What is social anxiety disorder?

Social anxiety disorder, also called social phobia, is an anxiety disorder in which a person has an excessive and unreasonable fear of social situations. Anxiety (intense nervousness) and self-consciousness arise from a fear of being closely watched, judged, and criticized by others.

A person with social anxiety disorder is afraid that he or she will make mistakes and be embarrassed or humiliated in front of others. The fear may be made worse by a lack of social skills or experience in social situations. The anxiety can build into a panic attack. As a result of the fear, the person endures certain social situations in extreme distress or may avoid them altogether. In addition, people with social anxiety disorder often suffer “anticipatory” anxiety — the fear of a situation before it even happens — for days or weeks before the event. In many cases, the person is aware that the fear is unreasonable, yet is unable to overcome it.

Some people fear only one or a few types of social situations. For other people, many situations cause stress. This problem affects your daily life. You may be so stressed or afraid that you avoid public situations, including missing work and school.

What causes social anxiety disorder?

Doctors don’t know what causes social anxiety disorder. They think it may run in families, but they are not sure if it’s because of genetics or a response to a traumatic situation.

What are the symptoms?

Social anxiety disorder causes both emotional and physical symptoms:

• It can make you nervous, sad, or easily upset before or during a social event. You may worry a lot or be afraid that something bad will happen.
• The anxiety can cause you to blush, sweat, and feel shaky. Your heart may beat faster than normal, and you may have a hard time focusing.

How is social anxiety disorder diagnosed?

To diagnose social anxiety disorder, your doctor will examine you and ask about your symptoms. He or she may ask other questions to see how you are doing emotionally. This is called a mental health assessment.

Your doctor may also do blood or urine tests to rule out other conditions, such as thyroid problems that can cause similar symptoms.

How is it treated?

Treatment of social anxiety disorder includes counseling and sometimes medicine, such as antidepressants. Whether you need medicine depends on how much the problem affects your daily life. If you already feel anxious around other people, it may be hard to ask for help. But treatment for social anxiety disorder works for many people.

Some people with social anxiety disorder turn to alcohol or drugs to help them relax. This can lead to addiction problems. They may also have depression. It is important to treat these issues too.