Everyone experiences anxiety; sometimes it comes from stress for justifiable causes – the fear of the unknown.  In other cases, it's more chronic, and persistent, and manifests as a mental illness:  Social Anxiety Disorder.  This condition manifests as fear, or worry, or apprehension at a heightened level.  It can be directly confirmed if the subject is easily embarrassed, or terrified of practically any social situation.

Some cases of social anxiety disorder are tied to public speaking.  Now, it's normal – even for trained speakers – to have a bit of stage fright before going on to give a presentation.  However, for someone with social anxiety disorder, the experience is heightened, and not in a good way.  The date of the presentation or speaking engagement becomes filled with foreboding, often times for days or weeks in advance.  A lot of social anxiety disorder can be described as a fear response completely disproportional to the anticipated stimulus.

Another name for social anxiety disorder is social phobia; the phobia is a category for long lasting stress, fear and anxiety, to the degree that it makes it difficult for the patient to function in normal daily activities.  It is often triggered by extreme stress, or repeated high stress actions, and results in a recursive loop where the subject dwells upon and scrutinizes their activities and anxieties, at the expense of going out and doing anything. Somewhere around 13% of Americans have suffered from social anxiety disorder during their lives.

A person suffering a panic attack shows a number of common signs. These include, but are not limited to, blushing, sweating, nausea, trembling and stammering.  It's better to get a diagnosis early, as this can help stave off transitions of the syndrome to greater problems, like depression, or dysthemia. Some sufferers of social anxiety disorder self medicate, trying to numb themselves to their fear with alcohol, or using stimulants like cocaine or amphetamines to "jolt them over the top" and boost confidence.  Even large doses of caffeine can be seen as an attempt at self-medication.

Social phobics have a difficult time working with normal social lives.  They are overly self-conscious, and they place too much attention (and criticism) upon themselves, when it comes to attempting any activity.  They abound in negativity.

Their fear can be crippling, as it is persistent and all pervasive, and often completely out of line with the thing they're responding to.  It can cause them to be shut-ins; they're so afraid of being scrutinized by others, that they don't date, or go out with friends, eat out at restaurants, or even attend parties where they might have to talk to a stranger.  In children, social anxiety disorder shows up as shyness, clinging to parents, and crying.  In adults, it's sweating, and flushing and stammering.  All of these make a self-reinforcing cycle when the subject is exposed to social activities.
 

Social anxiety disorder can be treated, and treated effectively.  The usual treatment is a mixture of medication and psychotherapy.  Cognitive behavior therapy, done individually or in group sessions, can be an effective remedy. The behavioral and cognitive components search for thought patterns that can be adjusted, in effect, identifying the triggers so that the subject can learn to avoid the triggers without avoiding their life.

The most common prescription medication for social anxiety disorder is the anti-depressent Paxil and the related compound Welbutrin.  As the frequency of diagnosis has increased since it was added to the lexicon in the late 1990s, the marketing of drugs to treat it has increased tremendously.  Both Paxil and Welbutrin are anti-depressants of the selective seratonin reuptake-inhibitors, or SSRIs, which have the benefit of not causing physical dependency, though it takes a habituation cycle for them to become effective.  SSRIs have side effects such as insomnia, headaches and nausea.  Many SSRIs will put a significant damper on sexual interest.