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Social Anxiety – Symptoms and Treatment

Family gatherings can be a great time to reconnect with family you haven’t seen for a while. They can also be a great time to deepen relationships with the family who you do see more often. Meeting friends at a party can be fun and meeting people who you don’t know at that same party can bring on a mix of excitement and nervousness. 

Whatever the reason for the gathering or party or who will be there, some people thrive in these types of environments. They look forward to the event and feel energized by it. For others, a social event produces a different reaction. Feelings of dread and worry can overwhelm them to the point that they skip the event altogether, missing opportunities to build relationships, be with friends and meet new people.

What is social anxiety? 

People with social anxiety disorder (SAD), also known as social phobia, have anxiety about being judged harshly by others or inadvertently causing embarrassment to themselves in social situations. They are excessively worried about their behavior and how they fit in with others.

Both women and men can have social anxiety disorder, with women being slightly more likely to develop this disorder. The disorder can begin in childhood or early adolescence. 

Symptoms of Social Anxiety

There are a cluster of symptoms people experience when they have social anxiety disorder. If someone thinks they have this disorder, these symptoms must be present for at least six months for a diagnosis.

Social anxiety consists of the following emotional, physical and behavioral symptoms:

  • Avoiding situations and places where people gather
  • Feeling that others judge them severely
  • Feeling physical sensations of anxiety (ex. sweating, heart palpitations, and nausea)
  • Not fully engaging with other people, especially with new people (ex. lack of eye contact and responsiveness and speaking softly)
  • Having a general fear of being around people and social situations
  • Being highly self-conscious around people and in social situations

A quick google search will show that there are many social anxiety tests that one can take to find out if they might have this disorder, such as this one: https://www.mind-diagnostics.org/social_anxiety-test. Taking a test is not the same as being diagnosed, but it can be enlightening and help clarify what you’re experiencing. It’s best to talk to a doctor about your results and your experiences to determine if you do indeed have social anxiety disorder and to discuss next steps regarding treatment.

Types of Social Anxiety Disorder

People express social anxiety in different situations. There are generally two types of social anxiety disorder:

  • Social anxiety disorder based on performance: This disorder involves those who have a fear about how they perform in front of others (ex. making a speech or completing a task while being observed).
  • Social anxiety disorder based on social interaction: People who fear meeting new people fall into this type. They might also fear that how they appear to others will cause embarrassment or humiliation. For example, they might blush when speaking or their hands might be sweaty when they go to shake someone’s hand. They might even believe and fear that they’ll appear as less intelligent than those around them.

Regardless of the type of social anxiety one experiences, both types are treatable. Treatment options are discussed near the end of this article.

Causes of Social Anxiety

There might be a genetic factor linking those who have social anxiety disorder to their 

first-degree relatives who also have this disorder. This alone, though, is not necessarily the single cause. Usually, this genetic factor coupled with another factor such as the environment or one’s personal experiences can lead to social anxiety disorder.

Environmental factors include being in new situations. This can be starting a new job, transferring to a new school or moving to a new neighborhood or city. Any situation that places a person outside of their familiar surroundings and the people they know and into new surroundings that also involves meeting new people can be the starting point of developing social anxiety.

Past experiences of embarrassment or humiliation might also factor in as an underlying cause of social anxiety disorder. Some examples are asking for a raise at work only to be rejected or being made fun of because of another condition, such as severe acne.

Treatment Options for Social Anxiety

The leading treatment option for social anxiety disorder is cognitive behavioral interventions therapy. With this type of therapy, a person learns to “reprogram” their thinking. When negative thoughts (ex. I’m stupid, I have ugly acne, I’m always rejected) are replaced with positive ones (ex. I’m intelligent, my acne doesn’t define me, rejection is not about rejecting me personally) these can lead to positive behaviors. Basically, negative thoughts lead to negative behaviors, while positive thoughts lead to positive behaviors.

Other types of treatment are folded into cognitive behavioral interventions therapy. Relaxation techniques are taught to the client that can be used before and during anxiety-provoking situations. The therapist will also help the client develop social skills, so the client can manage social situations better. Role playing during a therapy session is one way to develop these skills. 

Facing the fear is another type of therapy a therapist might employ. A therapist will encourage a client to face a fear that is considered low stakes for the client. For example, when they bring their dog to a park, they will introduce themselves to one person. After the client accomplishes this, the client then moves on to a more fearful situation and faces that one – building on each situation until they reach (and are ready) to face the ones that cause the most fear.

Antidepressant medication is used in combination with therapy when therapy alone doesn’t yield the desired results. Benzodiazepines (i.e., tranquilizers) are sometimes used but only for the short term because of the possibility of dependence.

Social anxiety disorder is treatable. People with this disorder can learn to minimize the impact this disorder has on them and their lives, creating opportunities for growth and fulfillment. 

by Marie Miguel

Biography:

Marie Miguel has been a writing and research expert for nearly a decade, covering a variety of health- related topics. Currently, she is contributing to the expansion and growth of a free online mental health resource with Mind-Diagnostics.org. With an interest and dedication to addressing stigmas associated with mental health, she continues to specifically target subjects related to anxiety and depression.

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