A mental health problem in which individuals experience fear and anxiety when they are around people in social situations is called social anxiety disorder or social phobia. Commonly, those who develop this condition fear being watched or judged by other people. In most cases, this disorder is treated with talk therapy (also called psychotherapy) and medicines (such as antidepressants).
Moreover, social phobia is a type of anxiety disorder. Anxiety or fear often occurs in the following cases. For example:
- Meeting new people
- Performing in front of people
- Using public restrooms
- Making phone calls
- Dating
- Asking for help in a restaurant, store, or other public spaces
- Eating surrounded by other people
- Participating in an interview
The primary characteristics of social anxiety disorder are fear of being humiliated, rejected, or judged.
In general, this is a common mental health disorder that affects about 5% to 10% of people in the entire world. Moreover, it is the third most common mental disorder behind substance use disorder and depression.
Types of Social Anxiety Disorder
There are different types of this mental condition. People may develop a mild, moderate, or severe form of social phobia. For instance, some people may experience symptoms only when eating or performing in front of others, while others may have social anxiety symptoms in all forms of social interactions.
- Mild social anxiety – This type of condition usually causes physical and psychological symptoms. However, people can still participate in or endure social situations.
- Moderate social anxiety – In moderate cases, people may avoid some social situations because they experience more intense symptoms.
- Severe social anxiety – Those who develop a severe form of this mental disorder may experience symptoms such as a panic attack. In such cases, they often avoid most social situations at all costs.
Commonly, people have anticipatory anxiety when participating in these situations more times. Therefore, this condition may vary between different levels throughout your life. In any case, if you suspect you have this disorder, it is advised to get medical help right away.
Symptoms
Usually, people experience different symptoms, behaviors, and thoughts when they are around or in front of other people. While the following symptoms may occur during specific types of social situations, they may also appear in all social interactions. Check below some examples:
Psychological and Physical Symptoms
These include:
- Sweating, shaking, blushing, or a fast heart rate
- Nervousness that may lead to nausea
- Avoiding eye contact when interacting with other people
- Stiff body postures when you are around other people
Thoughts and Behaviors
In some cases, the following symptoms may indicate social phobia. For example:
- Feeling awkward or embarrassed
- Very self-conscious in front of other people
- Fear or concerns that other individuals will judge or reject you
- Frequently avoiding places where there are people
If any of the previous symptoms occur, you should visit a doctor right away.
Causes
Experts do not fully understand why this condition occurs, but studies are ongoing. For instance, some people with social anxiety disorder have a family history of this condition, but physicians do not understand why some people get it and others do not. However, researchers are looking at how stress and environmental factors contribute to this mental condition.
Risk Factors
While it is not possible to determine the exact cause of the condition, physicians have identified some factors that could increase the risk of developing it. Check below some examples:
- Shy people are more likely to develop social anxiety
- Family history of social anxiety disorder – If you have a parent or sibling with this condition, your risk of developing it significantly increases.
- Traumatic events (including bullying, abuse, or neglect)
- Physical appearance – Conditions such as disfigurement or stuttering may increase the risk of self-consciousness and social phobia.
- Other anxiety disorders
- Depression
- Major life changes may also trigger social anxiety disorder
- Sex – Females are more prone to develop this mental disorder compared to males
What Are The Potential Complications of Social Anxiety Disorder?
It is not uncommon for people with social anxiety disorder to experience complications. The following complications often occur because most people with this condition do not get treatment. Check below some examples:
- Substance abuse
- Depression
- Other anxiety disorders
- Relationship problems
- Social isolation
- Reduced academic achievement
- An increased risk of other health problems, including heart disease, digestive conditions, and headaches
- Decreased quality of life
- Suicidal thoughts
This document does not contain a complete list of social anxiety disorder complications.
How to Prevent Social Anxiety Disorder?
It is not possible to prevent this condition because healthcare professionals do not fully understand why it occurs. However, the following tips may help reduce the risk. For example:
- Get medical help if you have experienced stressful or fearful events in your life
- Do not hesitate to see a mental health professional if you have experienced abuse, neglect, or bullying in childhood
- Quit smoking
- Limit or avoid alcoholic beverages
Diagnosis
If your doctor suspects social anxiety disorder, you may be referred to a psychiatrist or psychologist. They often use the criteria for social anxiety disorder from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose it. These criteria include:
- Prolonged fear or anxiety about social situations
- Avoidance of social situations
- Experience intense anxiety that is too much for a specific situation
- Distress from social situations that you are interacting with every day
- The symptoms you experience are not explained by a disease, medicine, or substance abuse
Social anxiety disorder is often diagnosed when previous criteria occur for at least 6 months. Your healthcare professional may also ask several questions to better understand the severity of your symptoms.
Treatment
Commonly, social anxiety disorder is treated with medicines (such as selective serotonin reuptake inhibitors, also known as SSRIs) and a type of psychotherapy known as cognitive behavioral therapy (CBT).
Cognitive Behavioral Therapy
During this treatment, your psychologist or therapist will work with you to make changes in your thinking and behavioral patterns. Usually, people with this mental disorder require multiple sessions to notice improvements. Most people have a better response to stress, anxiety, and challenging situations after treatment.
Medicines
Your doctor may also prescribe some medicines along with talk therapy. Check below the most common medications recommended by doctors for people with social phobia:
- SSRIs (selective serotonin reuptake inhibitors) – This is a type of antidepressant that helps treat this condition. Usually, physicians prescribe Sertraline, Paroxetine, Fluoxetine, Citalopram, or Escitalopram.
- SNRIs (serotonin-norepinephrine reuptake inhibitors) – The most common SNRIs used to treat social anxiety disorder include Duloxetine and Venlafaxine.
- Benzodiazepines – These medications are often used for short periods until antidepressants begin to do their job. They help ease the symptoms and prevent serious complications. Mostly, doctors prescribe Alprazolam or Lorazepam.
- Beta-blockers – Primarily, this group of medicines is used to treat heart problems. It helps people relieve some anxiety symptoms (including a fast heart rate). Commonly, physicians prescribe Propranolol or Metoprolol.
Sometimes, it may take some time to find the best medicine for you. Moreover, it is very important to take the prescribed medications exactly as recommended by your doctor. Otherwise, you may not notice improvements, or the condition may return.
Frequently Asked Questions
What is the difference between having social anxiety disorder and being shy?
While anyone may experience shyness at times, this disorder causes persistent symptoms when you are involved in social situations. These include talking with other people, going to the grocery store, and others. Furthermore, social phobia may negatively affect your career, education, and personal relationships, but shyness does not impact these things.
How long will I have social anxiety disorder?
Usually, people begin to feel better within 2 weeks with treatment. If you ignore the symptoms and leave this disorder untreated, it may lead to depression or substance misuse. As a result, you may need psychotherapy and antidepressants for the rest of your life.
How to deal with social anxiety?
There are some tips that may help cope with social anxiety symptoms. These include focusing on gradually building confidence, relaxation techniques, challenging negative thought patterns, and seeking medical help, especially if you experience severe symptoms. Ask your healthcare provider if you have additional questions.
