Overview of Social Anxiety Disorder

Social anxiety - Masterfile

More than shyness or mild jitters, social anxiety or social phobia is a disorder that usually involves intense fear, worry, self-consciousness, and panic in social settings. In severe cases, social anxiety can interfere with normal daily activities and result in the avoidance of social situations.

Recent studies estimate that about 5 percent of adults in the United States have social anxiety disorder. In general, social anxiety symptoms develop in adolescence, but social anxiety usually is not treated until much later, if at all.

Symptoms of social anxiety can include both emotional and physical signs. Emotional symptoms of social anxiety may include the following:

  • Avoidance of social events or situations
  • Extreme self-consciousness in social situations
  • Feelings of uneasiness that interfere with normal activities
  • Intense fear of approaching or interacting with people
  • Mental confusion when interacting with people

Physical symptoms of social anxiety that can occur when interacting with other people may include:

  • Diarrhea
  • Heart palpitations
  • Nausea
  • Sweating
  • Trembling

The causes of social anxiety can be challenging to pinpoint. Both heredity (genetics) and environment are believed to play a role in the development of this mental health disorder.

Risk factors for social anxiety include gender (women have a higher risk), family history of anxiety, shy temperament, and certain life experiences, such as having been teased, bullied, overprotected, abused, or neglected as a child.

It is important to seek medical help for social anxiety disorder, as complications of the condition can be quite serious. Anxiety complications can include substance abuse, alcohol abuse, depression, and suicide.

Treatment for social anxiety usually includes a combination of psychotherapy and medication. Common medications that are prescribed for anxiety symptoms include selective serotonin reuptake inhibitors (SSRIs), such as the following:

  • Fluoxetine (Prozac, Serafem)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Sertaline (Zoloft)

Other medications that may be used to treat symptoms of social anxiety include serotonin and norepinephrine reuptake inhibitors (SNRIs), such as Venlafaxine (Effexor), as well as other anti-anxiety, antidepressant, or beta-blocker medications.

Psychotherapy for social anxiety usually involves meeting with a therapist on a regular basis over a period of time. There are several different kinds of psychotherapists and many different psychotherapy techniques. It often is helpful to know what events cause you the greatest anxiety when meeting with your doctor or therapist. Keeping a journal may help you pinpoint situations that are the most difficult for you.

Cognitive behavioral therapy is one technique that has shown to be effective for people who suffer from social anxiety. Finding a therapist who is a good match for you is important. Your doctor may be able to refer you to a therapist who is experienced in helping people with social anxiety.

As with most physical or emotional disorders, eating a healthy diet, getting enough sleep, and exercising daily can help improve your condition and enhance the effectiveness of your treatment. Ask your doctor before beginning an exercise program.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 28 Oct 2009

Last Modified: 01 Sep 2015