Phobias Social Anxiety Disorder Information By Lisa Fritscher Lisa Fritscher Lisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics. Learn about our editorial process Updated on November 02, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Jupiterimages/Photolibrary/Getty Images Table of Contents View All Table of Contents Symptoms Diagnosis Progression Treatment Coping Social anxiety disorder is a mental health condition that was 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. Wanting to Be Invisible With Social Anxiety Disorder 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. Find Help With the 7 Best Online Anxiety Support Groups 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. How Behavioral Therapy Plays a Role in the Treatment of Phobias 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 the remedy you choose. Treatment for Phobias Coping 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 severely distressing 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. 8 Ways Social Anxiety Changes the Way You Think About Everything 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. Things to Start Doing If You Have Social Anxiety Disorder 7 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute of Mental Health (NIMH). Social Anxiety Disorder: More Than Just Shyness. National Institute of Mental Health Information Resource Center. Khdour HY, Abushalbaq OM, Mughrabi IT, Imam A, Gluck M, Herzallah MM, et al. Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation. Front Integr Neurosci. 2016;10:20. Published 2016 Jun 29. doi:10.3389/fnint.2016.00020 Anxiety And Depression Association Of America (ADAA). Social Anxiety Disorder. ADAA: Understand the Facts. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). doi:10.1176/appi.books.9780890425596 Healthwise Staff. Social Anxiety Disorder. Kaiser Permanente. Otte C. Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci. 2011;13(4):413–421. PMID: 22275847. Bystritsky A, Hovav S, Sherbourne C, Stein M, Rose R, Campbell-Stills L, et al. Use of complementary and alternative medicine in a large sample of anxiety patients. Psychosomatics. 2012;53(3):266–272. doi:10.1016/j.psym.2011.11.009 Additional Reading Blanco C, Bragdon LB, Schneier FR, Liebowitz MR. The evidence-based pharmacotherapy of social anxiety disorder. Int J Neuropsychopharmacol. 2013;16(1):235-49. doi:10.1017/S1461145712000119 Canton J, Scott KM, Glue P. Optimal treatment of social phobia: systematic review and meta-analysis. Neuropsychiatr Dis Treat. 2012;8:203–215. doi:10.2147/NDT.S23317 Cremers HR, Roelofs K. Social anxiety disorder: a critical overview of neurocognitive research. Wiley Interdiscip Rev Cogn Sci. 2016;7(4):218–232. doi:10.1002/wcs.1390 Parekh R. What are anxiety disorders? American Psychiatric Association (APA). Steenen SA, van Wijk AJ, van der Heijden GJ, van Westrhenen R, de Lange J, de Jongh A. Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis. J Psychopharmacol. 2016;30(2):128–139. doi:10.1177/0269881115612236 Williams T, Hattingh CJ, Kariuki CM, et al. Pharmacotherapy for social anxiety disorder (SAnD). Cochrane Database Syst Rev. 2017;10(10):CD001206. Published 2017 Oct 19. doi:10.1002/14651858.CD001206.pub3 Wong Q, Rapee R. Social Anxiety and Phobia in Adolescents. (Ranta K, La Greca A, Garcia-Lopez L, Marttunen M, eds.). New York: Springer; 2015:11-17. By Lisa Fritscher Lisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.