Social Anxiety Disorder

Social anxiety disorder is the third most common mental health condition behind substance use disorder and depression. 

What is Social Anxiety Disorder?

Social anxiety disorder (formerly known as social phobia) is a mental health condition where you experience intense and ongoing fear of being judged negatively and/or watched by others.

Anxiety is a fear that arises in anticipation of an event, and a phobia is an irrational fear of certain objects or situations. Severe stress can negatively impact relationships, daily routines, work, school, or other activities.

Types of Anxiety Disorders

Generalized Anxiety Disorder: Generalized anxiety disorder statistics show that this condition affects 2.7 percent of the population, with 3.4 percent of females and 1.9 percent of males being affected. 

Panic Disorder: The prevalence of this condition is 2.7 percent, with 3.8 percent of females and 1.6 percent of males being affected. 

Social Anxiety Disorder: It impacts 7.1 percent of the population, 8 percent of women and 6.1 percent of men.

Obsessive-Compulsive Disorder: It shows a prevalence rate of 1.2 percent. The condition affects 1.8 percent of women and only 0.5 percent of men. 

Phobias: Specific phobias are the most common anxiety disorders, impacting 9.1 percent of the population. Rates vary based on gender, with 12.2 percent of women and 5.8 percent of men being affected. 

Post-Traumatic Stress Disorder: It occurs in 3.6 percent of the population or 5.2 percent of women and 1.8 percent of men.

Social Anxiety in Children and Teens

Children and teens with social anxiety disorder have an excessive and persistent fear of social and/or performance situations such as school, parties, athletic activities, and more. They are extremely worried that they may do something embarrassing, or others will think badly of them. These children constantly feel “on stage,” which can lead to a great deal of self-consciousness, distress, and avoidance. Some children are only afraid of speaking or performing in public, while others fear and avoid a wide range of social situations. Being a shy or quiet child is not the same as having social anxiety disorder.

Young socially anxious children tend to experience a number of physical symptoms such as stomachaches or complaints about feeling ill. In addition, they may cry, whine, freeze, or cling to parents in social situations, begging the parent to stay. These children may even refuse to participate in social activities or attend school. They also might not speak in certain situations (e.g., when meeting new or unfamiliar people). Even if children successfully engage in the previous activities and demands, it is not without a fuss or fight, often ending with the child in tears and the parents feeling upset, guilty, and even angry. Despite such extreme behaviors, young children are often unable to say why they are so worried or to identify what it is that is so upsetting.

In middle childhood, children are starting to become more self-conscious and may begin to expect things to go “bad” when they are around other children. They might be overly concerned about others looking at them or talking about them in a bad way. While they may continue to experience many of the same feelings and behaviors as in younger children, now they are starting to be able to identify what is so upsetting for them.

Teens and young adults are typically more self-focused and may have harsh negative thoughts about themselves. They may be more likely to mumble or avoid eye contact.

Symptoms Can Change Over Time

Social anxiety disorder has many effects on the body and mind, causing physical, emotional, and behavioral symptoms. The symptoms tend to occur in certain social situations and may include physical symptoms, such as blushing, sweating, trembling, nausea, an increased heart rate, and the mind “going blank”.

Additional symptoms include feelings of panic or panic attacks, a fear of experiencing anxiety or of seeming anxious in front of others, an intense fear of judgment from others, feelings of fear or dread in situations with other people, especially strangers, feeling very self-conscious, embarrassed, or awkward in front of others, having difficulty speaking, avoiding situations that might trigger anxiety, a rigid body posture and a soft voice during social interactions, difficulty making or maintaining eye contact, sensitivity to criticism, low self-esteem, and negative self-talk

Although avoiding situations that produce anxiety may make you feel better in the short term, your anxiety is likely to continue over the long term if you don't get treatment.

Causes

The causes of social anxiety disorder are complex. They are likely to involve a combination of genetic and environmental factors. Social anxiety disorder typically starts early in life, during a person’s adolescence or teenage years, but it can affect people of all ages. The condition is more common in females than males.

Anxiety disorders can run in families, so there may be a genetic component at play. Stressful or traumatic events — such as abuse, violence, the death of a loved one, or a prolonged illness — may increase the risk of an anxiety disorder. Previous bullying, humiliation, or rejection can also increase the risk.

Social anxiety disorder may be a learned behavior — some people may develop significant anxiety after an unpleasant or embarrassing social situation. Also, there may be an association between social anxiety disorder and parents who either model anxious behavior in social situations or are more controlling or overprotective of their children.

Complications

Social anxiety disorder is treatable. Talking therapy, cognitive behavioral therapy, and medications can help people overcome their symptoms. If left untreated, social phobia can severely affect quality of life. Social anxiety disorder can be a chronic mental health condition. Some of the common complications may include low self-esteem, trouble being assertive, negative self-talk, hypersensitivity to criticism, poor social skills, isolation, difficult social relationships, alcohol abuse, misuse of prescription and non-prescription drugs, difficulty forming and maintaining relationships, curtailed education or employment opportunities, depression, suicidal thoughts, isolation from family, peers and community, and reluctance to leave the house.

Prevention

There's no way to predict what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you're anxious.

Anxiety, like many other mental health conditions, can be harder to treat if you wait. Keeping track of 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.

When embarrassing situations do happen, remind yourself that your feelings will pass, and you can handle them until they do. Most people around you either don't notice or don't care as much as you think, or they're more forgiving than you assume. Prepare for conversation, for example, by reading about current events to identify interesting stories you can talk about. Focus on personal qualities you like about yourself.

Practice relaxation exercises. Be physically active on a regular basis. Learn stress management techniques. Set priorities in your life. You can reduce anxiety by carefully managing your time and energy. Make sure that you spend time doing things you enjoy.

Get enough sleep. Eat a healthy, well-balanced diet. Eat with a close relative, friend, or acquaintance in a public setting.

Purposefully make eye contact and return greetings from others or be the first to say hello. Give someone a compliment. Show an interest in others — ask about their homes, children, grandchildren, hobbies, or travels, for instance.

Avoid unhealthy substance use. Alcohol and drug use and even caffeine or nicotine use 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 healthcare provider.