What Is Social Anxiety?

By: Sarah Fader

Updated May 19, 2020

Medically Reviewed By: Whitney White, MS. CMHC, NCC., LPC

Have you ever been consumed with fear at the thought of meeting strangers, or do you constantly feel as if those around you are forming negative opinions of you? When you've needed to speak publicly for a final, were you trembling without knowing why? You might want to read more here. Social anxiety disorder is "the fear of interaction with other people that brings on self-consciousness, feelings of being negatively judged and evaluated, and, as a result, leads to avoidance."

Social anxiety disorder affects 7% of the population and it is currently the third largest psychological issue that affects people today.

Getting to Know Social Anxiety Disorder

Different degrees of social interaction can affect each person with social anxiety disorder differently. The most important place to start when researching how social anxiety disorder affects people is to see if you have relevant symptoms. When doing so, it's important to utilize sound resources to determine what the best approach to treatment may be for you.

The following feelings experienced in social situations are symptoms of social anxiety disorder that may be referenced during diagnosis:

• Inadequacy
• Inferiority
• Embarrassment
• Humiliation
• Depression

These feelings are common in those that suffer from social anxiety disorder, whether specific social anxiety or generalized social anxiety, and are typically brought felt in situations such as:

• Being introduced to new people
• Interpersonal relationships (platonic/romantic/both)
• Having "all eyes on you"
• Being evaluated while completing a task
• Most, if not all, social encounters (school, weddings, family reunions, work functions)
• Having someone evaluate or criticize you
• Being the center of attention

What Causes Social Anxiety Disorder?

The exact cause of social anxiety is not fully understood. Research developed over time has supported the theory that social anxiety and social anxiety symptoms are caused by a multitude of environmental factors and genetics. External social situations that are negatively impactful on someone's life can also be a contributing factor to social anxiety disorder. These interactions include:

• Being bullied
• Family dysfunction and conflict
• Sexual abuse

Chemical imbalances in the brain are also a possible contributing factor to social anxiety disorder. Serotonin (a chemical in the brain) aides in regulating mood and an imbalance could be a possible trigger for social anxiety disorder. An overactive amygdala (the fear-response structure in the brain) could also be a contributing factor.

Additionally, there are two different types of social anxiety disorder. It's important to note that either type can be severe.

Specific Social Anxiety

Specific social anxiety is the stage of social anxiety disorder where a subject feels anxious or irrationally distressed in specific, consistent situations. For example, if a person feels severe social anxiety when answering questions in front of classmates at school yet is perfectly happy meeting strangers at social gatherings, that individual is specifically showing symptoms related to specific social anxiety.

Generalized Social Anxiety

Generalized social anxiety is a form of social anxiety disorder where a person suffers the same symptoms as suffered from specific social anxiety. However, most, if not all, social environments produce these symptoms. Generalized social anxiety can affect a person in almost any situation involving people they're not comfortable or familiar with.

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Generalized social anxiety tends to be more severe of the two types of social anxiety disorder, affecting someone in almost any aspect involving social interaction between people other than their immediate family. Generalized social anxiety tends to affect the day-to-day functions of a person. To expand, if you feel irrationally anxious in numerous types of social situations where different amounts of people are present, you want to research generalized social anxiety disorder further to better address your needs.

Understanding what you could be suffering from can significantly increase your chance of recovery. Having social anxiety disorder can inhibit many different facets of your life, whether generalized social anxiety or specific social anxiety, your personal, family and work life can be negatively affected if left untreated.

Emotional Symptoms of Social Anxiety Disorder

Social anxiety disorder has proven to consistently deliver a set of symptoms (whether specific or generalized) that enable social anxiety disorder to be diagnosed by specialists. Since different social situations can trigger the symptoms below in people differently, it's important to keep track of how social anxiety disorder affects you so you can communicate it when seeking treatment.

• Intense fear
• Almost debilitating and constant anxiety
• Crippling fear of negative judgment from strangers
• Excessive sweating
• Blushing/flushing/ turning red
• Racing heart
• Difficulty swallowing
• Stuttering/trembling
• Muscle twitches primarily in the neck and face

These symptoms can affect you negatively in high-pressure moments in your life. Whether you're on a date with a new person you like or participating in your annual performance review with your immediate superior, the symptoms of social anxiety disorder are extremely distracting. Most importantly, you're almost always alert and aware of the irrational thoughts and feelings of anxiety you're having but knowing what is irrational is very different than a feeling or believing it's irrational.

The best way to combat social anxiety disorder is treatment from a specialist or professional that understands your unique disorder and is willing to work with you in improving the social anxiety that you suffer from.

