Social Anxiety Disorder

What is Social Anxiety Disorder?

Social anxiety is a relatively common type of anxiety disorder. Someone suffering from social anxiety disorder will often experience intense and even debilitating bouts of fear at the thought of being in social situations or in front of people.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to be diagnosed with social anxiety disorder, someone must meet the following criteria:

• Intense, persistent, and irrational fear or anxiety about certain social situations
• Actively avoiding certain social situations
• Experiencing intense fear or anxiety while being around other people
• Levels of anxiety or fear that are debilitating and interfere with daily life
• Fear or anxiety not explained by a medical condition, substance abuse, or a side effect of a medication

Symptoms of Social Anxiety Disorder

Someone suffering from social anxiety disorder may struggle in certain social situations, including:

• Work or school
• Social gatherings
• Making eye contact
• Using public restrooms
• Entering a room that others are already in
• Eating in front of others
• Making eye contact
• Interacting with strangers
• Starting conversations
• Dating

They also may experience emotional, physical, and behavioral symptoms.

Emotional and Behavioral Symptoms

Behavioral and emotional symptoms that someone suffering from social anxiety disorder may experience include:

• Constant worry about embarrassing or humiliating yourself
• Low self-esteem
• Fear of talking to or interacting with strangers
• Fear of situations where others might judge you
• Being self-conscious about if others will notice that you seem anxious
• Fear of physical symptoms that might tip people off that you are anxious or nervous (see physical symptoms below)
• Avoiding certain situations or activities due to fear or anxiety
• Experiencing intense fear or anxiety in certain social situations
• Expecting the worst possible outcome when entering into a social situation
• Analyzing everything about a social interaction that just ended

Children and adolescents suffering from social anxiety disorder might also cry, have temper tantrums, or cling to their parents in certain situations. Others may experience panic attacks due to extreme anxiety before or during social situations.

Physical Symptoms

In addition to the emotional and behavioral symptoms, someone suffering from social anxiety disorder might also display physical symptoms, including:

• Rapid heartbeat
• Increased heart rate
• Sweating
• Blushing
• Trembling
• Nausea
• Upset stomach
• Trouble catching your breath
• Muscle tension
• Dizziness
• Lightheadedness
• Feeling like you are “out-of-body”

Social Anxiety Disorder Causes and Risk Factors

While the exact cause of social anxiety disorder is unknown, certain risk factors can encourage the development of the condition.

Genetics can play a substantial role in the development of social anxiety disorder. Research has shown that people with immediate relatives suffering from social anxiety disorder are more likely to develop the condition themselves.

Other potential causes and risk factors include:

• Chemical makeup of the brain
• Environmental factors (i.e., the environment someone grew up in)
• Witnessing or being the victim of abuse of any kind
• Having negative interactions with peers, especially at a young age
• Having overcontrolling parents
• Having a condition that draws attention to your physical appearance

Related Conditions

Since social anxiety disorder is a type of anxiety disorder, it shares many of the same symptoms and characteristics as other mental health conditions.

Some mental health conditions that are related to or similar to social anxiety disorder include:

• Panic Disorder
• Generalized Anxiety Disorder
• Major Depressive Disorder

Panic Disorder

Panic disorder and social anxiety both share the commonality of anxiety-like symptoms. However, they differ in how anxiety and panic are triggered plus how those emotions are experienced.

While someone with a panic disorder might get comfort in being around friends or loved ones, someone with a social anxiety disorder might experience even more anxiety.

Generalized Anxiety Disorder

Those suffering from generalized anxiety disorder tend to experience anxiety in a more broad and generalized manner. Anxiety associated with a social anxiety disorder is explicitly focused on social situations.

Major Depressive Disorder

Many people who suffer from social anxiety disorder also suffer from depression. If you are diagnosed with a social anxiety disorder at a young age, you are more likely to develop depression later in life.

Often, those suffering from both major depressive disorder and social anxiety disorder only seek treatment for their depression. Doing so can result in less effective treatment from a mental health professional.

Social Anxiety Disorder and Addiction

While social anxiety disorder affects millions of Americans, less than 5% of all people seek treatment in the year following its development. Many people do not immediately seek treatment because they are ashamed or embarrassed or might get anxious thinking about talking to someone.

Those who don’t seek help might turn to drugs or alcohol to self-medicate. While drinking or doing drugs might alleviate some initial symptoms of social anxiety, it can worsen symptoms over time. Drinking and doing drugs can also increase the risk of developing a substance use problem.

Social Anxiety Disorder Treatment Options

While talking to someone or getting help might cause anxiety, getting treatment for your social anxiety disorder is essential. There are multiple treatment options available to you or your loved one.

Psychotherapy

Psychotherapy is a standard treatment option for various mental health conditions, including social anxiety disorder.

Psychotherapy helps patients better understand what caused the development of their social anxiety disorder. From there, your therapist can help teach new, healthier ways to deal with triggers in the future and improve the patient’s social skills.

Examples of psychotherapy for treating social anxiety disorder include:

• Cognitive Behavioral Therapy (CBT)
• Acceptance and Commitment Therapy (ACT)
• Exposure Therapy
• Group Therapy

Medication

Your doctor or therapist may prescribe medication alongside or in place of psychotherapy. This medication can help address some of the side effects of social anxiety disorder.

Medications that have been FDA approved to treat social anxiety disorder include:

• Antidepressants, including Selective Serotonin Reuptake Inhibitors (SSRIs)
• Selective Norepinephrine Reuptake Inhibitors (SNRIs)
• Propanol
• Beta-blockers
• Anti-anxiety medications
• Benzodiazepines

Before taking any medication to treat social anxiety disorder, you should discuss your options with your healthcare provider or a licensed treatment professional.

Home Remedies

In addition to therapy and certain medications, there are also things you can do in the comfort of your own home to help better manage your social anxiety disorder symptoms.

These home remedies and alternative forms of treatment include:

• Meditation
• Mindfulness
• Breathing exercises
• Cutting down or eliminating caffeine
• Creating a regular sleep routine
• Exercise
• Yoga
• Tai Chi
• Adopting a healthy diet
• Confiding in a trusted person
• Finding support groups

Find Help For Social Anxiety Disorder

If you or someone you know is struggling with Social Anxiety Disorder, it’s crucial to seek help before symptoms worsen.

You can reach out to your healthcare provider or a licensed treatment professional to discuss treatment options. If you don’t have a healthcare provider or want a list of treatment professionals in your area, you can visit the SAMHSA online Behavioral Health Treatment Services Locator.