Understanding Social Anxiety Disorder

Understanding Social Anxiety Disorder

Social anxiety disorder, or social phobia, is a common mental health condition involving intense fear and anxiety in social situations. It affects around 15 million American adults and typically develops during the teenage years. While occasional nervousness in social situations is typical, a social anxiety disorder can severely impact a person’s quality of life if left untreated. This article will provide an in-depth look at the signs, symptoms, causes, diagnosis, and treatment options for social anxiety disorder.

What is Social Anxiety Disorder?

An intense, ongoing fear of other people watching and judging you in social situations is a defining feature of social anxiety disorder. This fear can be so overwhelming that it interferes with a person’s ability to function normally. Sufferers often experience severe emotional distress in everyday social interactions.

Some everyday situations that trigger anxiety for people with social phobia include:

  • Participating in small talk
  • Eating or drinking in front of others
  • Attending parties or social gatherings
  • Starting conversations
  • Making eye contact
  • Public speaking
  • Using public restrooms
  • Writing or working while being observed
  • Talking on the phone

Physical symptoms often accompany the anxiety, including blushing, profuse sweating, trembling, nausea, and difficulty talking. The fear of showing these visible symptoms can worsen a person’s stress. Panic attacks may also occur in some severe cases.

Signs and Symptoms

People with social anxiety disorder fear that others will judge them negatively or that they’ll act humiliatingly or embarrassingly. Common thoughts include fear of stumbling over words, appearing incompetent, blushing, sweating, trembling, or sounding boring.

These persistent worries lead to the following common behavioral symptoms:

  • Avoiding social situations altogether or enduring them with intense distress
  • Staying silent or barely talking in social situations
  • Obsessively comparing themselves to others
  • Excessive rehearsing or planning before social events
  • Relying heavily on alcohol or medications to get through social events
  • Withdrawing from relationships and isolating oneself

Physical symptoms of social phobia often include:

  • Blushing or profuse sweating
  • Trembling or shaking
  • Rapid heart rate and shortness of breath
  • Upset stomach or nausea
  • Muscle tension
  • Confusion or disorientation
  • Dizziness or lightheadedness

Sufferers usually recognize that their anxiety is disproportionate to the social situation. But they feel powerless against their overwhelming fear. Simply thinking about entering feared social situations can trigger worry.

Causes and Risk Factors

Environmental factors and inherited traits cause social anxiety disorder.

Environmental causes include:

  • Overly critical or controlling parents
  • Sexual abuse or harassment
  • Bullying or teasing as a child
  • Traumatic social experiences
  • Frequent moving or changing schools as a child

Genetic and brain differences:

  • The hyperactive amygdala, which regulates fear responses
  • Irregular serotonin or dopamine activity
  • Family history of anxiety disorders

Risk factors for developing social phobia:

  • Shyness or introversion
  • Perfectionism
  • Negative social experiences
  • Self-perception of social inadequacy
  • Substance abuse
  • Depression
  • Having an autism spectrum disorder

Getting Diagnosed

If you regularly experience intense fear in social interactions, it’s essential to reach out to a mental health professional for an evaluation. They can determine if your symptoms align with social anxiety disorder.

To be diagnosed with social phobia, the anxiety must:

  • Last for six months or more
  • Cause significant distress and impairment
  • Occur in multiple social situations (not just one specific scenario like public speaking)

A diagnosis is based on a psychological evaluation of your reported symptoms. No lab test can definitively diagnose social anxiety disorder, but blood tests and imaging scans may help rule out medical conditions causing anxiety.

Treatment Options

Social anxiety disorder is highly treatable through professional care. Many sufferers find a combination of psychotherapy and medication provides the most significant relief.


Exposure therapy is commonly used to treat social phobia. This involves gradually and repeatedly exposing yourself to feared social situations under the guidance of a therapist. Cognitive behavioral therapy helps patients identify negative thought patterns and intentionally change behavior.


Antidepressants like Zoloft, Paxil, and Effexor can help reduce social anxiety. Anti-anxiety meds like benzodiazepines may provide temporary relief. Beta-blockers can control physical symptoms like sweating and trembling.


Relaxation exercises like yoga, mindfulness meditation, and deep breathing can soothe anxiety. Aerobic exercise also helps reduce stress. Joining a social phobia support group provides community and accountability.

Living with Social Anxiety Disorder

With professional treatment, social anxiety disorder can be managed effectively over the long term. While brief anxiety may always arise in social situations, the distress typically reduces to a manageable level. It’s possible to reclaim a satisfying, fulfilling social life.

Here are some tips for minimizing social anxiety:

  • Remind yourself that your fear is disproportionate
  • Accept some anxiety and awkward moments as normal
  • Gradually increase exposure to feared situations
  • Shift focus outwardly to others rather than inward
  • Let go of perfectionism and be yourself
  • Remember successes after events rather than perceived failures
  • Avoid catastrophizing mishaps as the end of the world

Joining an organization, volunteering, or rec sports league can also help overcome social isolation. Open up to loved ones about your struggles too.

Social anxiety disorder is a deeply distressing condition. But the social fears and avoidance it causes are treatable. Seeking help is the first step to feeling comfortable interacting with others again.

Frequently Asked Questions About Social Anxiety Disorder

What’s the difference between usual shyness and social anxiety disorder?

Shyness refers to mild social awkwardness or tentative behavior, often around unfamiliar people. Social anxiety disorder causes significant emotional distress, fear, and avoidance, disrupting daily life. The anxiety persists for at least six months.

Can social anxiety disorder go away on its own?

Social anxiety disorder generally does not go away without professional treatment. Some people can overcome milder social phobia through self-help techniques. But most require therapy, medication, or both to reduce symptoms substantially.

What age does social anxiety disorder start?

Social anxiety disorder typically emerges in the early to mid-teens. Most people develop symptoms before age 10. The condition rarely first appears in adulthood, though symptoms can resurface later in life.

Does social anxiety disorder get worse with age?

Without treatment, social anxiety disorder can worsen over time and lead to significant depression. As sufferers retreat and isolate more, their anxiety is reinforced, and opportunities to overcome fears decrease. But appropriate treatment often improves symptoms, even into adulthood.

Can you be born with a social anxiety disorder?

No, social anxiety disorder is not a condition you can be born with. But some infants may show extreme shyness, irritability, or avoidance of people that precedes social anxiety disorder later in childhood. There is often a genetic predisposition.