What is Social Anxiety Disorder?

Medically Reviewed By N. Simay Gökbayrak, PhD
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Social anxiety disorder is an intense fear of social situations. Unlike shyness or nervousness, social anxiety disorder is a mental health diagnosis that can severely affect someone’s life. An estimated 7% of people in the United States have a social anxiety disorder. Social anxiety disorder can range in severity and interfere with someone’s ability to keep a job or close relationships. However, the condition is treatable. 

This article will explain more about social anxiety disorder, its diagnosis, identifying if you might have it, and what treatments are available for the condition.

What is social anxiety disorder? 

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The National Institute of Mental Health (NIMH) explains that social anxiety disorder is an intense fear of having someone watch or judge you. The disorder is a very common one and can have many different forms. 

For instance, you may fear doing something “big” in public where people will be watching you, such as public speaking. Your social anxiety could also manifest as fearing eating lunch in public because someone might see you.

Someone could have general social anxiety disorder or social anxiety that centers around one specific fear, such as public speaking or crowds. 

How social anxiety disorder can impact your life

Social anxiety disorder is much more than nervousness or shyness in a social situation. It can be debilitating and affect every facet of someone’s life.

Some people may be unable to hold down a job, go out in public, or even be around others. They may even avoid social situations completely. Without treatment, the disorder can last for a lifetime. 

Who is more at risk of developing social anxiety disorder?

The NIMH notes that social anxiety disorder can occur in anyone. However, it tends to happen more in females (assigned at birth) and in the teenage years.

Social anxiety disorder vs. shyness 

This table illustrates the differences between being shy and having social anxiety disorder.

ShynessSocial anxiety disorder
temporarylasts for an extended period, potentially a lifetime without treatment
does not affect life in many areascan affect jobs, relationships, or many areas of life
may disappear once familiar with a place or personmay remain unchanged or worse, even if familiar with the person or place
does not make you feel self-critical may cause you to feel self-critical, harbor negative or pessimistic thoughts
not debilitating affects daily life, such as going out, work, and education, to the point you avoid social situations
does not make you feel bothered about being shymay cause you to always feel under scrutiny from others
no physical symptoms has physical symptoms, such as sweating and faster heart rate, to the point you may consider medication

Social anxiety can involve shyness, but shyness is not a social anxiety disorder. Shyness is temporary and does not affect someone’s life in many areas. 

When it affects your job, life, or relationships, it is a social anxiety disorder. 

What are the symptoms of social anxiety disorder? 

The primary symptom associated with social anxiety disorder is fear. 

The fear could include attending a social event. It could also include worrying about what will happen or what people will think about you there.

Some other symptoms include:

  • worrying about speaking to people
  • avoiding answers to questions in class
  • dreading social events, even weeks in advance
  • avoiding eye contact
  • avoiding talking to people
  • having low self-esteem
  • worrying about everyday activities such as meeting strangers, starting conversations, or speaking on the phone
  • avoiding social settings, such as parties
  • feeling “frozen” or not being able to speak correctly in social settings
  • feeling watched, judged, or criticized
  • avoiding being the center of attention 
  • worrying about physical symptoms, such as blushing and sweating

Physical symptoms 

The physical symptoms of social anxiety can appear before, during, or after a social event. 

They can include: 

  • heart palpitations
  • fast heart rate
  • trembling or feeling weak
  • excessive sweating
  • feeling sick to your stomach
  • blushing
  • “freezing” or your mind going blank
  • not being able to speak up
  • feeling stiff or uncomfortable, such as not knowing what to do with your hands

When to contact a doctor

Contact a mental health professional anytime your fears or anxiety affect your ability to live your life the way you want. If you do not have a mental health professional, your doctor can refer you to one.

If you are avoiding places, people, or situations out of fear or anxiety, treatment and help are available. 

What causes social anxiety?

There is no one known cause of social anxiety disorder. However, it could have various roots, such as:

  • having a close blood relative with the disorder
  • experiencing an unpleasant, traumatic, or embarrassing social situation as a child
  • a link between genetic factors and anxiety in the brain
  • brain activity

How can you treat social anxiety disorder? 

You can treat social anxiety disorder through a variety of different treatments. Treatment should be unique since everyone will respond differently. For instance, some people may respond to only cognitive behavioral therapy (CBT). In contrast, others may need a combination of therapy and medication.

Speak to a mental health professional specializing in treating the disorder. In general, treatment options include therapy, medication, and lifestyle management.

Psychotherapy 

There are different types of therapy that you can use for social anxiety disorder, including

  • Cognitive behavioral therapy: This therapy can help you reframe some of your beliefs about yourself, leading to more intentional actions and behaviors.
  • Exposure therapy: This therapy exposes you to what you fear, individually or in a group setting.
  • Acceptance and commitment therapy: This therapy helps create a new and more effective relationship, so fear and anxieties do not get in the way of life.

