Written by Shannon,
Brightside Health
7 Minute Read
Medically reviewed by:
Erin O'Callaghan, PHD
Director of Therapy
10 Minute Read
Have you ever felt “butterflies” in your stomach before giving a presentation or going on a first date? You probably have, as feeling nervous before certain social situations is expected and normal.
However, it’s not common for individuals to feel nervous before everyday social interactions that lead to anxiety or avoidance of those situations entirely.
For people with social anxiety disorder, or social phobia, even the most minute social interactions can feel overwhelmingly frightening, and this can lead to major disruptions in daily life. Let’s learn more about this type of anxiety disorder as well as ways to overcome it.
What is Social Anxiety?
Social anxiety disorder is a common mental health condition marked by intense and persistent fear of being watched or judged by others. Those with social anxiety don’t necessarily fear the social situation itself. Rather, they fear how others will respond to their presence and actions.
People with social anxiety disorder have an intense fear of social situations such as meeting new people or going to job interviews because they are worried about being judged for being humiliated. Even doing everyday things in front of others, such as eating or drinking, can cause fear and anxiety.
Why Does It Happen?
Like most mental health conditions, it is believed that social anxiety disorder is caused by a complex interaction between biological and environmental factors.
For one, anxiety disorders are believed to run in families. If you have a family member with anxiety, it may put you at a predisposition to develop it.
Additionally, social anxiety is thought to be a learned behavior. If you experienced an unpleasant or embarrassing event in a social context, you may start to associate social interactions with the humiliation of that isolated event.
Finally, brain scans revealed that people with social anxiety disorder have hyperactivity in the amygdala, which is the area of the brain responsible for the physiological changes associated with fear and the stress response. Activation of the stress response can cause immense anxiety and stress in the face of perceived danger, even if actual danger isn’t present.
Symptoms of Social Anxiety
The symptoms of social anxiety disorder can look different for everyone, though they usually fall into three categories: physical, emotional, and behavioral:
Physical symptoms of social anxiety disorder include:
- Rapid heart rate
- Sweating
- Dizziness or lightheadedness
- Nausea or upset stomach
- Muscle tension
- Blushing
- Shaking or trembling
Emotional symptoms include:
- Fear of situations in which you may be judged or humiliated
- Intense fear of interacting with strangers
- Fear that others will notice you look anxious
- Fear that others will make fun of you or judge you
- Fear of anxiety or physical symptoms in social situations
- Expecting the worst possible consequences from every social interaction
Finally, behavioral symptoms might include:
- Avoiding common social situations, like attending parties or gatherings
- Difficulty making eye contact
- Difficulty starting or continuing conversation
- Avoiding speaking in front of others
- Over-analyzing your performance in front of others
- Experiencing tics, or repetitive muscle movements, during social interactions
How Is It Diagnosed?
Social anxiety disorder can only be diagnosed by a psychiatric provider, licensed therapist, or medical provider. They’ll usually conduct an assessment to evaluate your thoughts and behaviors before comparing them to the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
The DSM-5 criteria for social anxiety disorder includes:
- Persistent and intense fear of specific social situations because you believe you’ll be embarrassed or judged negatively.
- Excessive anxiety that is out of proportion to the situation.
- Distress that interferes with daily living.
- Avoidance of anxiety-inducing social situations.
Impact On Life
Those with social anxiety disorder can experience an intense drop in quality of life that might even lead to feelings of loneliness or isolation. For instance, some may decline going out to dinner with friends because they fear that they’ll be judged for the way they eat or drink.
People with social phobia may also miss out on opportunities because of their fear. They might avoid job interviews or avoid joining school clubs and organizations where they may have been very successful and at-home otherwise.
Everyday tasks can also become agonizing. Talking on the phone can induce a lot of fear and anxiety, while some might even be afraid to walk down the street because they worry people will judge the way they walk.
Treatment Options
Social anxiety disorder can be successfully treated through a number of different methods. One of the best remedies is therapy, specifically cognitive behavioral therapy (CBT).
CBT can help guide you through different ways of thinking about social situations, as well as improved ways of reacting to those situations when they arise. It can help lessen anxiety and fear when faced with social interaction.
Medications are also effective for treating the anxiety and depression that is often associated with social phobia. Sertraline (Zoloft) is just one example of an antidepressant that can be used to treat social anxiety disorder.
Self-care techniques can also be helpful for those who struggle with social anxiety. Mindfulness techniques such as deep breathing or yoga can help to alleviate feelings of anxiety and stress, both before, during, or after a social situation.
Finally, social anxiety is linked to insomnia, or trouble sleeping. With that in mind, practicing proper sleep hygiene may be able to help improve the symptoms of social phobia, especially if you know you’ll encounter a big social event in the coming days.
Living With Social Anxiety
Many people are able to live with social anxiety disorder by practicing techniques to overcome stress during social situations. For one, it is important to try to challenge your own negative thinking.
For example, if you go into a meeting thinking “I’m going to mess up,” you can try to reframe your thoughts to “There’s no reason to believe that I’m going to mess up.” This can help boost your confidence and self-esteem before engaging with the situation.
Additionally, try not to focus on yourself during interactions with others. Instead, focus on forming a connection with those around you. Not only can this help to lessen your own insecurities, but it can help you foster a more meaningful relationship with those around you.
Finally, remember that your anxiety is not as visible as you think. Even if you appear nervous, people will not think immediately negatively of you — everyone gets nervous, some people just feel it a little more intensely than others. Focus on the present, and don’t beat yourself up for small mistakes or errors.
In Summary
Social anxiety disorder is a type of anxiety disorder that’s marked by a persistent and intense fear of being judged by others, especially if humiliation can be involved. It can lead to major disruptions in daily life, such as avoidance of common social situations or major anxiety in relation to speaking with others.
While social anxiety disorder can be debilitating, it is also highly treatable. Brightside can help you overcome your depression and anxiety right from home, on your own terms. With personalized treatment plans that can include medication, therapy, or a combination of both, you can join 85% of members who have felt better within just 12 weeks.
Social anxiety can be difficult to deal with, but you’re not alone. Click here to get started.
Sources:
Social Anxiety Disorder | Anxiety and Depression Association of America
Causes of Social Anxiety | Bridges to Recovery
Social anxiety disorder (social phobia) – Diagnosis and treatment | The Mayo Clinic
Clinical Practice Review for Social Anxiety Disorder | Anxiety and Depression Association of America
