Social anxiety disorder, also known as social phobia, is a
psychological disorder and mental health condition.
Social anxiety disorder is acute anxiety or persistent fear of being watched and judged by others, evaluated negatively, or dismissed in a social or performance state.
This fear can lead to stress, loss of self-awareness and confidence and feelings of embarrassment and can affect school, work, and other daily activities.
Social anxiety disorder can wreak havoc on the lives of those who suffer from this disorder.
Social anxiety disorder is acute anxiety or persistent fear of being watched and judged by others, evaluated negatively, or dismissed in a social or performance state.
This fear can lead to stress, loss of self-awareness and confidence and feelings of embarrassment and can affect school, work, and other daily activities.
Social anxiety disorder can wreak havoc on the lives of those who suffer from this disorder.
![]() |
Social anxiety disorder is a chronic mental health condition |
Social Anxiety Disorder (SAD): Symptoms, Causes, Diagnosis, and Treatment
What is Social Anxiety Disorder (SAD)
Social
Anxiety Disorder - Social Phobia
It is normal
for a person to feel emotional in some social situations but being extremely
emotional is not good and can be harmful to health.
Social anxiety disorder or so-called social phobia is
a chronic mental health condition in which a person
feels very frightened and anxious.
For example, going to a romantic date or
presenting a presentation that can lead to feelings of tension, anxiety, and
emotion.
A person may
feel embarrassed when he speaks for the first time to people he does not know
because he fears that others will evaluate him or judge him.
Social
anxiety disorder can lead to extreme anxiety, acute stress, feelings of
tension, intense and irrational fears, loss of self-awareness and
self-confidence, and embarrassment due to the fear of being focused on daily
conversation and monitoring the actions of a person or judging them.
In the case
of social anxiety disorder, fear and anxiety lead to
avoidance that can disturb life.
Acute stress
can affect normal daily activities, work, school, or other activities.
Tension is
also a type of social anxiety disorder where a person experiences fear and
anxiety only when speaking or dealing with the public.
Psychotherapy
and medication can help the patient gain self-confidence and improve the
ability to interact with others.
Symptoms of Social Anxiety Disorder
Shame or
discomfort in some situations does not necessarily reflect signs of social
anxiety disorder, especially in children.
Comfort
levels differ in social attitudes, depending on personality traits and life
experiences. Some people by nature are conservative and others are more open.
Unlike the
nervous tension that can occur on a daily basis, social anxiety disorder
involves fear, anxiety, and avoidance that goes against daily routines, work,
school or other activities.
Social
anxiety disorder symptoms often appear at the onset of adolescence to
mid-teens, although they sometimes can begin in younger children or in adults.
In children,
anxiety may arise when interacting with adults, peers or parents in the form of
crying, anger, clinging to parents or refusing to speak in social situations.
Emotional and Behavioral Symptoms
Emotional
and behavioral symptoms of social anxiety disorder may include the following:
- Fear of situations in which a person is judged
- Fear of interacting or talking to outsiders
- Fear that others will notice your anxiety
- Fear of physical symptoms that may cause you embarrassment, such as redness of the face from shyness, sweating or trembling or speaking with a weak voice
- Avoid doing things or talking to people for fear of harassment
- Avoid situations where you may be center of interest
- Anxiety is the anticipation of an activity or a frightening event
- Concern about embarrassing or humiliating oneself
- Carry a social attitude in fear or anxiety
- Spending time after a specific social situation to analyze performance and identify defects and flaws in your interactions
- Expecting the worst possible consequences because of a negative experience in a social situation
- Feeling anxious about any activity or scary event
Physical symptoms
A social
anxiety disorder may be accompanied by physical signs and symptoms, which may
include:
- Flushness
- Rapid heart palpitations or accelerated heartbeat
- Sweating
- Shivering
- Stomach upset or nausea
- Breathing difficulties
- Feeling dizziness
- Feeling that your mind has become empty
- Muscle strain and tension
Avoid Common Social Attitudes
Social
anxiety disorder symptoms may change over time. They may increase if you
are facing great stress or many demands.
Although
avoiding situations that result in anxiety may make you feel better in the
short term, long-term anxiety is likely to continue and persist if you do not
go to the doctor to receive treatment.
