Social anxiety, often known as social phobia, is a common but widely misunderstood mental health condition affecting millions worldwide. If you’ve ever felt your heart race, your palms become sweaty, or your mind goes blank in social situations, you may have experienced a glimpse of what it’s like to live with social anxiety. Understanding the roots of social anxiety is crucial. Genetic predisposition and life experiences can all contribute to the development of social anxiety. Many people who experience social anxiety have suffered humiliation, bullying, or painful social encounters that have left a lasting impact. Sadly, the pressures of social media have added even more layers to the already complex network of social anxiety. 

People suffering from social anxiety disorder (SAD) have a substantial and persistent fear of social or performance circumstances in which they may be embarrassed, rejected, or scrutinized. A parameter for determining social anxiety disorder is “the fear and anxiety you feel cannot be due to the effects of a medication or drug, must not be better explained by another mental disorder, and cannot be related to a medical condition.” (Mayo Clinic, n.d.). Social anxiety disorder is more than being worried or awkward in social situations. It can be debilitating, wreaking havoc on relationships and jeopardizing your career. Your symptoms cause interference with daily life, including work or other routine tasks.  If your anxiety is at a level where you miss work and need to stay in bed, seeing a mental health professional to deal with the matter at hand is highly recommended. 

Impact of Social Anxiety 

Although individuals are aware that their fear is unreasonable, it can be difficult to overcome, so they either avoid these situations entirely or endure them while experiencing extreme anxiety and distress. 

Signs and symptoms of social anxiety disorder typically fall within three categories: physical, cognitive, and behavioural symptoms. While everyone’s experience is different, these symptoms greatly impact the individual. These physical symptoms might sometimes become so critical that they result in a panic attack. People with SAD, unlike those with panic disorder, are aware that their panic is triggered by anxieties of social and performance-related events rather than fears of the panic attacks themselves. According to research, social anxiety disorder is one of the most common of all anxiety disorders. Furthermore, according to results, women are somewhat more likely to have the condition (National Library of Medicine, n.d.). It was also found that women feared more social situations and scored higher on a variety of social anxiety measures in a clinical sample. As a result, while women are more likely to feel social anxiety, men appear to be more inclined to seek treatment and do so with less severe symptoms. 

When does social anxiety disorder begin, and how long does it last? 

Social anxiety disorder typically appears in childhood or adolescence, with the majority developing it before reaching their twenties. However, a small percentage of people develop this disorder later in life. Social anxiety looks different for everyone. For example, some people may be able to pinpoint the onset and link it to a specific event (such as moving to a new school or being bullied or mocked). Others may view themselves as naturally shy and regard their social anxiety disorder as a gradual development and an increase of their fear while approaching or being approached by others. Some people may never be able to recall a time when they were free from social anxiety. 

Symptoms of Social Anxiety Disorder  

Social phobia was replaced by social anxiety disorder in the DSM-IV, released in 1994. The new word was developed to describe the broad and ubiquitous nature of the concerns associated with this disorder (Cuncic, 2020). 

Mayo Clinic (n.d.) states symptoms must be present for at least six months to be diagnosed with SAD. The DSM-5 criteria for social anxiety disorder include:  

Persistent, intense fear or anxiety about specific social situations because you believe you may be judged negatively, embarrassed, or humiliated.

Avoidance of anxiety-producing social situations or enduring them with intense fear or anxiety. 

Excessive anxiety that’s out of proportion to the situation. 

Anxiety or distress that interferes with your daily living. 

Fear or anxiety that is not better explained by a medical condition, medication or substance abuse. 

Other Common physical symptoms include: (Daniel B. Block, 2022)

Blurred vision 

Blushing 

Chest pain and tightness 

Chills 

Diarrhea 

Dizziness 

Dry mouth 

Disconnection from oneself (depersonalization) or emotions of unreality (derealization) 

Headaches 

Heart palpitations and racing (tachycardia) 

Lump in the throat 

Muscle tension 

Nausea 

Paresthesias (tingling) 

Ringing in the ears 

Shaking 

Shortness of breath 

Sweating 

Trembling voice 

Cognitive Symptoms of Social Anxiety

Cognitive symptoms, such as cognitive distortions, are also present in social anxiety disorder. If you suffer from social anxiety disorder, you might be conflicted with negative thoughts and self-doubt when confronted with social and performance-related situations. 

Common Cognitive Symptoms may include:

Negative beliefs: You strongly believe you are inadequate to deal with social and/or performance-related situations. 

Negative bias: A tendency to degrade beneficial social interactions while amplifying the social abilities of others. 

Negative thoughts: You automatically make negative assessments about yourself in social or performance-related situations. If you have social anxiety disorder, you may start to have negative thoughts such as, “Everyone else looks so much more relaxed,” “What if I say something dumb?” or “What if everyone notices my voice shaking?” For example, imagine you start a new job or arrive on the first day of a new class. The instructor or manager asks everyone to introduce themselves to the group. 

These thoughts can quickly spiral out of control, to the point where you don’t hear anything anyone else is saying, and when it comes to your turn, you speak as little as possible and hope that no one notices your nervousness. Negative thought patterns diminish your self-esteem over time, so it is important to seek professional treatment. 

Behavioural Responses 

Social anxiety disorder also alters your behavioural responses. You might find yourself making choices based on fear and avoidance instead of your actual goals, aspirations and ambitions. For example, you might turn down a class or job opportunity because you have a fear of doing a presentation, or that opportunity may demand increased social interaction and performance demands. 

Some common behavioural symptoms include:

Avoidance: You avoid situations that will increase anxiety levels. 

Safety behaviours: You find ways to limit experiences such as social or performance-related situations. 

Escape: You commonly leave or escape feared social interactions. 

What Are Avoidance Behaviours? 

