Table of ContentsView AllTable of ContentsTypesSymptomsDiagnosisCauses and Risk FactorsTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Diagnosis
Causes and Risk Factors
Treatment
Coping
Social anxiety disorder (SAD) is an intense and disabling fear of social situations. People with social anxiety experience severe emotional, physical, or cognitive symptoms related to everyday social settings. Left untreated, it can lead to social avoidance.
Formerly known as social phobia, SAD features intense anxiety about being negatively judged or rejected in a social or performance situation.It can affect your ability to work, go to school, or go about daily life and lead to isolation, loneliness, and depression.
This article provides an overview of social anxiety disorder. It describes the common symptoms of SAD and explains how it is diagnosed and treated.
Social anxiety is the second most commonly diagnosed anxiety disorder, affecting approximately 15 million American adults. About 7% of the general population in the U.S. will experience some form of social anxiety disorder in a 12-month period, and some estimates show the lifetime prevalence rate for developing SAD is 13% to 14%.
Theresa Chiechi / Verywell
Types of Social Anxiety
There are two types of social anxiety: specific and general. A specific or performance-only social anxiety example would be the fear of speaking in front of groups. People with generalized social anxiety are anxious, nervous, and uncomfortable in a variety of social situations.
It is much more common for people with social anxiety to have a generalized type of this disorder. When anticipatory anxiety, worry, indecision, depression, embarrassment, feelings of inferiority, and self-blame are involved across most life situations, a generalized form of social anxiety may be the cause.
Symptoms of Social Anxiety
Experiencing symptoms of social anxiety does not necessarily mean someone has an anxiety disorder. However, if these symptoms result in persistent emotional distress or are disrupting everyday routines, that could be a sign of social anxiety disorder.
Physical
People with SAD may experience the following when having to perform in front of or be around others:
Psychological
The psychological symptoms of SAD may be largely invisible to others, but they are serious and have the ability to derail someone’s life. These symptoms include:
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Complications
Without treatment, these symptoms can fester into significant problems. Difficulties communicating and connecting with others can mean lost opportunities.
Examples of complications arising from SAD may include the following:
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How Social Anxiety Is Diagnosed
While it’s normal to experience social anxieties in new or unfamiliar situations, social anxiety disorder causes persistent and significant distress. It can affect your ability to earn a living, attend social gatherings, and perform routine errands.
Social anxiety can even make it hard to make and keep friends. The consequences can be isolation and loneliness, as well as a breakdown of relationships with family, coworkers, and friends.
If you suspect you may have social anxiety disorder, start with a visit to your healthcare provider to rule out physical causes of your symptoms. This involves a physical exam and bloodwork or other tests.
They will also ask questions about your anxiety and the settings where it occurs. If there are no underlying medical causes, you may be referred to a mental health professional. Psychiatrists, psychologists, and social workers diagnose social anxiety based on criteria laid out in the “Diagnostic and Statistical Manual of Mental Disorders, 5th Edition”(DSM-5).
How Social Anxiety Disorder Is Diagnosed
SAD is sometimes confused with panic disorder. The key differences are that people with panic disorder experience unexpected panic attacks, rather than anxiety symptoms specifically related to social situations.
Causes and Risk Factors of Social Anxiety
It’s unclear what exactly causes SAD, but many factors influence a person’s likelihood of developing social anxiety:
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Subtypes
The National Social Anxiety Center recognizes several subtypes of social anxiety disorder:
Treatment for Social Anxiety
Treatment options can include helping a person develop healthier thought patterns and coping mechanisms and other psychosocial improvements. They can also be used to help manage and reduce the associated symptoms of social anxiety disorder.
Psychotherapy
Many research studies have shown that anxiety-specific cognitive behavior therapy (CBT), a type of psychotherapy that teaches healthier ways of thinking, behaving, and reacting to situations, can effect positive changes in brain structures involved in processing and regulating emotion.
Medication
Medications can be effective in the short term at managing symptoms of social anxiety. However, if they are not used in conjunction with an active, structured CBT program, medications alone will have no long-term benefits for people with SAD.
Medications that may be used to manage SAD include:
Fewer than 5% of people with SAD will seek treatment within a year following the initial onset of the disorder. More than a third of people report experiencing symptoms for 10 or more years before getting help.
Coping with Social Anxiety
There are additional ways to help improve quality of life and reduce symptoms of anxiety when living with SAD:
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Summary
Social anxiety disorder is a mental health condition that causes intense physical and emotional symptoms related to social or performance situations.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Anxiety and Depression Association of America.Social Anxiety Disorder.Social Anxiety Institute.What is Social Anxiety?National Institute of Mental Health.Social Anxiety Disorder: More Than Just Shyness.Social Anxiety Association.What is Social Anxiety Disorder? Symptoms, Treatment, Prevalence, Medications, Insight, Prognosis.Tillfors M, Furmark T, Marteinsdottir I, et al.Cerebral Blood Flow in Subjects with Social Phobia During Stressful Speaking Tasks: A PET Study.Am J Psychiatry. 2001;158(8):1220-1226. https://doi:10.1176/appi.ajp.158.8.122.xPsychiatry Online.Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596.xNational Social Anxiety Center.Shy Bladder Syndrome (Paruresis).National Social Anxiety Center.Conversational Anxiety.The National Social Anxiety Center.Male Sexual Performance Anxiety.National Social Anxiety Center.Public Speaking Anxiety.National Social Anxiety Center.LGBT Anxiety.Goldin PR, Ziv M, Jazaieri H, Weeks J, Heimberg RG, Gross JJ.Impact of cognitive-behavioral therapy for social anxiety disorder on the neural bases of emotional reactivity to and regulation of social evaluation.Behav Res Ther. 2014;62:97-106. https://doi: 10.1016/j.brat.2014.08.005.xHarvard Health.Treating Social Anxiety Disorder.HelpGuide.Social Anxiety Disorder.Health Harvard.Omega-3s for Anxiety?
