It is completely normal to feel nervous or awkward in some social situations. For example, if you have ever been on a blind date or have had to take an important exam you most likely experienced anxiety.
With social anxiety, or what used to be called social phobia, everyday interactions can cause amplified distress, sometimes to the point of not being able to function at your normal level. There is generally an unfounded perception when one has social anxiety that you are being judged or scrutinized by others.
Social anxiety affects a great deal of the world’s population. Approximately 7% or fifteen million American adults have social anxiety disorder, and over 75% of people experience their initial symptoms during childhood or adolescents.
Social anxiety can happen at any time and there can be various causes, both internal and external. For many with this disorder, anxiety is often caused by specific social events, such as meeting new people or having to speak in public.
There are many factors that lead to social anxiety. Some well-known social anxiety disorder causes include genetics, social experiences, cultural influences, substance use or abuse, and other psychological factors.
Social anxiety and addiction often follow from one another, and evidence shows that they commonly co-occur. Anxiety symptoms can be a risk for substance use disorder and anxiety symptoms can occur during drug or alcohol intoxication withdrawal.
According to the Anxiety and Depression Association of America, approximately 20% of Americans with an anxiety or mood disorder also have an alcohol or other substance use disorder and vice versa.
Viewing oneself negatively, overestimating the negative effect of a social encounter, and avoiding social situations can affect social anxiety. Many people who have social anxiety avoid potentially anxiety-inducing situations, which in turn leads to further social apprehension and anxiety.
There are emotional, physical, and behavioral signs and symptoms of anxiety. Knowing how to recognize the signs of social anxiety can help you develop coping strategies if they emerge.
Some emotional signs and symptoms associated with social anxiety include having trouble concentrating, racing thoughts, intense fear, overthinking, feelings of self-consciousness, and agitation. Not all of these symptoms happen in every person with social anxiety, as it can look different from each person who has been diagnosed.
Physical signs and symptoms of social anxiety can be overwhelmingly uncomfortable. Blushing, sweating, shaking, having difficulty making eye contact, rapid heart rate, feeling nauseated, and hot and cold flashes are just some of the few physical symptoms associated with social anxiety.
These types of signs and symptoms can include avoidance of situations that make you uncomfortable, difficulty forming friendships or romantic relationships, and minimizing exposure to social situations that you think will be scary or anxiety-inducing.
Being shy should never be confused with social anxiety disorder. Comfort level in different situations is often dependent on personality and life experiences. We all know people who are reserved and others who are outgoing, and social anxiety goes deeper than just being shy around new people or uncertain situations.4
Social anxiety, unlike shyness, includes overwhelming fear and avoidance that interfere with your routine, relationships, and other activities. While you can’t prevent social anxiety, you can seek treatment to help reduce the symptoms as well as learn to adjust in certain social situations.
If your physical or emotional well-being is compromised by the symptoms of social anxiety, it is time to speak with your doctor. If you have social anxiety disorder you will, at some point, likely experience physical symptoms that can affect your sleep, and cause other issues such as stomach aches and fatigue. Feelings of fear and worry can cause overwhelming emotional distress and a medical professional can help you overcome or address the underlying issues you have that are related to social anxiety.
Treatment for social anxiety includes talk therapies such as psychoanalysis and cognitive behavior therapies. Often medications are used as an adjunct to social anxiety therapy.
Social anxiety treatment options include psychotherapy, medication, and support groups. Often, all three therapies are used to help in varying ways.
Psychotherapy can occur individually or within a group. Group psychotherapy, for social anxiety, is an established treatment supported by evidence. Cognitive behavioral therapy (CBT), a form of psychotherapy, can help you learn to identify and manage contributing factors leading to social anxiety. The psychotherapist will help you learn how your thoughts contribute to your symptoms, and once you have a solid understanding of the tools and skills for coping with social anxiety, they may even encourage you to approach and participate in activities that could create social anxiety in order to face it head on.
There are many medications that can be used alongside therapy, including:
Knowing that you are not alone in your struggle with social anxiety can be helpful and reassuring. Social anxiety can cause feelings of isolation and loneliness, making it even more difficult to address and overcome. A support group may be exactly what you need as it will bring you together with other people facing similar challenges and will provide both socialization and a safe place where you can share your feelings.