What is social anxiety disorder? Signs, causes, and treatment

Social anxiety disorder is characterized by the fear of being judged, negatively evaluated, or rejected by others, which then leads to fear of social situations. Social anxiety can cause worry about appearing visibly anxious or awkward and may result in physical symptoms such as a rapid heart rate, nausea, sweating, and panic attacks. These social anxiety symptoms often begin during the teenage years and can continue into adulthood.

Individuals with social anxiety disorder either avoid the social situations that cause them distress or engage in those situations while experiencing intense anxiety. The feared social situations typically cause immediate anxiety, and that anxiety is often disproportionate to the actual threat of the situation. Social anxiety can interfere with relationships, work, school, daily routines, and other activities because individuals may avoid these situations due to their fear of being judged or evaluated by others.

Social anxiety is different from being introverted or shy because it has an ongoing negative impact on a person's daily functioning. Someone who is introverted may leave a party early, and a shy person may hesitate to interact with new people at a party, but someone with social anxiety disorder might stay home from the party entirely due to their anxiety. A person with social anxiety may seem like they have no desire to build relationships, but this is usually not true.Someone with social anxiety often wants to engage with others and have close connections, but the fear associated with social situations can override that desire.

This paradox is a commonly misunderstood aspect of social anxiety disorder, and it is important to separate a person's anxiety from the natural desire for socialization and connection that most people have. Understanding this distinction can help reduce stigma and increase compassion for those struggling with social anxiety.

What Causes Social Anxiety Disorder?

There is not one specific cause of social anxiety disorder. It may be inherited, it may be learned behavior, or it may be related to an individual's brain chemistry. In many cases, social anxiety develops due to a combination of these factors. A person with a family history of social anxiety is more likely to experience it themselves, as is someone who has experienced intense bullying, criticism, or scrutiny. Other social anxiety risk factors include trauma, abuse, family conflict, a naturally withdrawn temperament, or having a condition or physical appearance that draws attention from others.

Individuals with social anxiety disorder are at increased risk for low self-esteem, negative self-talk, poor social skills, isolation, substance abuse, poor school or work performance, other anxiety disorders, and major depressive disorder. Without treatment, social anxiety can continue to affect many areas of a person's life.

Social Anxiety Treatment and How Therapy Can Help

Social anxiety disorder affects approximately 15 million American adults, yet more than a third of people with this condition report dealing with symptoms for 10 years or more before seeking treatment. The good news is that social anxiety treatment can be highly effective, and therapy can help individuals learn how to manage their symptoms and improve their quality of life.

I have helped many clients work through and learn to cope with their social anxiety. Although therapy looks different for each individual, social anxiety can often improve when a client is able to challenge their negative self-talk. It is important for people with social anxiety to become aware of how they are speaking to themselves internally, as this can significantly impact self-esteem and the beliefs they hold about themselves. People with social anxiety may also need to work on improving their self-esteem and understanding why they struggle with it in the first place.

Additionally, therapy for social anxiety often includes gradually exposing oneself to the social situations that cause distress. If an individual can identify the different levels of anxiety they experience in various situations, they can begin with those that cause the least anxiety and slowly work their way toward more challenging situations.

The goal is for the individual to learn how to cope with each situation and recognize that they can successfully manage the experience. Over time, this can help build confidence and increase a person's willingness to continue working through situations that cause greater anxiety. Learning how to cope with social anxiety is not easy, but therapy can provide the tools, support, and guidance needed to help individuals engage with others and the world in a new way.

If you are struggling with social anxiety disorder, seeking professional support can be an important step toward building confidence, improving relationships, and reducing the impact that anxiety has on your daily life.