What Is “Scopophobia” and Its Link to Anxiety?

What Is "Scopophobia" and Its Link to Anxiety?

Most people feel uncomfortable when someone stares at them. Sometimes, this discomfort can escalate into anxiety, especially if you’re in a situation where you’re the center of attention. For people with scopophobia—the excessive fear of being stared at—someone watching them can be debilitating. Rather than “just” being stared at, scopophobia can feel as though the individual is scrutinizing or judging you.

As with other phobias, this fear is often far out of proportion to any actual danger and can interfere with a person’s quality of life, sometimes greatly. In the sections that follow, we’ll take a closer look at this unique condition and discuss some strategies and treatments for managing it.

What’s Scopophobia?

Scopophobia is an excessive fear of being looked at or watched. If you believe you have scopophobia, it can be helpful to know you’re not alone. Experts believe that scopophobia is often a symptom of social anxiety disorder, which affects approximately 12% of U.S. adults at some point in their lives. It could also have some relation to autism spectrum disorder, which often involves difficulty with eye contact and being stared at.

Interestingly, these conditions are also risk factors for scopophobia. If you have one of them, you are more likely to have scopophobia. Other risk factor conditions include post-traumatic stress disorder, various movement disorders, epilepsy, and Tourette’s syndrome.

How Scopophobia Affects Perception

As humans, we are very good at recognizing faces and where people are looking. Experts will often refer to this as the “cone” of gaze perception. When looking at a person, we can roughly tell where they are looking. Someone with social anxiety or scopophobia may perceive a “wider” cone, meaning they feel that a person is staring at them whenever that person gazes in their direction. In a 2011 study, people with social anxiety were far more likely to believe someone was looking at them even when they were not. Study participants with social anxiety also felt like they were being singled out for attention more often.

Symptoms and Causes of Scopophobia

All phobias are anxiety disorders. In this sense, scopophobia symptoms are similar to those of other anxiety issues. Being stared at or watched can trigger anxiety symptoms in someone who has scopophobia. Depending on the severity of the phobia, these anxiety issues may dramatically impact a person’s life.

For example, people who have scopophobia tend to avoid social encounters and turn down invitations to events where many other people will be present. They may have trouble leaving their home, which can lead to attendance problems at work or school. Often, these individuals do want to be social, they just can’t bring themselves to go out. Because of this, they may develop strong feelings of loneliness, shame, and anger.

People with scopophobia can also interpret eye contact and facial expressions differently than those without the condition. They may feel people who watch them are angry or thinking negative thoughts about them. They may also believe others are judging their appearance, behavior and speech, which can lead to a state of hypervigilance about how they look and act—and usually being overly negative in the process.

Scopophobia can affect nearly every aspect of a person’s life. People with this phobia might find it difficult or impossible to:

  • Eat in front of others
  • Go on dates
  • Participate in job interviews
  • Perform in front of a group
  • Attend meetings
  • Ask for help in stores
  • Use public restrooms

The symptoms of scopophobia can differ from one person to the next. They may include:

  • Shortness of breath
  • Shaking and trembling
  • Sweating
  • Chills
  • Racing heart or palpitations
  • Pain or a feeling of tightness in the chest
  • Nausea and abdominal pain
  • Feelings of impending danger or doom
  • Needing to escape a situation by any means possible
  • Depersonalization or a feeling of the world being unreal

People with scopophobia often also suffer from social anxiety, which includes symptoms such as:

  • Difficulty maintaining eye contact
  • Fear of being judged by others
  • Excessive blushing
  • Rigid body posture and inability to relax around others
  • Speaking very softly in public
  • Trouble making and keeping friends

Although social anxiety can cause scopophobia, it isn’t the only reason people develop this fear. People with conditions such as epilepsy and Tourette’s syndrome may develop scopophobia because they fear their condition will draw attention and cause others to stare at them. Trauma can be a major contributor to certain anxiety disorders, including phobias. Scopophobia may develop in people who were bullied as children or had other negative social experiences in their younger years.

