Symptoms of Social Anxiety Disorder

People with social anxiety disorder (SAD) experience significant and chronic fear of social or performance-related situations where they might be embarrassed, rejected, or scrutinized. In these situations, people with SAD almost always experience physical anxiety symptoms.

Although they know their fear is unreasonable, they can't seem to do anything to stop it, so they either avoid these situations altogether or get through them while feeling intense anxiety and distress. In this way, social anxiety disorder extends beyond everyday shyness and can be extremely impairing.

This article explains the common symptoms of social anxiety disorder. It also describes potential complications and how symptoms may present differently in children.

Social Anxiety Disorder Symptoms
Verywell / Brianna Gilmartin

Signs & Symptoms

Symptoms of social anxiety disorder typically fall within three different areas. While everyone's experience is different, symptoms of the condition typically result in physical, cognitive, and behavioral symptoms.

Physical Symptoms

The physical symptoms of SAD can be extremely distressing. Common physical symptoms include:

  • Blurred vision
  • Blushing
  • Chest pain and tightness
  • Chills
  • Diarrhea
  • Dizziness
  • Dry mouth
  • Feelings of unreality (derealization) or feelings of detachment from oneself (depersonalization)
  • Headaches
  • Heart pounding (palpitations) and racing (tachycardia)
  • Lump in the throat
  • Muscle tension
  • Nausea
  • Paresthesias (tingling)
  • Ringing in the ears
  • Shaking
  • Shortness of breath
  • Sweating
  • Trembling voice

In some cases, these physical symptoms may become so severe that they escalate into a full-blown panic attack. However, unlike those with panic disorder, people with SAD know that their panic is provoked by fears of social and performance-related situations rather than fears about the panic attacks themselves.

Cognitive Symptoms

Social anxiety disorder also involves cognitive symptoms, which are dysfunctional thought patterns. If you have this condition, you might find that you are bothered by negative thoughts and self-doubt when it comes to social and performance-related situations.

Below are some common symptoms that you may experience:

  • Negative beliefs: Strongly held beliefs about your inadequacy in social and/or performance-related situations
  • Negative bias: A tendency to discount positive social encounters and magnify the social abilities of others
  • Negative thoughts: Automatic negative evaluations about yourself in social or performance-related situations

For example, imagine you start a new job or arrive on the first day of a new class. The instructor or manager asks everyone to introduce themselves to the group.

If you have social anxiety disorder, you may start to have negative thoughts such as, “Everyone else looks so much more relaxed,” “What if I say something dumb?” or “What if everyone notices my voice shaking?”

These thoughts start to rapidly spiral out of control to the point that you don't hear anything anyone else has said. When it comes to your turn, you say as little as possible and hope that no one has noticed your anxiety.

Negative thought patterns can also erode your self-esteem over time, so it's important to seek treatment.

Behavioral Symptoms

Social anxiety disorder can also cause you to act in certain ways. In many cases, you might find yourself making choices based on fear and avoidance rather than your actual preferences, desires, or ambitions. For example, you may drop a class to avoid doing a presentation or turn down a job promotion because it meant increased social and performance demands.

Below are some common behavioral symptoms:

  • Avoidance: The things done or not done to reduce anxiety about being in social or performance-related situations
  • Safety behaviors: Actions taken to control or limit experiences of social or performance-related situations
  • Escape: Leaving or escaping from a feared social or performance situation.

Complications & Comorbidities

Social anxiety disorder can lead to serious complications in your life. It can result in panic attacks, which can be frightening and contribute to increased feelings of fear and avoidance.

Avoidance of social situations can make it difficult to maintain interpersonal relationships. This can affect your ability to work, attend school, and participate in other social events. It can contribute to feelings of isolation and loneliness, which can have a detrimental impact on your health and well-being.

In severe cases, if left untreated, social anxiety disorder can increase your risk of having a poor quality of life. You might have few or no friends and no romantic relationships. It may even lead you to drop out of school or quit jobs, and use alcohol to tolerate anxiety.

Symptoms in Kids

Social anxiety disorder in children and teens may appear differently than in adults. Young children with the disorder may cling to a parent, have a tantrum when forced into a social situation, refuse to play with other kids, cry, or complain of an upset stomach or other physical problem.

Behavioral inhibition during childhood is often a precursor for later social anxiety. Later during adolescence, teens with SAD may avoid group gatherings altogether or show little interest in having friends.

Symptoms in Women and Girls

Research has shown that social anxiety tends to affect women more frequently than men. As such, experts recommend that clinicians should screen girls and women aged 13 and older for anxiety disorders. Because anxiety disorders can grow worse over time, early intervention can result in better outcomes and improved well-being.

Frequently Asked Questions

When should I see a doctor about my social anxiety?

If you experience symptoms of anxiety in social situations, you may wonder whether your symptoms are severe enough for you to be diagnosed with social anxiety disorder (SAD). It can be difficult to know whether what you are experiencing is an illness that can be diagnosed.

As a rule of thumb, if the symptoms you are experiencing are significantly affecting aspects of your daily life—such as relationships, work, or school—in a negative way or you find yourself avoiding situations because of anxiety, a trip to the doctor may be in order.

Can treatment help relieve symptoms of social anxiety disorder?

A psychiatrist or other mental health professional can help with treatment. The good news is that symptoms of SAD respond well to treatment. The physical, cognitive, and behavioral symptoms of SAD can respond well to psychotherapy such as cognitive behavioral therapy (CBT), exposure therapy, and medication.

How do you know if you have social anxiety disorder?

While only a trained mental health professional can provide a diagnosis, learning more about the disorder's symptoms can help you better recognize whether what you are feeling is typical of social anxiety disorder. When faced with a social situation, do you almost always experience physical symptoms of anxiety, including muscle tension, dry mouth, rapid heartbeat, and shortness of breath?

Cognitive symptoms, including negative beliefs and thoughts, are also common. As a result, you may also engage in avoidance, escape, or safety behaviors to cope with feelings of fear.

If you do find that your symptoms match a diagnosis of SAD, it is important to know that help is available. Getting help may feel difficult at first, but it will very much be a step in the right direction and worth it.

If you or a loved one are struggling with social anxiety disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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8 Sources
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