How Do I Know If I Have Social Anxiety?

Most of us can relate to a time we felt anxious, where that pit settled in the bottom of our stomachs as our heart rate picked up and sent waves of nervous energy through our bodies. But while most of us know what it’s like to feel anxious in social settings, dealing with a social anxiety disorder is a very different experience.

Read to explore the signs of social anxiety disorder, treatments for social anxiety, and the differences between social phobia, shyness, and more.

What is Social Anxiety Disorder?

Social anxiety disorder (SAD), sometimes called social phobia, is an anxiety disorder that prompts extreme fear responses in social settings. Many who’ve dealt with social phobia explain that even though they know their fears are irrational, their anxiety prevents them from participating in situations that could lead to humiliation, embarrassment, or judgment.

Social anxiety disorder is one of the most commonly treated mental health conditions, affecting nearly 15 million adults in the U.S. Roughly 7% of American adults experience social anxiety disorder in any given year, with many experiencing the onset of their symptoms during their early teen years. In Canada, the number of Canadians with anxiety disorders has doubled, with one in 14 (7.1 percent) now suffering from social anxiety disorder.

Social Anxiety Causes

While we’ve yet to pinpoint exactly what triggers social anxiety disorder, the culprit is likely a combination of factors. Research suggests negative experiences such as bullying, abuse, and family conflict are all risk factors that may lead to someone developing social anxiety disorder.

Environmental factors and family history also impact the development of social anxiety disorder. However, research has yet to identify whether this influence is due to genetics or learned behaviour as children absorb their parent’s anxiety responses.

What Settings Trigger Social Anxiety?

Those with social anxiety disorder find it challenging to fulfill social obligations that others might consider easy. Where others may not blink an eye at answering the phone, working with colleagues or talking to strangers, these tasks can become debilitating and trigger anxiety responses for people with social phobia.

Settings and scenarios that can trigger people with social anxiety include:

  • Meeting strangers (at a party, at work, daily life)
  • Asking questions
  • Eating in public
  • Talking on the phone
  • Working with colleagues
  • Going on dates
  • Talking to a cashier
  • Job interviews
  • Giving speeches or presentations

More so than shyness or introversion – social anxiety disorder can limit one’s ability to operate and thrive in critical settings including work, school, and relationships.

Common Signs of Social Anxiety

It’s important to note that not all settings are triggering for everyone with social phobia. Some people may find their anxiety flares up when talking to strangers but are fine in work settings. Others may find going to the store is a struggle, but picking up the phone to be easy.

There’s no one-size-fits-all for social anxiety. Regardless of the setting, social anxiety typically presents with several common symptoms.

Social Anxiety Disorder Symptoms and Signs:

  • Blushing
  • Rapid heart rate, dizziness
  • Shallow breathing, shortness of breath
  • Nausea
  • Difficulty speaking, mind ‘goes blank’
  • Excessive sweating
  • Shaking or trembling

Additionally, People With a Social Anxiety Disorder May:

  • Avoid eye contact, talk quietly, or demonstrate rigid body posture
  • Worry for days or weeks before an upcoming event
  • Attempt to blend into the background of social situations
  • Avoid triggering situations (work, school, social settings)
  • Worry intensely about being judged negatively or embarrassing themselves
  • Worry others will notice their anxiety
  • Seek alcohol or develop substance abuse issues to deal with anxiety-inducing settings

Social Anxiety vs. Shyness

Those struggling with social phobia often find their fears are dismissed as being “just shyness.” But the main differences come down to the (1) intensity of fear, (2) level of impairment, and (3) level of avoidance. Someone shy might feel uncomfortable in social settings, but they’re able to push themselves and ultimately relax.

Those with social anxiety may instead experience paralyzing physical symptoms and intense fear that limit their ability to function. Where shyness is a character trait, social anxiety is a mental disorder.

Social Anxiety vs. Introversion

Introversion is a personality trait that captures where you get your energy from and your preference for engaging with people. When an introvert wants to relax, they’ll often choose alone time over socializing. They might appear reserved or shy. But similar to shyness, the difference between social anxiety disorder and introversion lies in the distinction between personality traits and mental disorders.

Where an introvert might prefer solitude, they don’t experience the symptoms of social anxiety disorder and can often attend social situations with little trouble. For those with SAD, even if they want to attend an event, they may find themselves unable due to physical and psychological symptoms.

