children. She shivers, sweats profusely and avoids eye contact when interacting mostly with strangers or where she is the center of attraction. The emotions are an expression of discomfort at social places.
Relevant History
Mary, in her late thirties, has experienced devastating effects on her social life as a result of her condition. She has been unable to qualify for most jobs due to her low performance recorded in her academic results and her weak character. She has ended up depending on her parents to satisfy her most basic needs. Over the years, the lady has developed a low self-esteem that has scattered her most treasured childhood dreams of being a manager at a corporate institution. Besides, unlike other girls, she is unable to engage in a romantic relationship which has made her remain single for almost a decade. Her doctor indicates that her poor health, which has been experienced in the past few years, has been widely influenced by the fact that she spends most of her time in the house seated, either watching the television or asleep. Her fewer interactions with the society since childhood have done her more harm than good. Her parents in interviews have identified that at the age of 14, she was sexually molested by a group of high school students. The parents relate the incidence with her current dysfunctional state. Since that time, her social interactions have been negatively affected and have cost her a lot of self-development opportunities in her life. Her parents have tried to enroll her in programs that will improve her condition, but most of them have done little changes on her behavior.
Diagnosis
The DSM-5 provides guidelines for the diagnosis of Mary’s condition. Her challenge meets the criteria provided in the DSM-5 thereby facilitating her diagnosis. She satisfies the criteria outlined in that: She expresses fear of being ridiculed or molested by people and when expected to get involved with strangers. Also, Mary experiences profuse sweating, nausea, and diarrhea when supposed to interact with people. Besides, she performed poorly in college and high school as well as in the few companies she has managed to secure a job. There is a need that her condition is addressed with immediate effect to identify the causes of her behavior and the best permanent solution to eliminate it. Proper application of the DSM-5 diagnostic procedures will ensure that she overcomes her anxiety problem.
Case Formulation
One of the major influences of Mary’s challenge can be explained from a genetic perspective. Research indicates that some individuals are more likely to be prone to social anxiety than others as a result of their genetic makeup (Waszczuk, Zavos, & Eley, 2013). The information is further emphasized on by the fact that Mary’s younger brother too has a similar condition. Her brother, unlike his sister, has had a smooth life since childbirth and hence implying that her genes could influence her condition. Kindergarten teachers have identified that one out of four kids experiences social relation challenges that are genetically influenced. Such children withdraw from others, and there is a higher likely hood that they carry the same emotions to their adulthood. Mary should have easily overcome the molestation she experienced were it not for her genetic makeup. Her parents have identified that most of the programs that they have enrolled her in have impacted less on her life. Genetics are crucial in determining human behavior.
On another perspective, her condition can be explained from a neuroscience point of view. Research indicates that there is an excellent coordination between the brain and the emotions exhibited by individuals. Cases of social disorder are an indication of disruptions on the neuroendocrine, neuroanatomical and neurotransmitters (Martin, Ressler, Binder & Nemeroff, 2010). Research indicates that the emotional regions of the brain influence anxiety disorders in the brain. These centers include the prefrontal cortex and the orbital frontal cortex that affect the processing of information and humans emotions. In this approach, researchers have nullified the information that anxiety is influenced by one’s genetic makeup. One’s social phobia is developed over time as a result of exposition to certain stimuli in the environment. In this case, Mary, at the age of 14 was unable to protect herself from the sexual molestation due to her young age. The impact of this incident resulted in the brain into developing impulses that are released whenever she is near a crowd of people. Whenever Mary sees strangers, her brain sends impulses that define her emotions. Her nervous system conducts impulses through her body that explain why she exhibits fear when around many people. Mary’s behavior is as a result of the information released from her brain which influences her behavior significantly. Also, she may opt to remain alone due to the impulses that make her believe that she is inferior. The brain, in such situations of molestation, develops ideas that one is weaker than other members of the society. As a result, when she is around people, Mary’s brain sends impulses through the nervous system which defines her social behavior.
Lastly, Mary’s behavior can be explained by applying cognitive theory. In the method, researchers have identified that individuals who experience social disorders are more likely to base their thinking on the negative aspects of social interactions rather than on the positive side (Hedman and Ström et al., 2013). Research further indicates that a majority of such individuals are pessimists. Mary’s behavior can be explained by the fact that she sees the negative in every encounter with strange people. In most scenarios, she misses the idea that social interactions are important in her self-enhancement. She overestimates the threat posed by the social institutions such as being judged and underestimates her ability to tackle issues. Her thoughts are clouded by the notion that she is less superior in the society which has developed her low self-esteem.
Treatment
Mary’s case should be addressed in the most suitable ways. The aim of the treatments should be to reduce the effects of the symptoms caused by her social anxiety disorder. One of the means would involve psychotherapy. In the treatment, the client will have the chance to change her perception in relating with people. The process would include engaging her in a therapy series with experienced psychologists who will take her in step by step process until she recovers from her condition. The treatment would include engaging her in social activities and allowing her to lead a team in tackling duties. Also, during her treatment, negative comments about her are highly avoided. Through the psychological therapy, she gets the chance to develop her confidence and self-esteem. In another mode of treatment, the physician may prescribe the client with drugs such as Paroxetine and Sertraline that inhibit her behavior. The medications may also include taking anti-anxiety drugs which alter the normal coordination of the nervous system inhibiting the relay of impulses that influence emotions that cause social anxiety. Gradually, Mary will improve in her social life.
In a nutshell, Mary’s challenge of social anxiety disorder has begun since her childhood. The various perceptions try to explain the causes of the problem and provide a bearing to the best treatment methods.
- Hedman, E., Ström, P., Stünkel, A., & Mörtberg, E. (2013). Shame and guilt in social anxiety disorder: effects of cognitive behavior therapy and association with social anxiety and depressive symptoms. PloS one, 8(4), e61713.
- Martin, E. I., Ressler, K. J., Binder, E., & Nemeroff, C. B. (2010). The neurobiology of anxiety disorders: brain imaging, genetics, and psychoneuroendocrinology. Clinics in laboratory medicine, 30(4), 865-891.
- Waszczuk, M. A., Zavos, H. M. S., & Eley, T. C. (2013). Genetic and environmental influences on relationship between anxiety sensitivity and anxiety subscales in children. Journal of Anxiety Disorders, 27(5), 475-484.