Social Anxiety Disorder

What Is Social Anxiety Disorder?

Social anxiety disorder (a.k.a., social phobia) is one of the most common mental health disorders, characterized by an intense fear or anxiety toward ordinary social interactions, such as meeting new people or engaging in conversation.

Someone with 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. Their social anxiety symptoms negatively impact their quality of life and can manifest in intense ways.

Learn more about this common disorder, including how symptoms manifest, what treatment options are available, and more.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines the following criteria for someone to be diagnosed with social anxiety disorder:

1. Intense, irrational, and persistent fear about certain social situations, especially those where the person fears being judged or scrutinized (i.e., meeting new people, public speaking, etc.)
2. Levels of anxiety or fear that interfere with daily life, causing the person to make an effort to avoid these “scary” situations
3. Anxiety or fear is long-lasting (e.g., typically lasting 6 months or more)
4. Fear or anxiety not explained by a medical condition, substance abuse, or a side effect of medication

Social Anxiety Disorder VS Shyness

Shyness is a personality trait or temporary discomfort in social situations, whereas social anxiety disorder involves intense and persistent fear that significantly impairs one’s ability to function in everyday life.

While social anxiety disorder may sound similar to someone who is shy, it is a distinct mental health disorder characterized by more severe and pervasive symptoms.

Conditions Related to Social Anxiety Disorder

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: 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.
• Generalized Anxiety Disorder (GAD): Those with generalized anxiety disorder tend to experience anxiety in a more broad and non-specific manner. Anxiety associated with a social anxiety disorder is explicitly focused on social situations.
• Major Depressive Disorder (MDD): Many people with social anxiety disorder also suffer from depression. While both disorders can significantly impair daily functioning and quality of life, MDD primarily affects mood and emotional regulation, whereas social anxiety disorder centers around social interactions and performance.

Symptoms of Social Anxiety Disorder

Individuals with social anxiety disorder experience intense worry about being judged, criticized, or embarrassed by others, causing them to avoid social interactions or attending but with extreme distress.

They also may experience emotional, physical, and behavioral symptoms that can interfere with their day-to-day lives.

Some common social situations that can cause anxiety or negative thoughts include: 

• 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

Emotional and Behavioral Symptoms

Behavioral and emotional symptoms that someone with 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 who have 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 who has 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 family members with social anxiety disorder are more likely to develop the condition themselves.

Other potential causes and risk factors include:

• The 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 over-controlling parents
• Having a condition that draws attention to your physical appearance

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. Others may feel anxious about talking to someone about such personal issues.

Those who don’t seek help might turn to drugs or other habits (like gambling) to self-medicate. While substance use or behavioral habits might alleviate some initial symptoms of social anxiety, it can worsen symptoms over time—and increase the risk of developing an addiction.

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that among individuals seeking treatment for substance use disorders, approximately 20% also meet the criteria for social anxiety disorder.

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 form of psychiatry often used when treating mental health conditions, including social anxiety disorder. Also known as “talk therapy,” psychotherapy helps individuals identify and challenge negative thought patterns and beliefs related to social situations.

With the help of a therapist, individuals gradually confront feared social situations in a supportive environment, learning to manage their anxiety more effectively.

Additionally, psychotherapy helps individuals develop coping strategies, practice social skills, improve self-esteem, and build confidence in social interactions, ultimately reducing the severity of symptoms and improving overall functioning.

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 antidepressants or anti-anxiety medication alongside psychotherapy. This medication can help address some of the side effects of social anxiety disorder.

Medications commonly used to treat social anxiety disorder include:

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft), paroxetine (Paxil), and fluoxetine (Prozac) or serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor XR) and duloxetine (Cymbalta).
• Anti-anxiety medications: Benzodiazepines such as alprazolam (Xanax) and clonazepam (Klonopin) may be prescribed for short-term relief of symptoms but are not typically recommended for long-term use due to the risk of dependence and tolerance.
• Beta-blockers: Can be used to treat anxiety symptoms like rapid heart rate or shaky hands.

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

Contact your healthcare provider or a licensed 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.