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Anxiety and Depression Association of America.Social Anxiety Disorder.Social Anxiety Institute.What is Social Anxiety?National Institute of Mental Health.Social Anxiety Disorder: More Than Just Shyness.Social Anxiety Association.What is Social Anxiety Disorder? Symptoms, Treatment, Prevalence, Medications, Insight, Prognosis.Tillfors M, Furmark T, Marteinsdottir I, et al.Cerebral Blood Flow in Subjects with Social Phobia During Stressful Speaking Tasks: A PET Study.Am J Psychiatry. 2001;158(8):1220-1226. https://doi:10.1176/appi.ajp.158.8.122.xPsychiatry Online.Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596.xNational Social Anxiety Center.Shy Bladder Syndrome (Paruresis).National Social Anxiety Center.Conversational Anxiety.The National Social Anxiety Center.Male Sexual Performance Anxiety.National Social Anxiety Center.Public Speaking Anxiety.National Social Anxiety Center.LGBT Anxiety.Goldin PR, Ziv M, Jazaieri H, Weeks J, Heimberg RG, Gross JJ.Impact of cognitive-behavioral therapy for social anxiety disorder on the neural bases of emotional reactivity to and regulation of social evaluation.Behav Res Ther. 2014;62:97-106. https://doi: 10.1016/j.brat.2014.08.005.xHarvard Health.Treating Social Anxiety Disorder.HelpGuide.Social Anxiety Disorder.Health Harvard.Omega-3s for Anxiety?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Anxiety and Depression Association of America.Social Anxiety Disorder.Social Anxiety Institute.What is Social Anxiety?National Institute of Mental Health.Social Anxiety Disorder: More Than Just Shyness.Social Anxiety Association.What is Social Anxiety Disorder? Symptoms, Treatment, Prevalence, Medications, Insight, Prognosis.Tillfors M, Furmark T, Marteinsdottir I, et al.Cerebral Blood Flow in Subjects with Social Phobia During Stressful Speaking Tasks: A PET Study.Am J Psychiatry. 2001;158(8):1220-1226. https://doi:10.1176/appi.ajp.158.8.122.xPsychiatry Online.Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596.xNational Social Anxiety Center.Shy Bladder Syndrome (Paruresis).National Social Anxiety Center.Conversational Anxiety.The National Social Anxiety Center.Male Sexual Performance Anxiety.National Social Anxiety Center.Public Speaking Anxiety.National Social Anxiety Center.LGBT Anxiety.Goldin PR, Ziv M, Jazaieri H, Weeks J, Heimberg RG, Gross JJ.Impact of cognitive-behavioral therapy for social anxiety disorder on the neural bases of emotional reactivity to and regulation of social evaluation.Behav Res Ther. 2014;62:97-106. https://doi: 10.1016/j.brat.2014.08.005.xHarvard Health.Treating Social Anxiety Disorder.HelpGuide.Social Anxiety Disorder.Health Harvard.Omega-3s for Anxiety?
Anxiety and Depression Association of America.Social Anxiety Disorder.
Social Anxiety Institute.What is Social Anxiety?
National Institute of Mental Health.Social Anxiety Disorder: More Than Just Shyness.
Social Anxiety Association.What is Social Anxiety Disorder? Symptoms, Treatment, Prevalence, Medications, Insight, Prognosis.
Tillfors M, Furmark T, Marteinsdottir I, et al.Cerebral Blood Flow in Subjects with Social Phobia During Stressful Speaking Tasks: A PET Study.Am J Psychiatry. 2001;158(8):1220-1226. https://doi:10.1176/appi.ajp.158.8.122.x
Psychiatry Online.Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596.x
National Social Anxiety Center.Shy Bladder Syndrome (Paruresis).
National Social Anxiety Center.Conversational Anxiety.
The National Social Anxiety Center.Male Sexual Performance Anxiety.
National Social Anxiety Center.Public Speaking Anxiety.
National Social Anxiety Center.LGBT Anxiety.
Goldin PR, Ziv M, Jazaieri H, Weeks J, Heimberg RG, Gross JJ.Impact of cognitive-behavioral therapy for social anxiety disorder on the neural bases of emotional reactivity to and regulation of social evaluation.Behav Res Ther. 2014;62:97-106. https://doi: 10.1016/j.brat.2014.08.005.x
Harvard Health.Treating Social Anxiety Disorder.
HelpGuide.Social Anxiety Disorder.
Health Harvard.Omega-3s for Anxiety?
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