Social Anxiety Disorder

Many people get nervous or anxious or feel shy in social situations from time to time. For these people, however, the anxiety is short lived and doesn’t interfere with life or fuel their avoidance of social situations. People with social anxiety disorder, on the other hand, are paralysed by their fear of social situations. Those who suffer from social anxiety disorder are plagued by a fear that lasts at least six months. Often, people with social anxiety disorder know that their intense fear of situations is slightly irrational, but still can’t shake the anxiety. One’s social, professional, academic, and romantic relationships may suffer if they are plagued by a fear of social interaction.

What is Social Anxiety Disorder?

Social anxiety disorder, also called social phobia, is a type of anxiety disorder characterised by an intense, persistent fear of social situations. Someone with social anxiety disorder will be extremely worried about people judging them or being embarrassed in front of others. People who suffer from social anxiety disorder fear being observed or performing in front of others. In addition, they may be afraid that others will notice that they are stressed out. The fear is inappropriate compared to the actual threat of the situation, often leading to avoidance of social situations, which just fuels the intense fear. An individual’s ability to function and enjoy life is negatively impacted by their level of anxiety and avoidance about the situation.

Social anxiety disorder can be generalised or non-generalized. Fear of social situations in general is indicative of a generalised disorder, whereas fear of social situations in particular is indicative of a non-generalized disorder. Some people’s social anxiety is restricted to situations in which they must perform, such as giving a speech or performing on stage.

The disorder usually begins in adolescence or childhood. It’s most common in people under the age of twenty. Adults with the disorder, on the other hand, are more likely to seek treatment later in life. Some people can pinpoint when their social anxiety began or what triggered it, such as being bullied in school, while others just recall being shy and social anxiety getting worse over time.

In the years 2001–2003, an estimated 7% of adults over the age of 18 were diagnosed with social anxiety disorder. Of those, 29.9% had severe impairment, 38.8% had moderate impairment, and 31.3 percent had mild impairment as a result of the disorder.

Social Anxiety Disorder Symptoms & Behaviors

Physical and psychological signs abound for people suffering from social anxiety disorder. Intense and debilitating symptoms vary from person to person, but they are almost always present.

The following are some of the more severe signs and symptoms:

  • Anxiety-inducing beats
  • Blushing
  • Sweating
  • I’m feeling trouble breathing.
  • Irritable bowel syndrome
  • dizziness or lightheadedness
  • Trembling

Mental symptoms include:

  • Feeling embarrassed or self-conscious in front of other people
  • Having difficulty being with and talking to new people
  • Having an intense fear of being judged by others
  • Having trouble with eye contact
  • Avoiding social situations that would trigger anxiety

Some examples of situations that may be trigger these symptoms include:

  • Meeting new people
  • Talking to strangers
  • Speaking up in group settings such as meetings
  • Attending classes or working
  • Using public toilets
  • Being observed while consuming food or beverages
  • delivering a speech in front of an audience

Causes and Symptoms of Social Phobia

Anxiety about social situations can have a variety of underlying causes. People who suffer from this condition often have a number of risk factors and causes working against them.

Causes and risk factors for social anxiety disorder include:

Brain structure: The amygdala is a part of the brain that is responsible for regulating anxiety and the fear response. Research has shown that the amygdala is overactive in people with social anxiety disorder, and this may play a role in the disorder.

Childhood: The way parents raise a child may affect whether or not they develop social anxiety disorder. For example, if someone’s parents were very controlling or overprotective, or if they demonstrated anxious behaviour socially, this could result in a higher risk of the child developing social anxiety disorder.

A person’s risk of developing social anxiety disorder may be increased if they have been subjected to any type of abuse, including physical, sexual, or emotional. Other stressful negative events, such as being bullied or being embarrassed in front of others, can also contribute to the development of the disorder in the later stages of one’s life.

Genetics: If close relatives experience social anxiety disorder, someone in that family is more likely to develop the disorder themselves.

Approaches to Treating Social Anxiety

Luckily, treatment options are available for social anxiety disorder. Treatment plans are individualised and tailored to someone’s specific needs, depending on the severity of the disorder and its impact on quality of life. Types of treatment include:


Therapy has been shown to be very effective for helping people with social anxiety disorder. There are a few types of therapy that are commonly used:

The most common treatment for social anxiety disorder is cognitive behavioural therapy (CBT). This type of therapy helps people to identify and understand their unhealthy, negative thought patterns and behaviours and create new healthy thoughts and behaviours. CBT teaches people how to look at stressful situations more objectively and clearly, weaving in coping skills and relaxation methods such as breathing techniques. When it comes to treating social anxiety disorder, studies show that cognitive behavioural therapy (CBT) is highly effective at altering negative thoughts and self-beliefs in patients.

People with social anxiety disorder can benefit from exposure therapy, which involves deliberately exposing themselves to the things that make them anxious in social situations. The goal is to feel the fear and attempt to do it anyway. With the help of a therapist, a hierarchy list of feared situations is created before the person with social anxiety goes out to actually face these fears. After a series of exposures, the theory goes, the triggers will become less intense, anxiety levels will drop, and interacting with others will become less difficult.

As a social situation with strangers and the potential for judgement, group therapy can appear to be a form of exposure therapy in and of itself. However, group therapy is a safe space for someone with social anxiety disorder to be able to interact with people who can relate to them on a deeper level, learn new skills, and practise interacting with others in a safe space. Research has found individual CBT and group CBT to be equally effective.


A combination of medication and therapy may be necessary to treat severe cases of social anxiety. Treatment options for social anxiety disorder include a variety of medications. They include:

Antidepressants: Antidepressants aren’t only used to treat depression, but they can also help with anxiety. The most commonly prescribed antidepressants for social anxiety disorder are SSRIs (selective serotonin reuptake inhibitors). These medications are frequently taken on a long-term basis, often every day.

Beta blockers: Beta blockers are a class of medications that lower blood pressure by blocking the effects of adrenaline. People with social anxiety disorder may be prescribed these medications to be taken on an as-needed basis before stressful events that set off their disorder, in addition to the conditions for which they are commonly prescribed for medical treatment. Propranolol (Inderal) is an example of a beta blocker that is commonly prescribed for social anxiety disorder. This type of medication helps to reduce the physical symptoms of anxiety, including a racing heart and feeling short of breath.

Antianxiety medications: The most common type of antianxiety medication for social anxiety is a drug class called benzodiazepines. They reduce anxiety and have a sedating effect. Because of their rapid action, benzodiazepines, like beta blockers, should only be used sparingly before stressful situations arise. However, this type of medication is more commonly prescribed after other therapy methods and medications have been tried since patients are likely to become physically dependent on them.

If you think you might have social anxiety disorder, you can start by taking an anxiety assessment. If you’re struggling with social anxiety, don’t hesitate to reach out to a mental health professional. It is possible to overcome your fears and take back control of your life with the help and support that is readily available to you today.

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