Social anxiety can significantly influence your life, and it can result in various other complications, such as panic attacks, diminished self-esteem, avoidance, exclusion of social interaction, etc. Avoiding social situations can make it increasingly difficult to maintain interpersonal relationships, affecting your work performance, school attendance and participation in social settings. These avoidance behaviours will contribute to feelings of isolation and loneliness, which could lead to other mental health illnesses such as depression. If left untreated, social anxiety disorder significantly decreases your quality of life, which can result in having few or no friends or romantic relationships. It can also lead you to drop out of school or quit your job. It is not uncommon for individuals to resort to unhealthy coping mechanisms such as alcohol use or gaming to numb their experiences and tolerate anxiety. 

Social Anxiety Disorder Symptoms In Children 

Symptoms in children and young people may appear differently than in adults. Young children with the disorder may cling to a parent, have a tantrum when forced into a social situation, refuse to play with other kids, cry, or complain of an upset stomach or other physical problems. (Daniel B. Block, 2022). Leaving it untreated in children will often manifest later in life. For example, teens may avoid any form of social gathering or show little interest in having friends. 

Frequently Asked Questions 

When should I seek professional help? 

As a rule of thumb, if the symptoms you are experiencing significantly affect aspects of your daily life, such as relationships, work, or school, or if you find yourself avoiding situations because of anxiety, an appointment with a mental health professional is necessary. 

Can treatment help relieve symptoms of social anxiety disorder? 

The good news is that a mental health professional can help with the treatment of SAD. Effective approaches to treating SAD include psychotherapy, cognitive behavioural therapy (CBT) and exposure therapy.  

How do you know if you have social anxiety disorder? 

Although only a mental health professional can provide an accurate diagnosis, learning more about the signs and symptoms can help you recognize challenges, such as whether the feeling is typical of social anxiety disorder. When confronted with a social situation, do you almost always experience anxiety symptoms such as muscle tension, dry mouth, rapid heartbeat, and shortness of breath? 

In the meantime… 

By incorporating healthy habits into your daily routine, you can significantly alleviate the burden of social anxiety and pave the way to a more confident, enjoyable life. 

• Make use of stress management tools. 
• Make a conscious effort to be physically active on a regular basis. Regular exercise is a powerful tool for managing social anxiety. It boosts endorphins, reduces stress hormones, and improves your mood. Whether it’s a brisk walk, yoga, or hitting the gym, physical activity can help release pent-up tension and enhance your self-esteem. 
• Eat a healthy, well-balanced diet. 
• Set realistic goals. 
• Focus on your strengths, and work on your weaknesses. 
• Avoid alcohol. 
• Limit or avoid caffeine. 
• Socially interact with people you feel comfortable with. Facing your fears is a key component of overcoming social anxiety. Start small and gradually work your way up to more challenging social situations. With each successful step, your confidence will grow. 
• Analyse your fears and identify what situations cause the most anxiety. Begin with setting small goals and taking small steps daily or weekly in less overwhelming situations. The anxiety levels will ease the more you practice. 
• Go for a meal with a close relative in a public setting. 
• Give someone a compliment. 
• Ask a store assistant to help you find an item. 
• Show an interest in others — create conversations. For example, ask them about their family, career, hopes and dreams, hobbies, travel, etc. 
• Call a friend to make plans. 
• Avoid using alcohol to calm your nerves. It may seem like it helps temporarily, but it can make you feel even more anxious in the long term. 
• Get enough sleep. School-age children between six to twelve years need 9-12 hours a day; 13 to 17-year-olds need 8-10 hours a day; and adults need between 7-9 hours a day. 

Healthy habits are not just a means of coping with social anxiety, they’re essential building blocks for a happier, more fulfilling life. By prioritizing your physical and mental well-being, you can equip yourself with the tools needed to relieve the grip of social anxiety and cultivate a newfound sense of confidence and connection with the world around you. Remember, it’s a journey, and every small step forward counts. 

References 

(n.d.). Retrieved from Beyond Blue: https://www.beyondblue.org.au/mental-health/anxiety/types-of anxiety/social-anxiety-disorder 

Blue, B. (2023, October 5). National Study of Mental Health and Wellbeing. Retrieved from Australian Breau of Statistics: https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health and-wellbeing/latest-release 

CDC. (n.d.). How much sleep do I need. Retrieved from Center for Disease Control and Prevention: https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html 

Cuncic, A. (2020, December 16). Social Phobia and Social Anxiety Disorder Differences. Retrieved from Very Well Mind: https://www.verywellmind.com/social-phobia-or-anxiety-disorder-3024447 

Daniel B. Block, M. (2022, April 22 ). Symptoms of Social Anxiety Disorder. Retrieved from Very Well Mind : https://www.verywellmind.com/social-anxiety-disorder-symptoms-and-diagnosis-4157219 

Erica Crome, R. G. (2015, March). DSM-IV and DSM-5 social anxiety disorder in the Australian community. Retrieved from National Library of Medicine: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4361462/ 

Health, B. (n.d.). Social Phobia. Retrieved from Better Health Channel: 

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/social-phobia 

James W. Jefferson. (2001, February 3). Social Anxiety Disorder: More Than Just a Little Shyness. Retrieved from National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181152/ 

Mayo Clinic . (n.d.). Retrieved from Social Anxiety Disorder (Social Phobia): 

https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/diagnosis-treatment/drc-20353567 

National Library of Medicine. (n.d.). Retrieved from Social Anxiety Disorder: Recognition, Assessment and Treatment.: https://www.ncbi.nlm.nih.gov/books/NBK327674/ 

Trevor Thompson, N. V. (2019, April 23). Social anxiety increases visible anxiety signs during social encounters but does not impair performance. Retrieved from BMC Psychology: 

https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-019-0300-5