Social Anxiety Disorder: Symptoms, Causes, and Treatment

Social anxiety disorder (or social phobia) is debilitating! Many people at one time or another are shy, experience performance anxiety or get nervous in front of others, however, this apprehension is not a social anxiety phobia.

Do you have an excessive fear of situation in which embarrassment may occur?

Do you to avoid those situations that cause you intense social anxiety? Does this avoidance or fear interferes with work, school or other daily activities.

Social phobia affects about 15 million American adults. You can overcome your social phobia with the right treatment which may include some of the following:

If you feel that you suffer from social anxiety we strongly recommend that you visit your doctor for treatment advice.

What are social anxiety disorders

People with social anxiety disorders have a persistent and overwhelming fear of being watched or judged in social or performance situation and that their anxiety response may cause embarrassment.

For example, lets suppose that you were to give a public speech or presentation.

If you were experiencing symptoms of social anxiety you would fear public speaking because others may notice your hands shaking or voice wavering, or you may fear talking to others because you fear being inarticulate to others.

While you may know that your social anxiety is excessive; you would avoid, fear or have anxious anticipation about the situation which interferes with your daily functioning.

Expert on social anxiety disorder, Dr Murray Stein


People with social anxiety fear and avoid particular situations such as performance anxiety or public speaking anxiety. Other people with social phobia have a generalized fear about many social situations.

A person with social phobia can fear and avoid a range of situation which may include:

  • being teased or criticized by others
  • meeting new people or meeting people in authority
  • shaking hands or going shopping
  • Situations that put them in the spot light or being observed while doing something
  • feeling as though you have nothing to say, or feeling out of place in a social situation
  • writing, talking or making a phone call in public
  • attending parties or other social functions.

Social anxiety disorder symptoms

social anxiety disorder

Anxiety is characterized by both phyiscal and psychological symptoms. The excess muscle tension, the film of sweat that covers your brow, the pounding heart....these are all physical symptoms of the fight or flight response.

In more extreme cases, the physical symptoms may be quite similar to anxiety attacks.

These physical anxiety symptoms may also be experienced with more emotional symptoms such as more negative thoughts, difficult concentrating or focusing on anything other than the physical symptoms they are experiencing.

Even though they know that these feelings and thoughts may seem to be irrational they still have an urge to flee from the situation that is causing distress.

Social anxiety disorder treatment

Without correct treatment people with this anxiety disorder may have difficulty holding down relationships, misuse prescription and non-prescription drugs, and because of their isolation start to develop anxiety depression symptoms.

Some of the typical treatment opions include:

Cognitive behavioral therapy

In CBT, a trained therapist will typically target the cognitions and behavior.

The cognitive part of the therapy helps people to change their thinking patterns that support their fears.

For example, a person with social phobia may enter a situation with certain rules “I must always appear witty and intelligent,” or assumptions “If the person gets to know me they will think I am boring,” or unconditional assumptions such as “I am weird and boring.”

Cognitive restructuring would involve challenging these rules, assumptions and expectations of humiliation and embarrassment. This in turn lessens anxiety and reducing avoidance.

The behavioral component helps people to change the way they behave towards stimuli that is anxiety-provoking.

For example using exposure to have the person with social phobia stay in contact with the feared social social situation until the anxiety diminishes – with the aim that connection between the situation and anxiety will be reduced.

Anxiety management techniques

Relaxation techniques may help to reduce the symptoms of anxiety disorders. Some of these may include:

Social skills training

People with social phobia may have got into many habits of behavior that make it challenging in their recovery.

For example a lack of eye gaze and closed body language with hesitant speech may not be conducive to positive social interactions.

As such, social skills training has also been used to teach people with social phobia the skills that they may lack. By modeling, role playing and putting into practice in real situations.

This can decrease the expectations of humiliation or embarrassment and increase the chances of positive interactions and feedback.

Anti anxiety medication

Some medications, such as selective serotonin re-uptake inhibitors (SSRIs) can help if the person is also suffering from depression. There are a number of other medications that can be prescribed by your local medical practitioner.

This site is for information purposes only and is no substitute for treatment. Please see your local medical expert or mental health professional for advice.

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