Social anxiety disorder (also known as social phobia) involves a fear or anxiety about being humiliated or scrutinized in social situations, which lasts at least six months. This fear causes significant distress or impairment in day-to-day functioning (e.g., social or occupational).
Fears may be associated with social interactions, being observed and/or performing. Examples include meeting strangers, dating, participating in small groups or playing sports.
Signs & Symptoms
Cognitive signs and symptoms include thoughts such as:
“I’ll look anxious and stupid.”
“People will think I’m weird.”
Physical signs and symptoms include:
rapid heart beat
trembling or shaking
tightness in chest.
Behavioural signs and symptoms include:
avoiding social gatherings, parties, meetings
avoiding public speaking
avoiding eye contact
being excessively submissive in conversations.
In children, anxiety may be expressed by crying, throwing tantrums, freezing, clinging, shrinking or failing to speak in social situations.
Causes & Risk Factors
There are no clear-cut answers as to why some people develop social anxiety disorder, although research suggests that various factors may be involved. Like most mental health problems, social anxiety disorder appears to be caused by a combination of biological and psychological factors and challenging life experiences. These include:
stressful or traumatic life events (e.g., bullying)
a family history of anxiety disorders
other mental health or substance use problems.
Symptoms of social anxiety disorder usually begin prior to age 18, and symptoms tend to appear more in women than in men. Approximately seven per cent of people experience social anxiety disorder.
Diagnosis & Treatment
The most effective form of treatment for social anxiety disorder is cognitive-behavioural therapy (CBT). CBT for social anxiety disorder may include exposure therapy, which involves direct or imagined controlled exposure to objects or situations that create anxiety. Medications, such as anti-anxiety medications and antidepressants, have also been proven effective, and many people receive CBT and medication in combination.
Support groups and self-help practices are also beneficial for people with social anxiety disorder. Regularly exercising, eating well, managing stress, spending time with loved ones, practicing spirituality or meditation, and monitoring alcohol and other drug use can help keep anxiety from getting worse.