Social Anxiety vs. Generalized Anxiety Disorder (GAD)

While both social anxiety disorder and generalized anxiety disorder are characterized by symptoms of extreme terror that exceed or are disproportionate to the current reality, the key difference between the two anxiety disorders comes down to their triggers.

The onset of anxiety symptoms from social anxiety disorder comes from worries about how others may evaluate and judge you. By contrast, those with GAD experience more widespread anxiety and worry covering many topics, including social triggers.

Social Anxiety vs. Avoidant Personality Disorder (AvPD)

Social anxiety disorder and avoidant personality disorder (AvPD) share numerous symptoms, making it easy to misdiagnose one for the other. People with either of these mental health conditions, both experience debilitating symptoms and often intense fear when confronted with social situations, and both demonstrate avoidance tendencies.

The main distinction between the two anxiety disorders is how deep-seated the roots of anxiety are. Those with AvPD have often internalized social anxiety into extremely low self-image and esteem, building it into their worldview. This can make AvPD much harder to treat because where people with social anxiety disorder understand their anxiety isn’t based in reality and want to engage in social interactions, those with AvPD have “learned” that socializing confirms their lack of value.

Social Anxiety vs. Panic Disorder

Panic disorder is another type of anxiety disorder that’s marked by recurring panic attacks that can occur unexpectedly or in response to specific events. Although both are anxiety disorders, it’s important to note that many with social anxiety disorder may never experience a panic attack.

Additionally, where social anxiety always relates to fear about social interaction, those with panic disorder often experience intense panic attacks for seemingly no reason, or due to wide-ranging reasons.

Social Anxiety vs. Performance Anxiety

Performance anxiety is a subset of social anxiety disorder that’s triggered by public speaking, performance, or being in front of an audience. Those with performance anxiety are often fine in social interactions and settings (work, parties, dates) whereas those with social phobia experience intense anxiety.

Social Anxiety Treatment

If you’ve been experiencing symptoms of social anxiety disorder, it’s important to connect with your primary care provider or a mental health professional. They’ll be able to provide support and guidance in determining your next steps.

Social anxiety treatment typically falls into three categories that can be used alone or in combination: therapy, support groups, and medications.

Therapies

The most effective form of talk therapy used to overcome social anxiety is cognitive behavioural therapy (CBT). CBT is particularly effective because it focuses on challenging current thought and behavior patterns to build better habits. CBT also prioritizes emotional coping skills and personal strategies for dealing with triggering situations.

Interestingly, new research suggests that CBT alone may be more effective than CBT and medication together. One team of researchers found 85% of participants significantly improved mental health using CBT alone, explaining that while medications lessen anxiety symptoms, they may hide the root triggers and prevent long-term healing. A mental health professional will be able to help you determine what type of therapy might be best for you.

Support Groups

Support groups can be pivotal for people overcoming social anxiety disorder. Surrounding yourself with others who understand and are dealing with the same fears can help create a safe space to work through anxiety-inducing social situations. Speaking with a group you feel comfortable with can also act as a more gentle form of exposure therapy.

Additionally, support groups help provide unbiased perspectives that help participants reflect on their expectations of embarrassment and others’ judgments, and realize they may not be based on their present reality.

Medications

Medications for treating social anxiety disorder fall into three categories: beta-blockers, antidepressants, and anti-anxiety medications.

Beta-blockers are typically taken before anxiety-inducing situations to block the physical symptoms of anxiety as they arise. Antidepressants also help treat social anxiety disorder, although they can take a few weeks to begin working.

Last but not least, anti-anxiety medications can provide immediate and powerful relief from anxiety symptoms. However, these and other mental health medications shouldn’t be taken for long periods as it’s easy to build a tolerance and develop a dependence on them due to their fast-acting nature. Please consult your physician for further information on anti-anxiety medication.

Get Help With Social Anxiety Disorder

At the end of the day, we all feel anxiety from time to time. But if you find yourself struggling with overwhelming and recurring feelings of fear in social situations, know that you don’t have to go through it alone. We at Bhatia Psychology Group are here to help.

Resources:

  1. https://adaa.org/understanding-anxiety/social-anxiety-disorder
  2. https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573560/?report=classic
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181683/
  5. https://www.karger.com/Article/FullText/447013
  6. https://www.sciencedaily.com/releases/2016/12/161221090117.htm
  7. https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376891/
  9. https://thehub.ca/2023-10-04/jonah-davids-sobering-new-statistics-show-canadas-mental-health-crisis-is-only-getting-worse/
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