Common
everyday experiences that are difficult to tolerate or deal with when
experiencing social anxiety include:
- Interaction with unfamiliar or strange people
- Attending parties or social gatherings
- Going to work or school late
- Starting conversations or acquaintance
- Conducting visual communication
- Bringing things back to the store
- Eating in front of others
- Dating for the first time with finance
- Entering a room where people are already seated
![]() |
Social anxiety disorder-Symptoms, causes, and treatment |
Causes
of Social Anxiety Disorder
Like
many mental health cases, social anxiety disorder is
likely to emerge from a complex interaction between environmental and
biological factors.
Acquired
behavior of a child's erroneous education, which dominates the behavior of
parents is the cause of social anxiety as well as the environment, which
refuses to express opinions and expressions.
Possible
causes include:
Inherited traits: Anxiety disorders tend to spread among
family members. However, it is not entirely clear how much of this can be
returned to genes and how much it can be attributed to acquired behavior.
Brain structure: A brain structure called the amygdala can
play a role in controlling fear response.
People
who have hyperthyroidism may have a high response to fear, leading to increased
anxiety in social situations.
Environment: Social anxiety disorder may be an acquired behavior -
some people may develop the situation after an annoying or embarrassing social
situation.
Also,
there may be a link between social anxiety disorder and parents who behave in a
socially anxious or overly protective manner in protecting their children.
Risk factors for SAD
There
are several factors that can increase the risk of social anxiety disorder,
including:
Family history: You are more likely to have a social
anxiety disorder (social phobia) if one of the parents or siblings suffer from
the same condition.
Negative experiences: Children who are harassed, bullying,
rejected, ridiculed, or insulted may become more vulnerable to social anxiety
disorder.
In
addition, other negative events in life, such as family conflicts, trauma, or
abuse, may be associated with social anxiety disorder.
Mood: Children who are shy, disoriented, withdrawn, or embarrassed
about new situations or people are more likely to be infected.
Modern social or practical requirements: The symptoms of
social anxiety disorder begin naturally in adolescence, but the onset of
symptoms may first provoke interviewing new people, speaking to an audience or
giving a presentation at work.
A striking appearance or condition: for example, facial
deformities, stuttering, or Parkinson's shivers, may all increase the sense of
shyness in particular, and maybe spread by the onset of social anxiety disorder
in some people.
Complications
of Social Anxiety Disorder
Social
anxiety disorder can dominate your life if it is left untreated. It can
interfere with your work, school, relationships, or life enjoyment. It may
cause:
- Low level of self-confidence
- Difficult to be sure
- Negative opinion about oneself
- Hypersensitivity to criticism
- Weak social skills
- Isolation and difficulty of social relations
- Weak academic and practical achievements
- Drug abuse, such as drinking too much
- Suicide or suicide attempts
Other
anxiety disorders and certain other health disorders, especially major
depressive disorder, schizophrenia, mood swings, and drug abuse problems, often occur
with a social anxiety disorder.
Diagnosis of Social Anxiety Disorder
Your
doctor will want to determine if there are other conditions that may cause
anxiety, or if you have a social anxiety disorder as well as other physical
disorders or mental health disorders.
Your
doctor may determine the diagnosis based on:
Physical
examination to help determine if a person is in a state of health or is taking
medication that causes anxiety.
Self-report
questionnaires on symptoms of social anxiety
Your
doctor may discuss the symptoms that appear to you, the number of times they
occur and the situations in which they occur.
Review
many cases and the list of positions to see if they are causing you anxiety or
not
Use
the criteria listed in the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5) published by the American Psychiatric Association, which
include:
- Continued fear and extreme anxiety about certain social attitudes, fearing people's judgment or criticism because of your belief that you may be misled, or shamed or insulted.
- Avoid social situations that cause anxiety or endure these situations
- Excessive anxiety is inappropriate for the situation
- Anxiety or distress can hinder your daily life and may negatively affect
- Uncertainty or anxiety that can not be explained by a medical condition
- Lack of any other medical explanation for anxiety and fear such as the presence of a particular illness or drug use or medication may cause anxiety.
Prevention of Social Anxiety Disorder
There's
no proven way to predict why a person's anxiety disorder is increasing, but you
can take steps to reduce the impact of your symptoms if you're worried:
Ask for help early: As with many other mental health
conditions, it may be difficult to treat anxiety whenever we are late in
treatment.
Keep a note: Keeping track of your personal life can help you and
your mental health professional identify the causes of stress and things that
seem to improve your condition.
