What are the Different Types of Social Anxiety Disorder?

What is the Difference Between Generalized and Specific Social Anxiety

Most people with social anxiety disorder fear public speaking.
Public speaking anxiety is one type of social anxiety disorder. Getty / Keith Brofskey

Types of social anxiety disorder (SAD) that are recognized by the mental health community have changed over time. In the past, two types of social anxiety disorder were identified, that differed in terms of their symptoms: generalized SAD and specific SAD.

Social anxiety disorder (SAD) in general involves a fear of social and performance situations in which others may judge you negatively.

Most people with the disorder are extremely self-conscious, and may have physical symptoms such as nausea, shaking, or feeling faint when around people or performing.

However, the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not recognize different categories of social anxiety disorder in the same way as the previous version (DSM-IV). 

Generalized Social Anxiety Disorder

Previous to the DSM-V, those with generalized social anxiety were described as having fears about most social and performance situations, including the following:

People with generalized social anxiety were thought to be uncomfortable around anyone but their closest family members. Generalized SAD was considered to be a more severe form of the disorder and was usually accompanied by greater impairment in day-to-day functioning.

Specific Social Anxiety Disorder

Previous to the DSM-V, specific social anxiety disorder was explained as anxiety and fear linked to just a few social situations rather than most or all. For instance, a person could have a fear of public speaking but be fine mingling at a party. This form of social anxiety was still thought to be extremely harmful, as it could limit people from enjoying life fully, meeting friends, or succeeding in a career.

 

DSM-5 Definition

With the release of the DSM-5, the generalized and specific types of social anxiety disorder were no longer recognized. Instead, a "performance only" specifier could be added to a diagnosis of SAD. In this way, it seems there are still categories of social anxiety disorder (SAD) as there have been in the past; however, the way that your doctor makes a diagnosis make look different than prior to the DSM-5.

The reason given by the American Psychiatric Association (APA), publisher of the DSM-5, for doing away with the generalized type, was that it was hard for doctors to measure the criterion, "fears include most social situations." However, the APA has acknowledged that people who only fear performance situations seem to be different from those with more generalized SAD, in terms of how old they are when they first experience anxiety, what physical symptoms of anxiety they experience, and how they respond to treatment.

Treatment for Social Anxiety

Regardless of whether you have generalized or specific social anxiety symptoms, effective treatment is available. Cognitive-behavioral therapy (CBT), a form of psychotherapy that addresses current problems and reframes negative thinking, can be very helpful.

Through CBT, you will learn strategies and techniques to help you cope with different situations. After completing cognitive behavioral therapy, many people with anxiety say that it changed their lives and opened doors for them; they can do things they never thought they could, like travel or perform in front of others. 

In some cases, particularly for those with more severe generalized social anxiety disorder, your doctor may recommend that you try medication. This can help to calm your mind and suppress negative self-talk, allowing you to focus on therapy and begin to make progress. 

Finding a Therapist for Social Anxiety

Look for a therapist who specializes in anxiety disorders.

Without a background in these conditions, your therapist may not fully understand your symptoms or may minimize or too easily dismiss what you are feeling. A healthcare provider who understands social anxiety disorder and cognitive behavioral therapy will work with you to develop effective strategies to manage the disorder. 

A Word From Verywell

It is important to understand the type of social anxiety disorder diagnosis you have been given. Work with your doctor or mental health professional to learn more about your diagnosis and what it means in terms of your treatment and prognosis. If your diagnosis includes the "performance only" specifier, treatment tailored to the specific performance situations that cause you anxiety is preferred.

Sources:

Dalrymple K, D’Avanzato C. Differentiating the subtypes of social anxiety disorderExpert Rev Neurother. 2013;13(11):1271-1283. 

Heimberg RG, Hofmann SG, Liebowitz MR, et al. Social anxiety disorder in DSM-5Depress Anxiety. 2014;31(6):472-479. 

National Institute of Mental Health. Anxiety Disorders

University of Pennsylvania Department of Psychiatry. Social Anxiety Disorder

Psych Central. DSM-5 Changes: Anxiety Disorders & Phobias.