What Is Social Anxiety Disorder?
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Have you ever been consumed with intense fear at the thought of meeting strangers, or do you constantly feel that people have negative opinions of you? If you need to speak publicly, do you tremble and become excessively nervous without knowing why? Sometimes, these experiences are chalked up to shyness, but they could indicate something more serious. What is social phobia? Social anxiety disorder is generally defined as a persistent fear of social situations where you are exposed to unfamiliar people or scrutiny and a fear of being humiliated or embarrassed. If you believe you may be living with social anxiety disorder, online therapy can be an excellent first step toward relief and improved mental health.
What causes social anxiety disorder?
Research indicates that social anxiety disorder may affect between five and 10% of people worldwide. It’s typically considered to be the most common anxiety disorder and the third most common mental health disorder.
The causes of social anxiety are not entirely understood. Research indicates that social anxiety disorder usually involves multiple parts of the brain, and genetics often affects how those parts of the brain function.
Despite that, research also suggests that environmental factors may play a role as well. Overly controlling or intrusive parenting can affect temperament to the extent that a child may develop a social anxiety disorder. Stressful and adverse life events can also play a part in the development of social anxiety.
Types of social anxiety disorder
Specific social anxiety
Specific social anxiety may be when a person feels anxious or irrationally distressed in specific, consistent situations. For example, if a person feels severe social anxiety when answering questions in front of classmates at school, yet is perfectly comfortable meeting strangers at social gatherings, that individual is likely showing symptoms of specific social anxiety.
Generalized social anxiety
Generalized social anxiety may be when a person experiences symptoms in most, if not all, social environments. It can affect a person in almost any social situation.
Generalized social anxiety tends to be more severe, as it can affect someone in almost any situation involving social interaction with people other than their immediate family and friends. It tends to affect the way a person functions in their everyday life.
Symptoms of social anxiety disorder
- Anxiety about being with other people
- Feeling self-conscious and embarrassed in front of other people
- Difficulty talking to other people
- Difficulty making and keeping friends
- Fear of judgment
- Avoiding public places
- Worrying for days or weeks about a public event
Physical symptoms of social anxiety disorder
People with this condition may also experience physical symptoms when around groups of people, such as:
- Blushing
- Trembling
- Sweating
- Nausea
- Diarrhea
- Confusion
- Arrhythmia
- Muscle tension
These symptoms can negatively affect people in high-pressure moments or everyday social situations. Whether you're on a first date with someone you like or participating in your annual performance review at work, the fear response and symptoms of social anxiety disorder are often incredibly distracting and can drastically affect your social skills.
Mental health care for people with social anxiety disorder
If left untreated, social anxiety disorder can worsen and have debilitating effects. It may result in lower education, poor work performance, lower-quality relationships, and decreased quality of life. This condition is also frequently associated with low self-esteem, suicidal ideation*, financial issues, and lower socioeconomic status.
Up to 90% of people with social anxiety disorder may have other mental health conditions as well, potentially including depression or substance use disorder. Social anxiety disorder is normally treatable, but many people experience symptoms for decades before they seek help.
*If you or a loved one are experiencing thoughts of suicide, please know that help is available. You can call the National Suicide Prevention Lifeline anytime, 24/7, at 988.
Cognitive behavioral therapy (CBT) for social anxiety disorder
Cognitive behavioral therapy is generally based on the idea that our thoughts may lead to our feelings and behaviors, rather than external factors like people, situations, and events. By participating in CBT with a therapist specializing in social anxiety disorder, you can start to overcome your symptoms.
It can be beneficial to talk to your doctor if you’re experiencing social anxiety disorder symptoms. Research indicates that CBT can effectively treat this condition.
Trials comparing treatment with only medication or only therapy show that medication may have faster results than CBT, but CBT’s effects tend to be longer-lasting. Never start or stop any medication unless under the guidance of a licensed medical professional.
Navigating stress and fear in social situations with therapy
Though the idea of social anxiety group therapy may sound intimidating to the person coping with social anxiety, this can also be a good way to face the fear in a safe and friendly environment.
Seeking professional help is usually the best way to begin overcoming social anxiety disorder. Talk to your doctor to come up with a treatment plan, and if you’re considering cognitive behavioral therapy, consider reaching out to a therapist through an online therapy platform.
