Overview

Social anxiety disorder, also known as social phobia, is characterized by significant anxiety, self-consciousness, and embarrassment in everyday social interactions. It goes beyond normal feelings of nervousness in social situations and can lead to avoidance behaviors that disrupt daily life. Social anxiety disorder can be a chronic mental health condition, but with the right treatment, individuals can gain confidence and improve their ability to interact with others.

Symptoms

Social anxiety disorder symptoms include:

  • Fear of negative judgment in social situations
  • Worry about embarrassing or humiliating oneself
  • Fear of interacting with strangers
  • Fear that others will notice anxious behavior
  • Fear of physical symptoms causing embarrassment (blushing, sweating, etc.)
  • Avoidance of social activities and interactions
  • Anxiety in anticipation of feared activities
  • Intense fear or anxiety during social situations
  • Overanalyzing social interactions and identifying flaws
  • Expectation of negative consequences from social situations

In children, social anxiety may be shown through crying, temper tantrums, clinging to parents, or refusal to speak in social settings.

Physical Symptoms

Physical signs and symptoms that may accompany social anxiety disorder include blushing, fast heartbeat, trembling, sweating, upset stomach, dizziness, and muscle tension.

Avoiding Common Social Situations

Individuals with social anxiety disorder may find it challenging to endure everyday experiences, such as interacting with strangers, attending social gatherings, going to work or school, starting conversations, making eye contact, dating, and more.

When to See a Doctor

If you fear and avoid normal social situations due to embarrassment, worry, or panic, it’s essential to seek help from a doctor or mental health professional.

Causes

The causes of social anxiety disorder are likely a combination of biological and environmental factors, such as genetics, brain structure, and learned behavior from negative experiences or overprotective parenting.

Risk Factors

Several risk factors increase the likelihood of developing social anxiety disorder, including family history, negative experiences, shy temperament, new social or work demands, and having an appearance or condition that draws attention.

Complications

Left untreated, social anxiety disorder can have various complications, including low self-esteem, difficulty being assertive, negative self-talk, hypersensitivity to criticism, poor social skills, isolation, academic and employment problems, substance abuse, and even suicidal thoughts or attempts. Other mental health disorders, particularly major depressive disorder and substance abuse, often co-occur with social anxiety disorder.

Prevention

While it may not be possible to predict anxiety disorders’ development, certain steps can reduce symptoms’ impact:

  • Seek help early
  • Keep a journal to identify stressors and coping strategies
  • Set priorities in life and engage in enjoyable activities
  • Avoid unhealthy substance use

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Diagnosis

If you believe you may have social anxiety disorder, your health care provider will perform a thorough evaluation to determine the underlying cause of your anxiety and whether you have social anxiety disorder or another medical or mental health condition.

Diagnostic Process

The diagnostic process for social anxiety disorder may include:

  • Physical exam to rule out any medical conditions or medications that may trigger anxiety symptoms
  • Discussion of your symptoms, frequency, and situations in which they occur
  • Review of a list of situations that cause anxiety
  • Self-report questionnaires about social anxiety symptoms
  • Assessment based on criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

DSM-5 Criteria

The DSM-5 criteria for social anxiety disorder include:

  • Persistent, intense fear or anxiety about specific social situations due to the fear of negative judgment, embarrassment, or humiliation
  • Avoidance of anxiety-inducing social situations or enduring them with intense fear or anxiety
  • Excessive anxiety that is out of proportion to the situation
  • Anxiety or distress that significantly interferes with daily functioning
  • Fear or anxiety that cannot be attributed to a medical condition, medication, or substance abuse

Treatment

Treatment for social anxiety disorder typically involves psychotherapy, medication, or a combination of both. Cognitive-behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Medications such as SSRIs and SNRIs are commonly prescribed to help manage symptoms.

Alternative Medicine

Some herbal remedies have been studied as treatments for anxiety, but their effectiveness is mixed. It is essential to consult with your health care team before trying any herbal remedies or supplements to ensure they are safe and won’t interact with other medications.

Lifestyle and Home Remedies

While professional help is crucial, some lifestyle changes can complement treatment:

  • Learn stress-reduction skills
  • Engage in regular physical exercise
  • Prioritize getting enough sleep
  • Eat a healthy, well-balanced diet
  • Avoid alcohol and limit caffeine intake
  • Participate in social situations with people you feel comfortable with

Coping and Support

Several coping methods can help ease anxiety and improve social interactions:

  • Reach out to friends and family regularly
  • Join support groups or organizations that offer opportunities to improve communication and public speaking skills
  • Engage in pleasurable and relaxing activities, such as hobbies

Over time, these coping methods can help control symptoms and prevent relapses.

Preparing for Your Appointment

Before your appointment, make a list of situations you’ve been avoiding, symptoms you’ve experienced, any recent life events, and your current medications. It may be helpful to bring a trusted family member or friend along to help you remember important information. Be prepared to answer questions about your fears, symptoms, and any family history of anxiety disorders.

Remember, seeking help is essential, and treatment may take time. Stick with your therapy and medication as directed by your health care provider and discuss any changes in your condition with them.

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