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Social Anxiety

One of several anxiety disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), social anxiety is an intense fear of social situations that can interfere with everyday life. Social anxiety disorder is the third-most widespread psychiatric condition in the United States after depression and alcohol dependence—conditions that social anxiety disorder clients are also at risk of developing.

Some studies have found that as many as 12% of the general population suffers from social anxiety disorder. Psychologists stress the difference between shyness and social anxiety, which we’ll discuss more below.

Understanding Social Anxiety

Social anxiety disorder is an intense fear of everyday social situations. These may include a much broader range than one might think. Meeting new people, socializing in large groups, talking to authority figures, and certainly public speaking are all situations that can trigger social anxiety. But for those with social anxiety disorder, everyday scenarios can trigger these feelings, from getting a haircut to interacting with a sales clerk.

Social anxiety disorder produces an extreme fear of doing something embarrassing, or perceived as embarrassing. Those who suffer fear that others will see them as anxious, boring, stupid, or even sweaty. This fear of humiliation can start weeks in advance of the actual social situation.

Effects of Social Anxiety

This fear resulting from social anxiety disorder can cause many short-term and long-term effects. Sufferers may avoid social situations altogether to avoid judgement or rejection. If they can’t avoid a situation, they might experience panic and distress. Serious physical symptoms may include nausea, raised heart rate and sweating. Sometimes, symptoms even rise to the level of a panic attack.

People with social anxiety often realize that their fear of being mocked, judged or dismissed in social situations is irrational. That doesn’t necessarily give them power over their anxiety. People may take steps to avoid social situations, even ones they’d like to partake in. Many go even further, arranging their whole lives around avoiding uncomfortable social situations. For example, they might turn down jobs to avoid potential embarrassment. They might not pursue friendships or romantic relationships to avoid rejection. Social anxiety can cause people to miss work or perform poorly. It can also wreak havoc on relationships and marriages.

The physical symptoms and overpowering nature of social anxiety is what distinguishes this disorder from shyness.

Social anxiety disorder, like other anxiety disorders, usually starts in childhood or adolescence. For some people, bullying or humiliation in school can trigger it.

Diagnosing Social Anxiety Disorder

If you have experienced extreme fear of social situations for six months or longer, you may have social anxiety disorder. You should consult a medical professional for a diagnosis. Effective treatments exist, but many people with social anxiety do not seek treatment quickly.

About half of all people with social anxiety disorder never seek treatment at all. Because treatment itself involves confrontation, those who do seek help tend to wait years or even decades. Other signs include: 

  • Expecting the worst from social interactions
  • Replaying or analyzing conversations for flaws
  • Fear of interacting with strangers
  • Feeling like the center of attention in everyday scenarios
  • Avoiding new situations for fear of judgement
  • Avoiding social situations, even when you want to join

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Social Anxiety Treatment

Wellness professionals can help you overcome social anxiety disorder through different kinds of therapy. Exposure therapy, for example, involves confronting social situations in a controlled setting, starting with less-feared situations and working up to the most anxiety-inducing situations.

Another form of treatment for social anxiety disorder is applied relaxation, which involves teaching the client relaxation exercises. This helps the client physically relax during a stressful experience such a social occasion.

Cognitive behavioral interventions, which include cognitive behavioral therapy (CBT), can help identify the thought processes at the root of the social anxiety and help promote more positive or rational reactions.

Mindfulness training can remedy social anxiety disorder. Mindfulness training includes meditation practice to gain a greater awareness of and control over emotions.

Additionally, medication can be used to treat social anxiety disorder. Among the medications that have been effective in treating social anxiety disorder are SSRIs (selective serotonin reuptake inhibitors), which are antidepressants used to treat major depressive disorder and anxiety disorders.

The stress of social anxiety can also lead some who suffer the disorder to self-medicate with drugs or alcohol. If you suffer from both drug addiction and social anxiety disorder, we can help. Get in touch to learn how addressing addiction and anxiety individually through personalized treatment can help you live a happy, healthy life free from anxiety and addiction.

Written By: Sprout Editorial Team

The Sprout Health Group editorial team is passionate about addiction treatment, recovery and mental health issues. Every article is expert-reviewed.