Read to explore the signs of social anxiety disorder, treatments for social anxiety, and the differences between social phobia, shyness, and more.
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.
What is social anxiety?
Also known as social phobia, social anxiety disorder (SAD) 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 judgement.
Social anxiety is one of the most commonly treated anxiety disorders, affecting nearly 15 million adults in the U.S. Roughly 7% of American adults experience SAD in any given year, with many experiencing the onset of their symptoms during their early teen years.
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, family conflict may contribute to social anxiety.
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 a struggle, but picking up the phone to be easy.
There’s no one-size-fits-all for social anxiety. But regardless of the setting, social anxiety typically presents with several common symptoms.
Signs of social anxiety:
- Rapid heart rate, dizziness
- Shallow breathing, shortness of breath
- 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 or embarrassing themselves
- Worry others will notice their anxiety
- Seek alcohol or other alternatives to deal with anxiety-inducing settings
Social Anxiety vs. Shyness
Those struggling with social phobia often find their fears are dismissed as cases of extreme 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 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 SAD 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 SAD 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 mental symptoms.
Social Anxiety vs. Generalized Anxiety Disorder (GAD)
While both SAD and GAD 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 SAD 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 SAD or AvPD both experience debilitating symptoms 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 SAD understand their anxiety isn’t based in reality and want to engage in social settings, 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 may never experience a panic attack. Additionally, where social anxiety always relates to fear about social settings, 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 actually a subset of social anxiety that’s triggered by public speaking, performance, or being in front of an audience. Those with performance anxiety are often fine in social settings (work, parties, dates) where those with social anxiety struggle.
Social Anxiety Treatment
If you’ve been experiencing symptoms of social anxiety, it’s important to connect with your primary care provider. 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.
The most effective form of therapy used to overcome social anxiety is cognitive behavioural therapy (CBT). CBT is particularly effective because it focuses on challenging current thought and behaviour 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 using CBT alone, explaining that while medications lessen anxiety symptoms, they actually hide the root triggers and prevent long-term healing.
Support groups can be pivotal for people overcoming social anxiety. 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. Additionally, support groups help provide unbiased perspectives that help participants reflect on their expectations of embarrassment and others’ judgements, and realize they may not be based on their present reality.
Medications for treating social anxiety 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 alleviate anxiety symptoms, although they can take a few weeks to begin working.
Last but not least, anti-anxiety medications provide immediate and powerful relief from anxiety symptoms, but shouldn’t be taken for long periods of time as it’s easy to build a tolerance and develop a dependence on them due to their fast-acting nature.
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 you don’t have to go through it alone. We at Bhatia Psychology Group are here to help.