Social Phobia and Social Anxiety Disorder Differences

Social Anxiety Disorder Has Replaced Social Phobia

Social phobia is just a different name for social anxiety disorder.
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The difference between social phobia and social anxiety disorder (SAD) is largely chronological, in that social phobia is the former term and SAD is the current term for the disorder. However, there are differences in the symptoms used to diagnose the two conditions.

The official psychiatric diagnosis of social phobia was introduced in the third edition of the Diagnostic and Statistical Manual (DSM-III). Social phobia was at that time described as a fear of performance situations and did not include fears of less formal situations such as casual conversations or meeting people for the first time.

When Did Social Phobia Become Social Anxiety Disorder?

The Diagnostic and Statistical Manual (DSM) is a tool healthcare providers use to determine whether a person meets the criteria for different mental illnesses, helping them to make accurate diagnoses.

The DSM-III referred to this mental disorder as social phobia and was very narrow in its scope of diagnosis.

Changes in the DSM-IV

When the DSM-IV was published in 1994, the term social phobia was replaced by social anxiety disorder. The new term was introduced to describe the broad and generalized nature of the fears that are a part of this disorder.

The criteria were also changed to reflect the latest research on this topic. 

  • In past editions of the DSM, social phobia was diagnosed if an individual felt extreme discomfort or fear when performing in front of others.
  • In the DSM-IV, social anxiety disorder could be diagnosed if an individual feared a variety of different social situations.

For example, a fear of conversation with strangers at a dinner party wouldn't have been considered social phobia; however, under the DSM-IV, this fear would fit the criteria for social anxiety disorder. 

Changes in the DSM-5

The 2013 publication of the DSM-5 saw further changes to the diagnostic criteria for social anxiety disorder. The DSM-5 specifies that social situations almost always provoke anxiety and fear. The DSM-5 no longer requires that the individual recognize that their fear is excessive or unreasonable, but does note that the fear must be out of proportion to the actual threat posed by the situation. 

The DSM-5 diagnostic criteria also require ruling out other mental disorders such as panic disorder, body dysmorphic disorder, or autism spectrum disorder. It also includes a specifier for anxiety that occurs only in the context of performing or speaking in public.

How Common Is Social Anxiety Disorder

While you may feel very alone if you have social anxiety disorder, more than 15 million Americans are affected.

Women are more likely to be diagnosed with the disorder than men.

Diagnostic Criteria for Social Anxiety Disorder

Social anxiety disorder goes beyond nervousness or feeling socially awkward; it can be debilitating, harm relationships with loved ones, and hurt your career.

To be diagnosed with SAD...

  • Your response must be completely disproportionate to the situation. For example, having a severe panic attack or vomiting before giving a work presentation.
  • Your symptoms must be present for at least six months. 
  • Your symptoms must interfere with daily life, including work or other everyday activities. If your anxiety is so bad that you miss work and need to stay in bed, this means you need social anxiety treatment.
  • You almost always experience this fear or anxiety in social situations. 
  • The fear and anxiety you feel cannot be due to the effects of a medication or drug, must not be better explained by another mental disorder, and cannot be related to a medical condition.

How Is Social Anxiety Treated?

Social anxiety disorder is treated with therapy, medication, or a combination of the two.

  • Cognitive behavior therapy (CBT) is one type of treatment that teaches you a new way of thinking and processing information.
  • Medication can minimize feelings of anxiety, allowing you to take a step back from your anxious thoughts. Often, therapy and medication are used in combination to minimize your anxiety so that you can handle social situations more easily. 

While social anxiety can be distressing and limit your activities, seeking treatment can make a substantial positive impact on your life.

If you have had symptoms of social anxiety disorder, consult with your physician for help in finding a good therapist. Or you can search online therapist directories and find therapists who list experience in treating anxiety disorders. Through therapy sessions and continual work to manage your symptoms, you will notice a substantial difference in the way that you are feeling.

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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Article Sources
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  1. Substance Abuse and Mental Health Services Administration. DSM-5 changes: implications for child serious emotional disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US): Table 16, DSM-IV to DSM-5 Social Phobia/Social Anxiety Disorder Comparison. Published June 2016.

  2. Kuo JR, Goldin PR, Werner K, Heimberg RG, Gross JJ. Childhood trauma and current psychological functioning in adults with social anxiety disorder. J Anxiety Disord. 2011;25(4):467-73.  doi:10.1016/j.janxdis.2010.11.011

  3. National Institutes of Health. Social anxiety disorder.

  4. American Psychological Association. How do I find a good therapist?.

Additional Reading
  • McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender Differences in anxiety disorders: prevalence, course of Illness, comorbidity, and burden of illness. J Psychiatr Res. 2011;45(8):1027-1035. doi:10.1016/j.jpsychires.2011.03.006

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-II). 1980. 
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 1994. 
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-V). 2013.