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Writer's pictureAvani Babtiwale

Social Anxiety Disorder

Updated: Nov 21, 2021

“Nobody realizes that some people expend tremendous energy merely to be normal” – Albert Camus


Social Anxiety Disorder, also called social phobia, is one of the most common mental disorders in the whole world. People with this disorder have crippling anxiety and fear which severely disrupts their life. This disorder can also become a chronic health condition, but the latest improvements in the field of psychology have caused it to be manageable.


Symptoms

Some people might be too quick to diagnose themselves with social anxiety if they experience shyness in public. This type of shyness is often normal, and not necessarily a sign of social anxiety. The comfort levels of people in social situations are different and related to their life experiences and personality traits. Some symptoms of social anxiety are:


a) Behavioral and Emotional Symptoms:

  • Fear of being judged negatively

  • Constant worrying about humiliating yourself

  • Anxiety about being perceived as anxious

  • Crippling fear of talking to strangers

  • Fear of entering into romantic relationships

  • Fear of drawing attention to yourself

  • Anxiety in anticipating an event

  • Expecting worst outcomes in situations

  • Fear of blushing, sweating, etc. because it will cause embarrassment

  • Avoiding being the center of attention

  • Constantly analyzing your flaws after a social event


b) Physical Symptoms:

  • Increased Heartbeat

  • Sweating

  • Trembling

  • Dizziness

  • Nausea

  • Muscle Tension

  • Blanked out mind

  • Blushing

  • Breathlessness


c) Avoidance of Regular Social Situations

  • Finding excuses to stay out of school or work

  • Not attending parties

  • Not speaking first unless being spoken to

  • Not eating in front of others

  • Avoiding the public restroom

  • Ignoring unknown people

  • Not making new friends

  • Not entering rooms with multiple people

These are just a few of the many symptoms of social anxiety. These symptoms may change as time passes, they may flare up if you are facing many stressful events in your life or they may even reduce if your life is not as stressful. Avoiding anxiety-prone situations sounds easy and is a short-term solution, but it is not good in the long run because it might just make your social anxiety worse, so it is better to seek treatment immediately if possible.


Causes

Like most mental health conditions, social anxiety disorder also comes up from various complex biological and environmental factors, these causes can include:

  1. Inherited genes and traits: Anxiety disorder tends to run in families. It still isn’t clear to specialists as to how much of it is due to genetics, and how much due to learned behavior, however, genes have proven to play a significant role in causing the disorder.

  2. Structure of the Brain: The amygdala possibly may play a role in controlling the response towards fear. If a person’s amygdala is overactive, they may be more likely to have a heightened fear response which would cause increased anxiety.

  3. Environment: Social anxiety disorder may be a learned disorder. It is possible to have developed because of an embarrassing or unpleasant social situation. There also may be a link between social anxiety disorder and parents who are very protective and controlling which results in children developing anxious behavior.


Risk Factors

Certain factors can increase the risk of social anxiety, these are:

  1. Temperament: A child who is timid, withdrawn, and shy when faced with new experiences is more at risk for developing social anxiety.

  2. Family History: An individual is more likely to develop social anxiety disorder if their biological parents or siblings have been diagnosed with it.

  3. Unpleasant Experiences: A child who has experienced bullying, teasing, rejection, humiliation, abuse, etc. would probably be more prone to developing a social anxiety disorder.

  4. New Social /Work Demands: The symptoms of social anxiety disorder typically start in the teenage years, but they may be triggered due to events like making a speech in public for the first time, meeting new people, etc.

  5. Having a condition that draws attention: If a child is born with a visible disability or disfigurement, that child is more likely to be very self-conscious which may trigger social anxiety.


Complications

If social anxiety is left untreated, it would take over your life. It could interfere with school, work relationships, and life in general. It can cause:

  • Negative self-talk

  • Low self-esteem

  • Struggling to be assertive

  • Being hypersensitive to criticism

  • Poor social skills

  • Being isolated

  • Not being able to maintain social relationships

  • Low academic and professional achievement

  • Substance abuse

  • Suicidal thoughts/attempts or Suicide

Other than these a person could also develop other mental disorders such as major depressive disorder etc. along with social anxiety disorder.


Prevention

There is no concrete way to predict if someone will develop anxiety disorder so there are some steps that you can take to reduce its symptoms.

  • Get help as soon as possible, it will be difficult to treat it if you wait for a long time.

  • Try to maintain a journal as keeping track of your day-to-day life can help you and possibly your therapist identify what is causing you stress or discomfort.

  • Set your priorities straight as you are less likely to be anxious, if you manage your time and energy well.

  • Try to stay away from alcohol and drug use and even keep caffeine and nicotine to a minimum as even their usage can maximize anxiety. Your anxiety may also increase if you try to quit these substances on your own and experience withdrawal symptoms. For this purpose, try contacting a health care provider.


Treatment

The treatment for social anxiety depends on how much it affects your ability to function in your everyday life. The most common forms of treatment are psychotherapy, medication, or a combination of both.

  1. Psychotherapy: It improves the symptoms as you learn to understand, analyze, and change the negative thoughts that you have about yourself, and also gain skills to help you develop confidence in social situations. Cognitive Behavioral Therapy (CBT) is the most effective form of therapy conducted in both individuals and groups. Exposure-based CBT is very helpful as you learn multiple things as you slowly expose yourself to situations that cause you anxiety.

  2. Medication: Out of the many medications available, selective serotonin reuptake inhibitors (SSRIs) are the first option of drug tried to reduce symptoms of social anxiety. The other option is the serotonin and norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor SR). You may also be prescribed medications like antidepressants, anti-anxiety medication, and beta-blockers.


Conclusion

Social Anxiety Disorder, as previously stated is a very commonly found mental illness, but thankfully as psychology has advanced it's become easier to get diagnosis and treatment. If you or anyone you know is experiencing symptoms of anxiety it is better to visit a mental health professional to make sure that your symptoms do not worsen over time. For being supportive, you can be more empathetic towards people having this disorder, and be understanding when they refuse to join in social events.


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