The benefits of online therapy for people with social anxiety
Online therapy frequently has many benefits for people with social anxiety disorder. If you find it overwhelming to make multiple phone calls to find an open appointment slot, commute to a therapist’s office, and meet with someone to talk face-to-face, getting online treatment may be a good option for you. Getting online therapy from the comfort and safety of your home can lower the stress you may feel about starting treatment.
The efficacy of online therapy for social phobia
Research indicates that online therapy can also be highly successful. One review found that CBT usually led to a 50% improvement in symptoms of multiple disorders, including social anxiety disorder. If you are experiencing symptoms of social anxiety disorder, online CBT may be an ideal way to seek treatment and work through your fears.
Takeaway
Am I socially awkward or do I have social phobia?
If you struggle in social situations, you might wonder whether you have social anxiety disorder (SAD), also known as social phobia. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), social anxiety disorder must:
- Cause “clinically significant distress” or otherwise interfere with daily life
- Cause extreme fear or avoidance of social situations
- Cause anxiety that can’t be better explained by another mental or physical health condition
If you are sometimes uncomfortable in social settings or feel that you have poor social skills, but you don’t experience extreme fear, you might not have social phobia. In contrast, if you go out of your way to avoid socializing because you’re worried you’ll embarrass yourself, or your worries lead to panic attacks or other physical symptoms, social phobia may be a possibility.
Keep in mind that only a qualified professional can officially diagnose social anxiety disorder. For this reason, you may want to talk to a healthcare provider for more personalized advice. They may want to perform a physical exam to rule out another medical condition that can cause similar symptoms, such as hyperthyroidism or an underlying heart condition. They may also be able to evaluate your experiences to determine if social anxiety is contributing to your symptoms.
What do people with social anxiety fear?
People with social anxiety fear being negatively judged, humiliated, shamed, or embarrassed in social situations. This fear goes beyond simple discomfort and can be so intense that it causes challenges at work, home, school, or in personal relationships.
What are three symptoms of social anxiety disorder?
Social anxiety disorder can cause various symptoms depending on the person. Three common examples include:
- Intense anxiety related to being shamed, embarrassed, or humiliated
- Physiological symptoms in social situations, such as nausea, rapid breathing, trembling, or lightheadedness
- Psychological symptoms, such as negative thoughts, panic attacks, excessive worry, or low self-esteem
What is the best mental health support for social phobia?
People with social phobia (also known as social anxiety disorder, or SAD) may be more likely to experience social isolation, stress, and challenges at work or in relationships. According to the Anxiety and Depression Association of America, people with SAD may also be at a higher risk for major depression and substance abuse challenges like alcohol use disorder. (Note that the term “substance abuse” is outdated and no longer used clinically. Mental health professionals instead use the term “substance use disorder” to describe symptoms formerly associated with this term.)
Having proper mental health support may help reduce symptoms of social phobia and avoid negative side effects like these. Social anxiety disorder, diagnosed and treated properly, can often be managed for a better quality of life. The best mental health support for social phobia may not be the same for everyone, but treatment typically consists of medication, talk therapy, or both. If you’re experiencing symptoms of social anxiety, you may want to start by talking to a mental health specialist. They may be able to give you a proper diagnosis and guidance on what form of care is right for your situation.
Can social anxiety be caused by stress?
The exact causes of social anxiety disorder are still being researched, but stress alone may not be enough to cause social anxiety disorder in someone who didn’t have it before. However, stressful and traumatic life events during childhood may raise a person’s risk of developing social anxiety. Stressful events may also make symptoms worse in people with existing social anxiety.
Who is most prone to social anxiety?
Although people of any age or gender can develop social anxiety, certain groups may be more susceptible than others. Research shows that social anxiety is more common among women, young adults, unmarried people, those with lower levels of education, and those with lower income levels. Social anxiety may also be more common in people with another anxiety disorder, depression, autism spectrum disorder, or body dysmorphic disorder.
Other potential risk factors for social anxiety include:
- Bullying, teasing, or other negative events during a person’s childhood or teenage years
- Traumatic life events
- Having a family history of social anxiety disorder
- Shyness early in life
What does social anxiety feel like?
