Experiencing nervousness in certain social situations is common. For instance, a first date or a public speaking engagement may evoke feelings of “butterflies” in the stomach. However, when the fear of being negatively evaluated or scrutinized by others permeates everyday interactions, it may be indicative of social anxiety disorder or social phobia. In such cases, a person experiences significant anxiety, self-consciousness, and embarrassment, leading to avoidance behavior that can disrupt their lives. The stress caused by this disorder can have detrimental effects on relationships, work, school, and daily routines. Social anxiety disorder may be a chronic mental health condition, but the acquisition of coping skills through psychotherapy and medication can enhance an individual’s confidence and improve their ability to interact with others.
Symptoms
Experiencing shyness or unease in certain situations is not necessarily indicative of social anxiety disorder, especially in children. Social comfort levels can vary depending on an individual’s personality traits and life experiences. While some people are naturally reserved, others are more outgoing.
In contrast to normal anxiety, social anxiety disorder is characterized by fear, anxiety, and avoidance that negatively impact relationships, daily routines, work, school, or other activities. Typically, this disorder begins in the early to mid-teens, though it can also manifest in younger children or adults.
The emotional and behavioral symptoms associated with social anxiety disorder may include ongoing:
• Fear of situations that may lead to negative judgment
• Worry about embarrassing oneself
• Intense fear of interacting with strangers or conversing
• Fear of appearing anxious in front of others
• Fear of physical symptoms, such as blushing, sweating, shaking, or stuttering
• Avoidance of situations or people due to fear of embarrassment
• Avoidance of situations where attention may be directed to oneself
• Anxiety before or during social events
• Criticism and self-blame for social interactions after the fact
• Expectation of the worst possible outcomes after negative social experiences
Physical Symptoms
Social anxiety disorder can manifest in physical symptoms such as:
• Blushing
• Rapid heartbeat
• Trembling
• Sweating
• Upset stomach or nausea
• Shortness of breath
• Dizziness or lightheadedness
• Inability to concentrate
• Muscle tension
Everyday situations that are typically easy to navigate may be difficult for individuals with social anxiety disorder, such as:
• Interacting with strangers or unfamiliar people
• Attending social gatherings or parties
• Attending school or work
• Initiating conversations
• Making eye contact
• Dating
• Entering a room where people are already present
• Returning items to a store
• Eating in front of others
• Using public restrooms
Symptoms of social anxiety disorder may fluctuate over time and may increase in response to changes, stress, or demands in an individual’s life. Although avoidance may provide temporary relief, it can exacerbate anxiety in the long run. Seeking treatment is crucial for effective management of social anxiety disorder. Consult a medical professional or mental health expert if you experience embarrassment, anxiety, or panic in normal social situations.
Causes
Social anxiety disorder is a complex mental health condition with a range of potential causes, including biological and environmental factors. Some possible causes of social anxiety disorder include:
• Inherited traits: Anxiety disorders often run in families, but it’s not clear how much of this is due to genetics versus learned behavior.
• Brain structure: The amygdala, a part of the brain involved in fear response, may play a role in social anxiety disorder. Overactivity in the amygdala could lead to heightened fear responses in social situations.
• Environment: Some people may develop social anxiety disorder after a negative or unpleasant social experience, while others may have learned anxious behaviors from their parents or caregivers.
Several risk factors can increase the likelihood of developing social anxiety disorder:
• Family history: People with a family history of social anxiety disorder are more likely to develop the condition themselves.
• Negative experiences: Childhood experiences like teasing, bullying, or rejection may increase the risk of social anxiety disorder. Trauma, abuse, or other negative life events can also contribute.
• Temperament: Children who are naturally shy, withdrawn, or timid may be more prone to social anxiety disorder.
• New social or work demands: Social anxiety disorder symptoms often start in adolescence or early adulthood, and new social or work demands can trigger symptoms for the first time.
• Appearance or condition: Having a visible difference, such as facial disfigurement or stuttering, may trigger self-consciousness and social anxiety disorder in some people.
Complications
If left untreated, social anxiety disorder can have a significant impact on your life. It can interfere with work, school, relationships, and your ability to enjoy life. Some of the effects of this disorder include:
• Low self-esteem
• Difficulty being assertive
• Negative self-talk
• Hypersensitivity to criticism
• Poor social skills
• Isolation and troubled social relationships
• Lower academic and employment achievement
• Substance abuse, such as excessive drinking
• Risk of suicide or suicide attempts
People with social anxiety disorder may also experience other anxiety disorders, as well as other mental health disorders, particularly major depressive disorder and substance abuse problems.
Prevention
Although there’s no guaranteed way to prevent the development of an anxiety disorder, there are steps you can take to reduce the impact of symptoms if you’re feeling anxious. Some of these steps include:
• Seeking help early. Like many other mental health conditions, anxiety can be easier to treat if you seek help early.
• Keeping a journal. Tracking your personal life can help you and your mental health professional identify what’s causing you stress and what seems to help you feel better.
• Prioritizing in your life. Reducing anxiety can involve carefully managing your time and energy. Make sure that you spend time doing things you enjoy.
• Avoiding unhealthy substance use. Alcohol and drug use, as well as caffeine or nicotine, can cause or worsen anxiety. If you’re addicted to any of these substances, quitting can make you anxious. If you can’t quit on your own, see your health care provider or find a treatment program or support group to help you.
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