Last reviewed:
Nov 22nd 2022
M.S. Counseling Psychology
Also known as a social phobia, social anxiety disorder involves an intense fear of being embarrassed or rejected during the course of social interaction or some form of public performance. The condition is more common among women when compared to men, and it is often treated with medication and therapy. [1]
Social anxiety disorder is a mental health condition that leads to fear in social situations where a person might be subject to evaluation or rejection by others. The condition was once called social phobia, but with newer editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), it is now referred to as social anxiety disorder, because mental health experts have determined that social anxiety disorder differs clinically from a specific phobia. [1]
People who live with social anxiety typically begin to experience symptoms during childhood. The condition makes it difficult to engage in social situations due to an extreme fear of being negatively judged. Some people with social anxiety disorder may avoid social situations altogether because of their intense fear and worry. [1]
According to the DSM 5, there are two overarching types of social anxiety disorder. The first type is a general social anxiety disorder diagnosis, in which a person experiences social anxiety in one or more common social settings, such as at work, when having conversations, or when eating in a public setting.
The second type is a specific form of social anxiety, referred to as performance only. This type of social anxiety occurs only in cases of public performance, such as when giving a speech or presentation. [1]
When a person lives with social anxiety disorder, there are some general symptoms that they will display. These symptoms can be divided into psychological symptoms, physical symptoms, and avoidance symptoms. [2]
Psychological symptoms of social anxiety disorder include: [2]
Physical symptoms, which appear when a person is faced with a social interaction, include: [2]
Avoidance symptoms appear as follows [2]:
There is not one single cause of social anxiety disorder. Rather, a combination of risk factors can make a person more likely to develop the condition. Some common risk factors are described below:
When a person presents with symptoms of social anxiety disorder, a mental health professional like a psychologist or clinical social worker will diagnose the condition using criteria in the DSM. The mental health professional will ask a series of questions to gather information about what symptoms the person is experiencing. They may also ask when symptoms began, as social anxiety disorder typically has an onset in childhood. [1]
A clinician making a diagnosis of social anxiety disorder may use standardized questionnaires or instruments that capture symptoms of the condition. Ultimately, a clinician must determine if a person meets diagnostic criteria for social anxiety disorder. The clinician may have to rule out alternative diagnoses, such as panic disorder, major depressive disorder, autism spectrum disorder, and personality disorders like avoidant personality disorder or schizoid personality disorder [1].
To receive a diagnosis of social anxiety disorder, a person must meet the following diagnostic criteria [4] in the DSM:
There is no proven way to prevent social anxiety disorder, but if risk factors are present for the condition, there are things that can be done to promote mental health functioning and make anxiety symptoms more manageable. For example, seeking help when first noticing symptoms can connect a person to professional support and help them to develop coping skills for managing anxiety. Studies suggest that receiving treatment for social anxiety during the teen years is beneficial. [5]
Practicing good habits, such as maintaining a consistent sleep schedule, and avoiding the use of drugs and alcohol can also play a critical role in preventing complications from social anxiety disorder. There is evidence that treating insomnia may play a preventive role against social anxiety. [6]
Treatment for social anxiety disorder typically involves medication, therapy, or a combination of the two. These approaches are described in more detail below.
There are several classes of medications that are used in the treatment of social anxiety disorder. The most commonly utilized medications are as follows: [1]
There are several therapeutic techniques that may be useful for social anxiety disorder. Some of the most common are described below: [10]
The best type of therapy for social anxiety disorder depends upon a patient’s specific needs. In general, therapy sessions can teach people with social anxiety how to cope with their symptoms and think differently about situations that cause fear and anxiety.
If you have social anxiety disorder, there are steps you can take to make anxiety more manageable, in addition to seeking treatment. Consider the self-care tips below:
If a friend or family member lives with social anxiety disorder, chances are that they would benefit from a loved one’s support. By learning more about the condition, a person has a far better understanding of what they are experiencing. It’s also important to be empathetic. Sometimes their reluctance to engage in social events can be frustrating, but remember, they are living with a diagnosable condition that makes these events seem quite threatening.
Perhaps one of the best things to do to help a loved one is encourage them to seek treatment. Left untreated, social anxiety disorder can lead to significant distress and make it difficult for people to function in everyday life. [1] However, treatment is effective and can improve an individual’s quality of life.
Social anxiety disorder is the most common anxiety disorder, and it affects 8.4% to 15% of people during their lifetimes. It is more common in women when compared to men, and it is the third most common mental health condition, behind substance use disorders and depression. [1]
There are effective treatments that can make symptoms of social anxiety disorder more manageable. Without treatment, people with this condition are at risk of low educational attainment, relationship problems, reduced quality of life, and poor work performance. Ultimately, social anxiety disorder can lead to unemployment, financial problems, suicidal ideation, and self-esteem problems. [1] This is why it’s so important to seek treatment.
Social anxiety disorder appears similar to avoidant personality disorder, but the two mental health conditions are distinct. Social anxiety disorder involves irrational fear or anxiety surrounding social situations, as a person is worried they will be negatively evaluated or rejected. Similarly, individuals with avoidant personality disorder avoid social situations because they are fearful of being rejected or criticized. However, avoidant personality disorder has additional symptoms that are separate from what is seen in cases of social anxiety.
What is different about avoidant personality disorder is that individuals with this condition view themselves as being socially inept, inadequate, or otherwise inferior to other people, which leads them to avoid developing new relationships. They avoid taking risks or getting involved in new activities, and they will only interact with other people if they are sure they will be liked. [13]
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