How Scopophobia Is Diagnosed

In a medical context, doctors will not diagnose anyone specifically with “scopophobia.” Should you continue to have issues with scopophobia with symptoms lasting six months or longer and causing noticeable distress, you may qualify for the diagnosis of specific phobia. To diagnose specific phobia, a doctor will first want to rule out other physical or mental conditions that may be causing your feelings of fear and anxiety. The diagnostic procedure can include:

  • Discussion of your symptoms and how often they occur
  • Discussion about events and situations that trigger your fear
  • Self-report questionnaire to help the doctor better understand your feelings
  • Physical exam and blood work
  • Review of medications you’re taking
  • Questions about alcohol and drug use

If you’re wondering if you meet the requirements for a specific phobia diagnosis, you can take a short survey from the Anxiety & Depression Association of America. While this isn’t an official diagnosis, it can help you to know if you need to speak with an expert.

Because scopophobia is closely related to social anxiety, your doctor may check to see if you meet the DSM-5 criteria for this condition. The criteria include:

  • Anxiety that causes significant distress and interferes with daily living
  • Anxiety that’s excessive in relation to the situation
  • Intense fear of social situations due to a worry of being humiliated or judged negatively
  • Avoiding social situations due to intense worry or fear
  • Anxiety that’s not explained by another medical condition or substance abuse
  • Symptoms being present for at least 6 months without improvement

Coping Strategies for Scopophobia

Isolating yourself may feel comforting if you have scopophobia, but this coping strategy may actually do more harm than good. Instead, consider taking steps that will allow you to build a tolerance to the fear of being watched. Start small and learn specifically what it is that triggers your worst scopophobia symptoms. Rather than avoiding every social situation, you can ease back into other activities and work your way up to those that worry you most.

Make sure to follow a healthy diet and get plenty of sleep to help keep stress low. It can also help to reduce caffeine and alcohol intake. (These substances can increase anxiety levels.)

Available Treatments for Scopophobia

Scopophobia is strongly associated with anxiety, so therapies used to treat anxiety disorders can be very effective in reducing feelings of fear. One of the best options is cognitive behavioral therapy (CBT), which aims to help people replace negative, unrealistic thoughts with less harmful patterns of thinking.

For example, someone with scopophobia may believe people don’t like the outfit they’re wearing that day. They might incorrectly assume that others are judging them for their poor taste in clothes. With the help of CBT, a person with scopophobia can learn to reframe the situation in a positive way. They may then assume someone is staring at them because they enjoy their outfit and wish to know where they bought their clothes.

Exposure therapy is another good choice for reducing anxiety-related thoughts and fears. This type of therapy uses scenarios, either real or imagined, to help patients acclimate to situations that would normally trigger their fear. Exposure therapy works by weakening associations between distressing situations and negative outcomes. Patients can feel empowered as they learn to manage their feelings and achieve goals in spite of their fears.

For instance, a therapist might begin by intentionally triggering the phobia for small periods in a controlled space. After warning and preparing the patient, they could stare for just a few seconds to start building up a tolerance. Eventually, the therapist may ask a patient to put themselves in social situations that gradually get more challenging, such as going to a park or grocery store where many other people are present. Eventually, they progress to more difficult tasks, such as giving a presentation.

Medication may also be used to treat scopophobia in conjunction with therapy. Commonly prescribed medications include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). These drugs boost the level of serotonin in the brain and may help users better regulate stress. There is no one-size-fits-all medication to treat scopophobia. You may need to try several drugs to find the one that’s best for you.

Managing any kind of mental health issue is not easy, even if you do have the help of a professional. Many people choose to find help outside of therapy. Many of these options are available through an online search or social media pages. You might even ask your therapist for recommendations.

One of the most common forms of support is a group that knows what you’re going through. There are plenty of online communities and in-person support groups for specific phobias and general anxiety issues.

Alternatively, share your problems with close friends and family members. Even if they don’t personally know what you’re experiencing, having the support of your loved ones can make a huge difference in your quality of life.

For more information about treatment for scopophobia, contact us anytime. Our experts have decades of combined experience helping individuals learn how to successfully manage their anxiety and find more peace of mind in their daily life.