Social Anxiety Disorder Diagnosis Fear of People as a Sign of Social Anxiety Disorder By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on July 26, 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 Rachel Goldman, PhD, FTOS Medically reviewed by Rachel Goldman, PhD, FTOS Facebook LinkedIn Twitter Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change. Learn about our Medical Review Board Print Twinpix / Cultura RM Exclusive / Getty Images Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatments People with social anxiety disorder (SAD) are intensely afraid of social and performance situations for fear of being embarrassed, humiliated, or judged negatively. The disorder is more than just shyness, and it requires diagnosis and treatment by a mental health professional. Whether you are fearful of just one type of situation (such as public speaking) or most social situations, social anxiety can severely affect your life. Symptoms If you are afraid of social situations, the fear can manifest with a range of symptoms, including: Avoiding certain places or social situationsAvoiding eye contactBlushingFeeling afraid that people will judge youFeeling nauseous or sick to your stomachFeeling very self-consciousRacing heartShaking handsShortness of breathSweating In addition to being afraid of people, people with social anxiety are often afraid that others will notice their anxiety. This "fear of fear" or cycle of panic that develops can be hard to break free from on your own. The Cycle of Panic in Social Anxiety Disorder Causes We don't know the precise reasons why some people develop social anxiety while others do not. Research suggests that it is probably a combination of genetic factors and the person's environment. Scientists have uncovered specific gene variations that are potentially related to social anxiety. The hope is that understanding these variations could help them pinpoint the causes of the disorder. If you have social anxiety, you likely won't be able to pin your fear of people down to one single cause. However, you might remember a triggering event—such as being embarrassed in front of a group or being reprimanded in public by a harsh or critical parent. For some, underdeveloped social skills might be a factor that contributes to their social anxiety. Why You Fear Some Situations and Not Others Each person with social anxiety disorder will have their own fears meaning that the specific social situations feared will vary from one person with the disorder to the next. Some people have very narrow worries, such as only being afraid of speaking in public. This type of social anxiety is usually less chronic and severe compared to people who fear most social and performance situations. In general, people with social anxiety disorder usually feel the worst in situations where they are the center of attention or feel as though they are being judged in some way. Diagnosis If you think you might have social anxiety, you can evaluate your fear of people and try to determine if it could be reflective of an underlying mental health disorder. The following questions can help you begin to evaluate your anxiety and help you decide if you might benefit from seeking treatment: How long has your fear of people been going on? Does it change or remain constant across situations and people?How much does your fear of people interfere with your daily life? Have you dropped classes or lost jobs because of this fear? Does the fear follow you through your daily life?Do you consider yourself introverted or extroverted? While both introverts (those who gather energy by being alone) and extroverts (those who gain energy from being with other people) can have social anxiety, people who are introverted can be mistaken as being socially anxious. If you find that social or performance situations leave you feeling drained but they don't cause you particular anxiety, it could be that you are simply wired to prefer having more time alone. Because anxiety conditions are so common and impact women at twice the rate of men, experts now recommend that all women aged 13 and old are screened for anxiety as part of routine preventative healthcare services. If you find that social situations do cause you anxiety that interferes with different aspects of your life, talk to your doctor or mental health professional. During your evaluation, your doctor will take a medical history, perform a physical exam, and may conduct lab tests to help rule out medical conditions that might be contributing to your symptoms. Your doctor may then make a diagnosis of social anxiety disorder if your symptoms meet the DSM-5 diagnostic criteria for the condition. Treatments If your symptoms are interfering with your daily functioning or causing stress, it's important to work with a mental healthcare professional. They can help develop a treatment plan that's right for you. People with social anxiety disorder do not always need medication, but the disorder is most often treated with therapy, medication, or both. Selective serotonin reuptake inhibitors (SSRIs) are the first choice medication used to treat social anxiety disorder. When combined with talk therapy, such as cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT), treatment success rates are very good. 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. How to Find an Anxiety Therapist A Word From Verywell If your fear of people or being in social situations is overwhelming, it is important to seek help from your doctor or mental health professional. These professionals can give you a proper diagnosis and help you find the most effective treatment. Many people with SAD live a long time with the disorder before they seek help. You might not feel comfortable talking about how you feel, but it's an important first step in getting the support you need. 4 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. Anxiety and Depression Association of America. Social Anxiety Disorder. Stein MB, Chen CY, Jain S, et al. Genetic risk variants for social anxiety. Am J Med Genet B Neuropsychiatr Genet. 2017;174(2):120-131. doi:10.1002/ajmg.b.32520 Cleveland Clinic. Anxiety Disorders: Diagnosis and Tests. Updated December 15, 2017. Harvard Health Publishing. Treating Social Anxiety Disorder. 2010. By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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