Social Anxiety Disorder

Social anxiety is the fear of interaction with other people that brings on self-consciousness and feelings of being negatively judged and evaluated. As a result, people with social anxiety have feelings of inadequacy, inferiority, embarrassment, humiliation, and depression and tend to avoid any situation that would bring on these feelings, including going to work or school or engaging in everyday tasks and activities.

Everyone has felt anxious or embarrassed at one time or another. For example, meeting new people or giving a public speech can make anyone nervous, but people with social phobia worry about these and other things for weeks before they happen.

People with social anxiety may become irrationally anxious in social situations, but feel better when they are alone.

Social anxiety can be specific (having anxiety in only some situation) or generalized (having anxiety in almost all situations). A specific social anxiety would be the fear of speaking in front of groups (only), whereas people with generalized social anxiety are anxious, nervous, and uncomfortable in almost all social situations. It is much more common for people with social anxiety to have a generalized type of this disorder, which includes anticipatory anxiety, worry, indecision, depression, embarrassment, feelings of inferiority, and self-blame across most life situations.

People with social phobia are afraid of doing common things in front of other people. For example, they might be afraid to sign a check in front of a cashier at the grocery store, or they might be afraid to eat or drink in front of other people, or use a public restroom. Most people who have social phobia know that they shouldn't be as afraid as they are, but they can't control their fear.

Social phobia usually starts during youth. A doctor can tell that a person has social phobia if the person has had symptoms for at least 6 months. Without treatment, social phobia can last for many years or a lifetime. However, therapy, coping skills, and medicines can help alleviate the symptoms of social anxiety.

The exact causes of anxiety disorders are unknown, but areas of the brain that control fear responses may have a role in some anxiety disorders. Anxiety disorders can run in families, which suggests that a combination of genes and environmental stresses can produce the disorders. The role of brain chemistry is also being investigated. In social anxiety disorder, especially, misreading others’ behaviors or body language and weak social skills may contribute to anxiety. Environmental factors, including family characteristics or being around others who have social anxiety, may lead to social anxiety disorder.

Talk with a doctor if fear of social situations is intense, lasting, and keeps you from work, school, or relationships. Therapy and, in some cases, medication are very effective.