![]()
What is Social Anxiety?
Social anxiety, also called social anxiety disorder or social phobia, is a mental health condition. People with this condition experience anxiety or fear of being seen negatively, judged, or rejected in social situations.
Social anxiety affects about 15 million adults, equating to 6.8% of the U.S. population.
It is equally common among women and men and usually begins in the early teen years. One survey in 2007 showed that 36 percent of individuals with this disorder wait 10 years or more before seeking help. (1)
Everyone might feel anxious or embarrassed at some time in social situations. Making a speech in public or meeting people for the first time can make many people nervous. However, people with social anxiety will worry about these and other things for days or weeks beforehand.
Symptoms
Social anxiety can have devastating effects on the lives of those who suffer from it. It might lead someone to turn down a job opportunity which involves interaction with new people. They might avoid social situations fearing they will make a fool of themselves.
Symptoms can be so extreme they interfere with daily life and routines. Occupational or school performance might be affected, and it can make it difficult to deal with job interviews. The thought of social interaction can be so overwhelming it is hard to maintain friendships or romantic relationships.
People with this condition know that their fears and worries are irrational, but they are unable to stop them.
Individuals with this disorder generally experience emotional distress in many daily situations. The thought of having to face these situations can cause worry for days or weeks before the event. As a result, they will try and avoid them.
Daily tasks which most people take for granted can cause worry and stress before, during and after they happen. These include things like speaking on the phone, starting conversations, shopping or working.
They dread meeting new people. This will be exacerbated if they happen to be authority figures. They will find it hard to communicate and might stammer or blush. It is unlikely they will make eye contact.
Fear of being watched or judged when they do things is also common. This could be something as simple as being looked at by a cashier while signing a check. They will imagine all sorts of shortcomings which might lead to them to be judged by others.
Eating or drinking in front of other people at a restaurant will be difficult. Individuals will worry that their hands might appear to shake or that they will do something embarrassing. This could include blushing, sweating or a feeling of incompetence.
Worry about rejection or humiliation will prevent people with this disorder from ever stepping out of their comfort zone. They are afraid that they may do or say something which will offend others.
People with social anxiety will not do anything to make themselves the center of attention. They will try and blend into the background whenever they can.
The thought of being teased or criticized leads to distress and will prevent someone from ever standing out from the crowd. They will refrain from making small talk, for fear of saying something that will leave them open to criticism.
People will avoid group situations where they might have to go around the room and speak about things. Likewise they will avoid social encounters, especially if it means dealing with people they don’t know.
There are endless situations which can cause extreme distress to a person suffering from social anxiety. As well as the emotional and psychological symptoms which manifest, there are also physiological symptoms.
These include intense fear, turning red or blushing, a racing heart, difficulty swallowing, dry mouth and throat, and muscle twitches. Individuals might also have shaky hands, sweat excessively or have issues making eye contact.
One of the most common features is a sense of intense anxiety and worry which does not go away. (2, 3, 4, 5)
Stages
There are no stages of this condition. There are however criteria used by psychiatrists and other medical professionals when diagnosing social anxiety. (6)
These criteria are:
Criteria A + B
There will be a marked fear when a person is exposed to close examination by others in one or more social settings. This can include observational and interactive situations. A person fears they will act in manner that will reveal their anxiety, or lead them to being judged or viewed negatively by others.
Criteria C
These fears are not occasional, and social situations often give rise to anxiety.
Criteria D
A person will either avoid social situations, or endure them with an intense feeling of fear or anxiety.
Criteria E
The feelings of fear and anxiety are completely out of proportion to the situation.
Criteria F
The feelings of fear, anxiety and avoidance have been present for at least 6 months.
Criteria G
These feelings lead to significant interference with daily life and cause extreme distress.
Criteria H
The feelings cannot be attributed to another medical condition or drug.
Criteria I
The person presenting with symptoms of fear, anxiety and avoidance does not suffer from any other mental disorder.
Criteria J
There is no relation between the symptoms of fear, anxiety and avoidance and existing medical conditions. The symptoms are also excessive, taking such conditions into account.
Treatment
Anxiety disorder is usually treated with medication, psychotherapy or a combination of both. Prognosis tends to be more effective when both treatments are used. (7)
Medication
Medication relieves the symptoms associated with social anxiety but does not cure it. It is often used as a first line treatment or sometimes if psychotherapy doesn’t work.
The type of medications used to treat social anxiety are antidepressants, beta blockers and anti-anxiety drugs.
Choosing the medication that is right for an individual, as well as the correct dosage, will be assessed under medical care. This way any potential side effects can be monitored and weighed against the potential benefits. (8)
Psychotherapy
Sometimes referred to as talk therapy, this type of treatment will also be tailored to an individual’s needs. There are different options for this therapy which include cognitive behavior therapy, self help groups and stress management techniques.
Cognitive Behavioral Therapy (CBT) teaches people to think, react and behave in a different way when confronted with fearful situations. It also enables people to learn and practice skills which will help them deal with social situations.
There are two approaches with this therapy: recognition of the thoughts that lead to anxiety (cognitive), and exposure therapy to confront fears. This therapy can be done on a one to one basis, or in a group with people who face similar issues.
Support groups enable people to share their issues and achievements with others, and stress-management techniques help people with social anxiety calm themselves through things like meditation and exercise. (9)
FAQ
What is social anxiety? Social anxiety, also called social anxiety disorder or social phobia, is a mental health condition. People with this condition experience anxiety or fear of being seen negatively, judged, or rejected in social situations.
What are the signs of social anxiety? Physical signs of this condition include blushing, a racing heartbeat, dry mouth, shaking hands and excessive sweating. Psychologically, an overwhelming worry and fear which lasts for days or weeks before and after social interactions is common.
How do you develop social anxiety? Genetic and environmental factors contribute to developing this condition. Risk factors include shyness or behavioral inhibition during childhood, negative experiences, stressful events, and new social or work demands. (10)
How are you diagnosed for social anxiety? There are set criteria which medical professionals follow when diagnosing this condition. They are based around symptoms experienced and the length of time they have manifested.
What is the best treatment for social anxiety? Treatment for this condition will be tailored to individual needs. It includes medication and psychotherapy.
What are the long term complications of social anxiety? Avoiding or fearing social situations can have a major impact on day to day life. It can interfere with an individual reaching their full potential. (11)
Is social anxiety considered a disability? This condition is not considered a disability. However there are occasions when you might qualify for social security benefits. (12)
Is there a cure for social anxiety? Treatments are available which help manage this condition and restore quality of life.
Is social anxiety life threatening? While not a life threatening condition, social anxiety can lead to other mental disorders like depression. When these conditions manifest together they can lead to suicidal tendencies. (13)
Summary
Social anxiety, also called social anxiety disorder or social phobia, is a mental health condition which can have a major impact on day to day life.
People with this condition experience anxiety or fear of being seen negatively, judged or rejected in a social situations. This happens even though the person with this condition knows it’s irrational.
Fortunately, treatment for social anxiety has a good success rate and allows people to get their lives back.