Social Anxiety Disorder Information

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Social anxiety disorder is a mental health condition that was is previously referred to as social phobia. While it's often assumed that having social anxiety means you are afraid of other people or are exceptionally shy, the anxiety disorder actually involves a fear of social situations.

Social anxiety disorder can be divided into two main types: specific, in which one or more situations are feared, and generalized, which encompasses fear of multiple situations.

If you have social anxiety disorder, you may be afraid of speaking in front of others, performing in front of others, or simply being around other people.

Whatever specific situations you fear, all forms of social anxiety disorder share several common characteristics.

While it can be a severely disabling mental health condition, when it's recognized and accurately diagnosed, social anxiety disorder can be treated.

Symptoms

Each person with social anxiety will have slightly different symptoms which are dependent on their specific fears and the intensity of their phobia.

Several symptoms are characteristics of social anxiety disorder. The most common include (but are not limited to):

  • Fear: You may feel a sense of dread or doom beginning in the days leading up to a scheduled social event. During the event, your dread may become overwhelming.
  • Physical Symptoms: You may have a physical reaction similar to a panic attack. Intense blushing, shaking, palpitations, and stomach distress are particularly common.
  • Self-Judgment: Many people with social anxiety disorder feel that they are being intensely scrutinized by those around them. You may become hyper-aware of the way you walk, talk, chew, and perform other everyday actions. Becoming very critical of yourself is also common.

Keep in mind that the symptoms of social anxiety disorder are quite similar to those of other disorders such as panic disorder, as well as certain medical conditions.

Your healthcare provider can determine the cause of your symptoms and decide on an appropriate treatment

Diagnosis

Like any phobia or other mental health disorder, social anxiety disorder can only be diagnosed by a trained medical or mental health professional.

One of the essential elements of diagnosing any phobia is that it must significantly impact a person's life. However, this is not always easy to demonstrate.

For example, if you fear public speaking but have created a life for yourself that does not require you to use this skill, you may not have a phobia. If you had a job, such as being a lawyer, that required you to speak in front of others you might be disabled by the fear.

Progression

Each case of social anxiety disorder is different. Your particular phobia may not follow a "typical" pattern.

In general, it appears that untreated social anxiety disorder tends to worsen over time. Social anxiety can progress from fearing a single social situation to multiple situations, or even develop into an overall fear of people.

Social anxiety can progress from fearing a single social situation to multiple situations, or even develop into an overall fear of people.

Extreme cases of untreated social anxiety disorder can lead to isolation, depression, other anxiety disorders, or even agoraphobia.

The following progression of social anxiety disorder is generally considered to be typical:

  • Early Warning Signs: Many people who eventually develop social anxiety disorder showed signs of timidity and social anxiety in early childhood.
  • Age at First Onset: Although social anxiety disorder can appear at any age, it typically begins at around age 13—an age at which some degree of social unease is normal. Social anxiety disorder in teens and children is diagnosed only when it persists for more than six months.
  • Progressive Effects: Untreated social anxiety disorder can cause difficulty with jobs and social relationships, and increasing isolation can lead to the development of other disorders.
  • Concurrent Disorders: The isolation and anxiety that comes with a social anxiety disorder have been linked to depression, substance abuse, and further anxiety disorders.
  • Prognosis: Untreated social anxiety disorder can become chronic and increasingly life-limiting. Over time, it can become more difficult to fight the phobia and maintain a normal life. With treatment, however, the prognosis is extremely positive.

Treatment

Social anxiety disorder can be treated with medication, therapy, and alternative methods. Many practitioners choose to use a combination of treatments.

Medication Options

The medications used in treating social anxiety disorder fall into four main categories:

  • SSRIs: Selective serotonin reuptake inhibitors, or SSRIs, work by affecting the level of serotonin in the brain. They're usually prescribed for depression, but they're also effective in treating anxiety disorders, including phobias.
  • MAOIs: Monoamine oxidase inhibitors (MAOIs) block an enzyme that breaks down certain neurotransmitters in the brain. These medications are popularly prescribed for depression, but they can also treat anxiety.
  • Benzodiazepines: Benzodiazepines are sedatives commonly used to treat anxiety disorders, including social anxiety. They ease phobias by addressing the associated anxiety.
  • Beta-Blockers: Typically prescribed for high blood pressure and certain heart conditions, beta-blockers work by suppressing the effects of epinephrine (adrenaline) in the body. Some studies have shown that beta-blockers effectively relieve certain aspects of social anxiety disorder, but the drugs aren't necessarily more effective than other treatments. The medication is also not without risk, which must be weighed against the benefit of trying the treatment.

Therapy

Various types of talk therapy can effectively treat social anxiety disorder. One of the most popular treatments for phobias is cognitive-behavioral therapy. Other therapies used include psychoanalysis, intensive group seminars, and behavioral techniques.

Alternative Treatments

Some people with anxiety disorders find relief from alternative treatments such as hypnotherapy, aromatherapy, guided imagery, acupuncture, and homeopathy.

However, not all of these remedies have been well-researched and many are not specific to social phobias. If you want to pursue alternative treatments, do so only under the guidance of both a licensed mental health professional and an expert in remedy you choose.

Living With Social Anxiety Disorder

If you have social anxiety disorder, you face many of the same challenges in daily living as those with any other phobia. Depending on the severity, your social anxiety might feel like a manageable annoyance or a devastating condition.

Since social anxiety disorder involves a fear of being in social situations, it can also present unique challenges, particularly when it comes to work, school, and dating.

Travel poses unique challenges if you have social anxiety disorder. Flying invariably involves close contact with strangers and enhanced airport security measures can trigger an intense reaction. Road trips can be more manageable, but only if you are comfortable with your traveling companions.

The symptoms of your social anxiety disorder may seem worse during the winter holiday season when streets and shopping malls are packed with hurried strangers.

The time of year is also generally a social one. As such, you may be expected to make the rounds to holiday parties hosted by friends or colleagues where you may not know many people.

Even if you generally love the holiday season, you may find even the most mundane tasks more difficult to accomplish during this overcrowded time of year.

A Word From Verywell

Social anxiety disorder can cause many difficulties in a person's daily life, but it's extremely treatable—but left untreated, it can be disabling. It's important to seek professional help as soon as possible.

A qualified mental health provider can develop an individualized treatment plan that effectively addresses your symptoms, as well as help you learn coping skills.

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Article Sources
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