Although social anxiety may not always feel the same for everyone, people with social anxiety disorder may experience the following symptoms, especially before or during social situations:
- Tense muscles
- A rapid heartbeat
- Rapid breathing
- Blushing
- Sweating
- Trembling
- Nausea or diarrhea
- Lightheadedness
People with social anxiety disorder may also be at an increased risk of panic attacks, episodes of overwhelming fear that are out of proportion to the actual threat posed. Keep in mind that while other mental health conditions, like panic disorder, may cause panic attacks with no obvious cause, the panic attacks involved in social anxiety disorder are mainly brought on by social situations.
What is an example of social anxiety?
People with social anxiety disorder (SAD) have an intense fear of being embarrassed, shamed, or negatively judged in social settings. Some examples of common anxiety-inducing situations for people with SAD include:
- Talking on the phone
- Using a public bathroom
- Eating in front of other people
- Group discussions at work or social gatherings
- Speaking or performing in front of a group
- Shopping for clothes or groceries
- Being photographed
- Attending or hosting social events
Situations like these can cause a variety of symptoms for people with SAD. Some examples include:
- Lightheadedness
- Racing thoughts
- Trouble focusing
- Nausea or digestive issues
- Blushing, trembling, or sweating
- Feelings of intense fear or discomfort
- Panic attacks
How to solve social anxiety?
While it’s not always possible to “solve” social anxiety, around 50% of people with social anxiety disorder, treated by a mental health professional, will experience remission. Even more may experience improvements in their symptoms, better well-being, and improvements in their quality of life. Treatment options for social anxiety typically include medication, therapy, and lifestyle changes.
Medications that may be used to treat social anxiety disorder include:
- Selective serotonin reuptake inhibitors (SSRIs): Often used to treat depression, SSRIs work by raising levels of the chemical serotonin in the brain. This may help reduce anxiety symptoms and improve mood.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs work by raising levels of the brain chemicals serotonin and norepinephrine. Research has found that SNRIs may be effective at treating anxiety disorders.
- Beta blockers: Beta blockers reduce the effects of hormones like adrenaline. This can help reduce anxiety symptoms like shaking, dizziness, and a rapid heartbeat.
- Benzodiazepines: Benzodiazepines are a type of anti-anxiety medication that boosts the effects of a brain chemical called GABA, creating feelings of relaxation. Benzodiazepines may pose a risk of dependence, especially when used long-term or at higher doses.
Types of therapy that may be used to treat social anxiety disorder include:
- Cognitive-behavioral therapy (CBT): Cognitive behavioral therapy aims to help patients identify and reframe thoughts and beliefs that may be contributing to their distress.
- Acceptance and commitment therapy (ACT): Acceptance and commitment therapy aims to help patients accept their thoughts and feelings and make changes to their lives that align with their values and goals.
- Exposure therapy (ET): Exposure therapy aims to gradually expose patients to situations that provoke fear, allowing them to confront their anxiety in a controlled and safe environment.
A doctor may also recommend making lifestyle changes to support general well-being and make it easier to manage anxiety symptoms. Some examples include:
- Practicing good sleep hygiene
- Limiting the use of caffeine, alcohol, and other substances
- Eating a nutritious and balanced diet
- Getting regular exercise
- Joining a support group for people with social phobia or other anxiety disorders
- Journaling daily
- Practicing yoga, breathwork, grounding exercises, or mindfulness meditation
- Having someone to turn to for support, such as a close friend or family member
Other possible treatments, such as nasal sprays, are also being studied in clinical trials. While there is currently no one-size-fits-all social anxiety treatment, working with your doctor may help you find the right combination of strategies.
What are 5 symptoms of social anxiety?
Social anxiety disorder, also called social phobia, can have different symptoms depending on the person. That said, five examples of social anxiety symptoms include:
- A marked fear of embarrassment or humiliation, leading to avoidance of social situations
- Trouble at work, school, or in relationships
- Extreme performance anxiety before speaking events, group events, or other situations where you might be judged
- Difficulty making eye contact, participating in conversations, making phone calls, or doing other social tasks
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