Symptoms | Causes | Diagnostic Criteria | Treatments

Social anxiety disorder (or social phobia) is a mental illness in which social interactions cause intense fear and anxiety, especially if the situations calls for the possibility for the individual to be publicly scrutinized by others.

Constant worry thoughts about their appearance, the way they are speaking to others, the way they walk, how other people are looking at them, constantly analyzing and judging other people’s body language and facial expressions is a normal occurrence for someone suffering from social phobia.

Someone with social anxiety disorder may go out of their way to avoid people as they may see them as the problem. Such isolation may cause them to feel lonely, depressed, insecure, and overall less content with their life.

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When exposed to such social situations, the individual fears that he or she will be negatively evaluated. The individual is concerned that he or she will be judged as anxious, weak, crazy, stupid, boring, intimidating, dirty, or unlikable.

The fear or anxiety is judged to be out of proportion to the actual risk of being negatively evaluated or to the consequences of such negative evaluation. Sometimes, however, the anxiety may not be judged to be excessive, because it is related to an actual danger (e.g., being bullied or tormented by others).

Symptoms of Social Anxiety Disorder

Someone suffering from social anxiety disorder may often experience a fight or flight response when around other people. Being in or around large crowds may be virtually impossible for them as they will experience an overwhelming influx of dread and vulnerability. In such a situation, they may truly feel and react as if they were in mortal danger, even when there is absolutely no danger in sight.

Even though people with social phobia are often very fearful of other people judging them, they themselves are often very judgmental towards themselves. They may experience some narcissistic traits as well, such as feeling as though everyone is looking at them or that everyone is concerned with the way they behave or speak even though the antithesis is likely true.

They may rarely leave the house as they may perceive their home to be a “safe space” for them where anxiety is minimal. Although this may help them reduce a lot of their anxiety, it may also help them to reinforce their irrational fears as well.

They may live at home longer. Men may be delayed in marrying and having a family, whereas women who would want to work outside the home may live a life as a homemaker and mother. Self-medication with substances is common (e.g., drinking before going to a party). Here are some additional symptoms of social phobia:

• Blushing when in social situations
• Intense anxiety when around other people
• Anxiety when thinking of being around other people
• Overly concerned with being judged
• Very judgmental of themselves
• Avoiding places where people gather
• Struggle with maintaining healthy relationships
• Deep fear of being rejected or humiliated
• Excessive sweating and shaking
• Feeling nauseous or lightheaded

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Causes of Social Anxiety Disorder

Temperamental, environmental, genetic & physiological factors are all likely to play key roles in the development of social phobia. Individuals with a family history of social phobia may be at risk for developing it themselves. In fact, researchers have found that several parts of the brain, as well as biological processes, play a key role in fear and anxiety.

Some underlying traits that predispose individuals to social anxiety disorder, according to the DSM-5, include behavioral inhibition and fear of negative evaluation. Furthermore, traits predisposing individuals to social anxiety disorder, such as behavioral inhibition, are strongly genetically influenced.

Having a family history of mental illness, especially of anxiety disorders like social phobia, may significantly increase one’s risk for developing social anxiety disorder, too. First-degree relatives have a two to six times greater chance of having social anxiety disorder, and liability to the disorder involves the interplay of disorder-specific (e.g., fear of negative evaluation) and nonspecific (e.g., neuroticism) genetic factors, according to the DSM-5.

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Diagnostic Criteria

To get properly diagnosed with social phobia, you will need to go through a psychiatric evaluation with your psychiatrist, psychologist, or other accredited mental health professional who can legally diagnose mental disorders. Psychiatric evaluations typically entail getting asked questions about your symptoms, such as how intense and frequent you experience them.

Some of the specific diagnostic criteria include having marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others, the social situations are avoided, as well as having their fear or anxiety be out of proportion to the actual threat posed by the social situation, among other criteria.

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Treatments for Social Anxiety Disorder

Someone suffering with social anxiety disorder may greatly benefit from cognitive behavioral therapy (CBT). CBT works by helping the patient to change their thinking patterns by becoming more aware of the way they currently think about their fears, among other things. The therapist will help coach the patient by providing them with more productive ways of thinking, as well as introducing coping skills to them.

Exposure therapy may be helpful for treating social phobia as it can be a way to desensitize them from their irrational fear of other people. This form of treatment is done by having the patient put themselves in anxiety provoking situations to help them overcome their intense fear.

Mindfulness meditation may also be very useful for someone with social phobia as it can help to redirect their worry thoughts to something with no emotional baggage, such as objectively observing the sounds around them or focusing on the sensations associated with breathing.

Additionally, someone suffering from social phobia may also greatly benefit by taking an antidepressant and/or an anti-anxiety medication. These drugs may be able to help minimize the amount of fear that someone with social phobia can expect to experience. However, this is something that you should first discuss with your doctor.

If you think you may be suffering from some of the symptoms of this condition, then you may benefit from therapy. Feel free to reach out to your doctor or local mental health clinic to see what your available options are and to see if there is any sort of discount or promo code available to help you with the costs of treatment, as well as if your health insurance will cover treatment costs.

References:

• https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561

• https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/

• https://adaa.org/understanding-anxiety/social-anxiety-disorder

• https://www.helpguide.org/articles/anxiety/social-anxiety-disorder.htm

• https://medlineplus.gov/ency/article/000957.htm

• https://www.med.upenn.edu/ctsa/social_anxiety_symptoms.html

• Diagnostic and Statistical Manual of Mental Disorders (DSM-5) https://www.psychiatry.org/psychiatrists/practice/dsm

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