Treating Social Anxiety Disorder

The most effective way to combat social anxiety disorder despite the severity is different forms of cognitive behavioral therapy (CBT). CBT has been remarkably effective when treating social anxiety disorder, and with the right therapist and the right program of CBT, recovery is possible for any individual suffering from social anxiety disorder. CBT is the most effective form of social anxiety treatment.

For most people suffering from social anxiety disorder, "dealing with it" and "moving on" aren't options. Those suffering from social anxiety disorder have essentially been "dealing with it" since they were born. What those who feel severe anxiety when in social situations need is a therapist that understands what social anxiety disorder is and the appropriate way to treat it for a specific patient.

CBT, and What It Means

By definition, cognitive behavioral therapy is "a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do." To further expand, "Cognitive-behavioral therapy is based on the idea that our thoughts cause our feelings and behaviors, not external things such as people, situations, and events." By implementing a CBT program by a therapist specializing in social anxiety disorder, recovery is possible for those suffering from the disorder in varying severities.

CBT is rapid, collaborative and surprisingly philosophical. When seeking a professional to begin your journey towards recovery, goal-achievement and practicing are two essential components of CBT. Repetition and, essentially re-teaching your brain to behave as you wish in situations is what CBT basically does for patients, giving control over the mind and body back to you.

Choosing a Therapist that Treats You, not Just Your Disorder

It's crucial to complete thorough research when looking for a professional to help treat your social anxiety disorder. Working with a therapist that understands what social anxiety disorder is and what it takes to treat it will help you with a successful recovery. Studies have shown the remarkable success anxiety-specific CBT sessions have given clients, and with the right therapist that has your thoughts and needs in mind, recovery is possible.

Group Therapy: Terrifyingly Ironic?

It might sound scarily ironic that group therapy would be an avenue to take when treating social anxiety disorder but have shown that interacting and developing with others that share your fears and anxieties can be immensely helpful for those currently in treatment. "Face your fears" is a philosophy behind social anxiety group therapy and being in a comfortable and peaceful environment like a support or therapy group enables patients to do just this.

Social anxiety support can come in the form of others that share the same or similar social anxiety symptoms that you do, and these connections can be a key to discovering how to overcome social anxiety.

Know Your Disorder and Take Control of Your Treatment

Being informed isn't just important for your safety, it's imperative to your recovery. You need to feel comfortable with your therapist enough that you can ask questions, even if they may seem silly. Understanding your disorder and your treatment will make the road to recovery that much smoother. Know your symptoms, practice your CBT exercises, and listen to what your therapist advises you to do. Communicate with loved ones and your therapist when setting goals, raising expectations and managing progress.

Is Medication the Right Way to Treat Social Anxiety Disorder?

Since social anxiety disorder is a psychological disorder or mental disorder, it's natural that medication prescribed by the appropriate parties would seem like a reasonable treatment plan to combat social anxiety disorder. Although the number one recommendation is CBT with a professional therapist, different medications can be used to treat social anxiety disorder.

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Anti-anxiety medication has proven to be successful in patients, not all, however, and additionally, some anti-depressants have also shown to be effective. Medication in conjunction with CBT therapy has proven to be effective in some individuals as well. Medications for social anxiety disorder only show short-term benefits if not paired with CBT sessions with a therapist.

Recovery, and Beyond

Recovery from a social anxiety disorder is possible regardless of severity of social anxiety disorder. According to a 2007 ADAA survey, 36% of people with social anxiety disorder report experiencing symptoms for 10 or more years without seeking professional help. It isn't necessary to wait to get help for social anxiety.

CBT has an amazing success rate among those that implement and integrate treatment into their lives. By re-training your brain, you can transform how you react to social situations that would typically only offer you fear. Meeting your boss for lunch to discuss a potential promotion or meeting someone special out for a first date will become normal and something that doesn't drive you into a physical frenzy of crippling nervousness. Removing the debilitating feelings of inadequacy from your mind and hushing that screaming voice in your head telling you how unimportant or foolish you are can drastically improve your life whether in a professional or personal situation.

Overcoming a psychological fear isn't an easy task, however, the curability of most mental disorders is sporadic. Social anxiety disorder is a diamond in the rough and can be treated successfully without the mandatory use of medication in treatment. Recovering from social anxiety disorder, with the correct therapist can be achieved through hard work, consistency, and persistence.

Social Anxiety Disorder Doesn't Have to be Forever

Seeking professional help is the best way to begin your steps to overcoming your social anxiety disorder. Resources like BetterHelp.com offer services providing clients with the help that suits them.

When researching your personal plan to recovery from social anxiety disorder keep in mind the necessity to have an educated therapist helping you design the correct program to help you. Every person that suffers from social anxiety disorder is different, and their treatment is unique to them. Working with a trained professional is imperative if you want to succeed and overcome social anxiety disorder, no matter the severity.