Describe the problems you face in your life according to their
priority: You
can reduce anxiety by managing your time and energy carefully.
Make
sure you spend time doing things you enjoy and feel better.
Avoid using unhealthy substances: Alcohol consumption,
drug use, even caffeine or nicotine can cause anxiety or worsen the condition.
If
you are addicted to any of these substances, self-abnegation may increase
anxiety, so consult your doctor, talk to the support group and develop a
treatment program to help reduce anxiety.
Treatment of Social Anxiety Disorder
The
treatment of social anxiety disorder depends on how well it affects your
ability to perform your practical tasks in everyday life.
The two most
common types of treatment are psychotherapy and medications.
Psychotherapy
The doctor
first begins with sessions of psychotherapy, which include identifying and
changing the negative beliefs of the patient and improving adjustment skills.
Psychotherapy
improves symptoms in most people with a social anxiety disorder.
In therapy,
you learn how to recognize and change negative thoughts about yourself, as well
as develop skills to help you gain confidence in social situations.
Cognitive-behavioral
therapy (CBT) is
the most common and effective type of psychotherapy used to treat anxiety
disorder when done individually or collectively, which is based on exposure to
situations, which makes the patient gradually excited to face the situations he
fears most.
Exposure-based
cognitive behavioral therapy can improve the adjustment skills and help the
patient to gain the confidence to deal with anxiety-provoking situations.
You can also
participate in skills training or role-play to practice your social skills and
gain comfort and confidence associated with other skills.
The practice
of exposure to social attitudes is especially useful in the face of your
concerns.
Medication
Although
many types of drugs are available, selective serotonin reuptake
inhibitors (SSRIs) are sometimes the first type of medication that has
been tried to treat symptoms of social anxiety disorder.
The doctor
may prescribe Paroxetine or Sertraline.
Serotonin
and norepinephrine reuptake inhibitors (SNRIs) are also available options to
treat social anxiety disorder, for example, Venlafaxine (Effexor XR)
To reduce
the risk of side effects, your doctor may start by giving you a low dose of
medication, and then gradually increase it to a full dose.
It may take
several weeks to several months of treatment until the symptoms improve
significantly.
Other medicines
Your doctor
may also prescribe other medications for symptoms of social anxiety, such as:
Antidepressants: You may have to try several
different antidepressants to find the most effective result with fewer side
effects.
Anti-anxiety
drugs:
Benzodiazepines may reduce the level of anxiety.
Although
they usually have a quick side effect, they may cause addiction, severe
inactivity and anesthesia, so they are usually described for short-term use and
commonly used before taking a particular social position.
Beta-blockers: They act by blocking the
stimulant effect of epinephrine (adrenaline), but they are not recommended as a
treatment for social anxiety disorder because they cause heart rate, blood
pressure, heart palpitations, tremors, and sound extremities.
Therefore,
they are advised to use them irregularly to control the symptoms of a
particular situation, such as a speech.
It is not
recommended in the general treatment of social anxiety disorder.
Alternative Option
Many herbal
remedies have been studied as treatments for anxiety. The results tend to be
different, and in many studies, people report that there is no benefit from
their use. More research is needed to fully understand the risks and benefits.
Some herbal supplements
increase the risk of serious hepatic cirrhosis and may have a calming effect,
but they often mix with other products so it is difficult to tell whether they
help relieve anxiety symptoms or not.
We do not
recommend any herbal supplements; we have discussed them in this article for
general information only.
So if you
want to benefit from them, talk to your doctor before taking any herbal
remedies or supplements to make sure they are safe and will not interact with
any of the medications you are taking
Commitment is Important
Do not lose
hope and do not despair if the effect of the treatment does not appear quickly.
You can
continue cutting off your psychotherapy sessions over several weeks or months.
Taking the right medication for your condition may go through trial and error.
Symptoms of
social anxiety disorder in some people may disappear over time and they may
stop taking medications.
While others
may need to take medicines for years to prevent relapses and recurrence of
the condition.
To take
advantage of the treatment as much as possible, always attend medical sessions
and maintain therapeutic visits, and challenge yourself by setting goals to
address social situations that make you anxious and take medications as
described, and talk to your doctor if there are any changes in your
condition.
Note: All
the medications (drugs) discussed here, are general information purposes only,
they are not intended to provide medical or
other professional advice.
Talk to your
doctor before taking any medicines to make sure they are safe and suitable for
your condition.