Medications 

Some of the medications used to treat social anxiety disorder include

  • Antidepressants: This class of medication includes selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). These can help increase levels of serotonin in your brain.
  • Beta-blockers: These medications help block the physical symptoms of anxiety. They may lower your heart rate and prevent sweating from happening.
  • Benzodiazepines: These are anti-anxiety medications you can use temporarily to reduce anxiety.

Tips on overcoming social anxiety disorder 

Seek professional help for anxiety if you think it is impacting your life. Many people with anxiety may not realize the seriousness of their condition. They may also think that they can overcome the anxiety on their own.

Help is available, and treatment can greatly improve your quality of life.

While you work with a professional to manage your anxiety, you can also use self-coping strategies. Try to understand your anxiety and where it comes from, including triggers. Relaxation techniques, such as breathing, yoga, and mindfulness, may also help manage your social anxiety disorder.

How is social anxiety disorder diagnosed?

A doctor will first perform a physical exam and health history to diagnose social anxiety disorder. They may run some tests to ensure that there is no medical cause triggering the anxiety.

For instance, some thyroid conditions or vitamin deficiencies can cause increased anxiety. Additionally, some medications could cause or increase anxiety. 

A mental health professional will also use the official criteria to diagnose social anxiety disorder. A diagnosis could be appropriate if the following symptoms are present:

  • fear of social situations with other people
  • fear of displaying anxiety symptoms in front of other people
  • in children, the anxiety symptoms could look like freezing, tantrums, or refusing to speak in social situations
  • symptoms have lasted more than 6 months
  • there is no other physical or medication-related explanation for the anxiety
  • if there is another physical condition present, the fear is still excessive with the other medical conditions 

What are the risk factors for social anxiety disorder? 

Anyone can develop social anxiety disorder. However, a traumatic experience — especially during childhood — could place someone at a higher risk of the disorder.

For instance, risk factors for social anxiety disorder include:

  • a family history of the disorder
  • a negative experience in a social situation
  • childhood trauma or abuse
  • a natural temperament toward being shy
  • having a new work or social demand
  • having an appearance or condition that draws attention, such as a physical disability, stuttering, or tremors

What are the complications of social anxiety disorder? 

Without treatment, social anxiety disorder can severely impact someone’s life to the point that they avoid any social situation. For instance, they may not be able to have a close relationship, leave their home, or work. In severe cases, social anxiety disorder could even lead to suicide. 

Suicide prevention

If someone you know is at immediate risk of harming themselves or others, or at risk of suicide:

  • Ask the question, “Are you considering suicide?” even if it is tough.
  • Listen without judgment.
  • Call 911 or your local emergency number.
  • Stay with them until emergency services arrive.
  • Try to remove any weapons, medications, or other potentially harmful items.

If you or someone you know is having suicidal thoughts, contact the National Suicide Prevention Lifeline:

This service is available 24/7.

People who have social anxiety disorder are also at a higher risk of depression and substance misuse disorder, especially if they are receiving appropriate help for their disorder. 

About 4 out of 5 people with social anxiety disorder develop another mental disorder during their lives.

How can you prevent social anxiety disorder? 

Like any mental health disorder, social anxiety disorder may not have any obvious cause, and certain events can worsen it.

The most important thing you can do if you or someone you love has social anxiety disorder is seek help from a mental health professional.

Frequently asked questions

Here are some frequently asked questions about social anxiety disorder.

What are three symptoms of social anxiety disorder?

Dreading social situations, increased physical symptoms, and worrying about embarrassing yourself are all symptoms of the disorder.

What age does social anxiety disorder begin?

It often begins before the age of 20, during the teen years.

Does social anxiety disorder get better?

It is rare for social anxiety disorder to resolve independently. However, with treatment, recovery is possible.

Summary 

Social anxiety disorder is a serious condition of intense fear in social situations. This fear could be anything from fear of public judgment to a fear of talking one-on-one with someone.

With treatment, someone with social anxiety disorder can live a fulfilling life.

The disorder occurs more often in females (assigned at birth) and first appears during the teen years. It is also associated with a higher risk of certain complications, such as depression and substance misuse disorder. The most important thing anyone with symptoms of the disorder can do is seek professional help as soon as possible.

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Medical Reviewer: N. Simay Gökbayrak, PhD
Last Review Date: 2022 Jun 13
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Bathla, M., et al. (2016). Prevalence of anxiety and depressive symptoms among patients with hypothyroidism. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911835/
  2. Dias da Cruz, E. L., et al. (2017). Factors related to the association of social anxiety disorder and alcohol use among adolescents: A systematic review. https://www.sciencedirect.com/science/article/pii/S0021755716302261
  3. Social anxiety disorder: More than just shyness. (n.d.). https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness
  4. Social anxiety disorder: Recognition, assessment and treatment. (2013). https://www.ncbi.nlm.nih.gov/books/NBK327674/
  5. Social anxiety disorder. (n.d.). https://www.mhanational.org/conditions/social-anxiety-disorder