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Guide to Social Anxiety Disorder

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Medically Reviewed By: Diana Vo, LMFT

March 18, 2022 (Originally Published)

March 17, 2022 (Last Updated)

Table of Contents

Social anxiety disorder, sometimes known as social phobia, is a form of anxiety disorder characterized by extreme fear in a variety of social settings.

For those struggling with social anxiety disorder, attending social gatherings, meeting new people, and talking to people can all be remarkably challenging. People diagnosed with this anxiety disorder often fear being watched by others and judged by others. If you have social phobia, you may understand that these fears are unreasonable and irrational, yet you may feel powerless in the face of debilitating anxiety.

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Fortunately, social anxiety is treatable.

What is Social Anxiety Disorder?

Social anxiety is a mental health condition impacting 15 million people in the United States, according to the ADAA.

Those with social anxiety disorder feel acute symptoms of fear or anxiety in situations where they feel they could be evaluated or judged by others. Example of these situations include:

  • Public speaking
  • Attending a job interview
  • Dating someone new
  • Meeting new people
  • Answering questions in class
  • Speaking with cashiers in stores

Beyond this, everyday activities like eating or drinking in front of others can trigger fear or anxiety. The same can apply to using a public restroom for some people with severe social anxiety disorder.

For some people with social phobia, the fear and anxiety triggered by some social situations is intense, overpowering, and induces a sense of loss of control. The symptoms can prevent people from working, attending school, and carrying out routine engagements. For others, it remains possible to accomplish these activities, but at the cost of intense feelings of anxiety and fear.

People react differently to social anxiety disorder. Some will worry about forthcoming social engagements for weeks, while others simply avoid places and events liable to cause distress or feelings of embarrassment.

Social anxiety disorder is a form of anxiety disorder separate from panic disorder. Panic disorder is a standalone condition.

For those with panic disorder, the panic attacks they experience often leads them to believe there is something physically wrong with them. Many people with panic disorder, for instance, feel that they are having a heart attack or losing their mind, lacking any logical explanation for the symptoms they are experiencing. For others with panic disorder, anxiety attacks can appear like the symptoms of an unknown and undiagnosed illness.

Most people with social anxiety disorder, by contrast, do not feel that the anxiousness and fear they experience is linked to a medical condition, disease, or physical illness. Instead, the anxiety manifests exclusively in social situations.

Where people with panic disorder experience a sudden panic attack accompanied by an array of physical symptoms, and for no apparent reason, those with social anxiety disorder are anxious during or in advance of social engagements.

Many people with panic disorder are highly sociable, while most with social anxiety find the heightened anxiousness they experience in social situations outweighs the pleasure delivered.

What Can Cause Social Anxiety Disorder?

Researchers do not know the precise cause of social anxiety disorder. Current research supports the concept that social phobia is caused by a mixture of genetic and environmental factors.

Adverse experiences can also contribute to the development of social anxiety. Examples include:

  • Sexual abuse
  • Emotional abuse
  • Bullying
  • Family conflict
  • Adverse childhood experiences (ACEs)

Studies suggest that an imbalance of serotonin can contribute to social phobia. Serotonin is a chemical in the brain associated with mood regulation.

Although anxiety disorders often run in families, there is no conclusive evidence proving a link to genetic factors causing anxiety disorders.

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Social Anxiety Disorder Symptoms

Someone exhibiting feelings of discomfort or shyness in social situations is not necessarily displaying signs of social phobia, especially when this occurs in children. Personality traits and life experiences combine so that people have different comfort levels in various social situations, with some people naturally outgoing and others more emotionally reserved.

Unlike everyday nervousness, though, this mental health disorder is characterized by anxiety, fear, and avoidance that interferes with performance at home, work, and school. Social phobia can also impact interpersonal relationships.

Symptoms of social anxiety disorder can be categorized as follows:

  • Behavioral and emotional symptoms
  • Physical symptoms

These are the most common behavioral and emotional symptoms of social anxiety disorder:

  • Intense fear of interacting with strangers
  • Fear of being negatively judged in social situations
  • Worry about embarrassing yourself in public
  • Avoiding situations where you could be the center of attention
  • Fear that others will see you appear anxious
  • Fear of the physical symptoms of anxiety – see below
  • Extreme fear during social situations
  • Avoidance of the above situations out of the fear of embarrassment
  • Analysis of your performance after social situations
  • Anxiety in the lead-up to a feared social event or activity
  • Fearing the worst in social situations

These are the most common physical symptoms of social anxiety disorder:

  • Muscle tension
  • Rapid heartbeat
  • Trembling
  • Blushing
  • Sweating
  • Nausea
  • Upset stomach
  • Difficulty catching your breath
  • Dizziness
  • Lightheadedness
  • Feeling of mental blankness
  • Avoiding routine social situations

The following routine experiences can be difficult to endure for those with social phobia:

  • Using a public restroom
  • Eating in front of other people
  • Returning something to a store
  • Starting conversations
  • Entering a room in which others are seated
  • Interacting with strangers
  • Attending parties and social gatherings
  • Going to school or work
  • Making eye contact
  • Dating someone new

The symptoms of social anxiety disorder can change over the years. Symptoms often flare up when you are dealing with lots of stress and change in your life.

If you find that fear or anxiety is causing you to avoid normal social situations, you should consult your healthcare provider and voice your concerns.

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Treatment for Social Anxiety Disorder at Renaissance

Here at Renaissance Recovery, we have many programs designed to help you combat social anxiety as well even more severe cases of anxiety disorders. 

Treatment is contingent on the extent to which this condition impacts your ability to function in everyday life. The most common approach to treatment involves a combination of medications and/or psychotherapy like CBT (cognitive behavioral therapy).

Most people with social phobia find that engaging with psychotherapy helps alleviate the symptoms. Your therapist will show you how to first recognize and then change negative thoughts, while also strengthening your skills in social situations, improving your confidence.

CBT is proven effective for the treatment of anxiety disorders. This form of psychotherapy works equally well one-to-one or in group settings.

With exposure-based cognitive behavioral therapy, you will gradually work up to facing the situations causing you most fear. Skills training and role playing exercises help you to increase your confidence in social situations and when interacting with others.

SSRIs (selective serotonin reuptake inhibitors) are antidepressants often used as a first-line medication for anxiety disorders.

If this medication proves ineffective, SNRIs (serotonin and norepinephrine reuptake inhibitors) like venlafaxine may alleviate symptoms of anxiety.

Other medications sometimes effective for treating social anxiety disorder include:

  • Other antidepressants
  • Benzodiazepines
  • Beta blockers

While it may take some time to find a combination of treatment that works for you, with patience you can leave the symptoms of social phobia behind you. Our team of mental healthcare professionals are here to help, call us at 866.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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