It is common to feel nervous in social situations, but people with social anxiety disorder feel extreme dread and anxiety that affects many areas of their lives. This chronic condition affects millions of people around the world. While the symptoms are serious, treatments can help those with social anxiety disorder cope with or overcome their condition.

Cognitive Effects

People with social anxiety disorder feel dread when participating in or thinking about social situations. Feeling overly self-conscious is common, as is having standards for themselves that other individuals would view as unreasonable. Those with social anxiety tend to imagine how a conversation could go and envision answers for each possible issue. Once a social situation has ended, they may feel as though they “performed” poorly. Even neutral or ambiguous conversations may feel negative to a person with the disorder.

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Physical Symptoms

Anxiety disorders can also produce physiological symptoms, the body's response to feelings of dread. Social anxiety disorder can lead to sweating, shaking, nausea, and tears — stress or fight-or-flight responses. In some cases, people with the disorder become overly conscious of the way they are moving, causing them to appear clumsy. Blushing is also extremely common.

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Behavioral Symptoms

Alongside the cognitive, emotional, and physiological effects of social anxiety disorder, it can cause unique behaviors. The most common is self-isolation from locations and situations with social expectations, such as restaurants, parties, dates, and jobs. Other behavioral effects include avoiding eye contact, crossing the arms, speaking softly, or wearing plain clothes. Avoidance behaviors can become severe enough that a person begins compulsively lying to protect against peer judgment or maintain a positive image.

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Shyness vs. Social Anxiety Disorder

Shyness can resemble social anxiety disorder in many ways. Shy or introverted people can have difficulty interacting with others and may also choose to avoid social situations. However, the key distinction between shyness and social anxiety disorder is the severity of the symptoms. People with social anxiety disorder do not just feel nervous before a social situation. They feel dread for days or weeks before the event and will often fixate on it for a significant period after it is over.

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Comorbidity With Other Conditions

Social anxiety disorder can exist alongside many other psychiatric disorders. Studies suggest that between 66% and 80% of people with the condition will experience at least one other disorder, the most common being clinical depression and other anxiety disorders. Substance abuse is also widespread, as affected individuals try to combat or escape anxiety and dread.

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Possible Causes

Research into the causes of social anxiety disorder is ongoing and explores many possible origins. The disorder is inheritable, and first-degree relatives of a person with social anxiety are two to six times more likely to develop it. Environmental issues such as traumatic experiences during childhood could also lead to anxiety disorders. Researchers also suggest that hormone changes and issues with the brain’s amygdala play a role.

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Medical experts typically diagnose social anxiety disorder in patients after discussing symptoms and past experiences. They may also notice behavioral patterns that indicate the condition. For diagnosis, a healthcare provider must ensure that the patient meets specific criteria:

  • A constant and pervasive dread or fear of social situations
  • Feelings of anxiety or panic before social interactions
  • Anxiety that interferes with daily life
  • Realizing that the fears are usually excessive

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Treatment Options

People seeking treatment for social anxiety disorder have many options available to them. One of the most effective is cognitive behavioral therapy, which allows individuals to slowly become acclimated to social situations while learning techniques to manage their anxiety. Medications, such as selective serotonin reuptake inhibitors or SSRIs, can help manage more severe symptoms while the person explores therapy or other methods. Most people must spend months or years in treatment to notice permanent changes.

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Because of the difficulty of managing and treating social anxiety disorder, some healthcare providers support preventative measures. Experts developed cognitive behavioral therapy programs targeting children who are at a greater risk of developing anxiety issues. While the premise is promising, the theory needs more research to confirm the long-term effectiveness and optimal timing for intervention.

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Seeking Help

Conditions like social anxiety disorder directly interfere with daily life. One of the most beneficial things a person can do is seek help. The Anxiety and Depression Association of America found that 36% of people with social anxiety disorder wait 10 years after they first experience symptoms to visit a doctor. With treatment, the outlook for social anxiety disorder is extremely positive. Even in moments of anxiety or panic, the techniques from therapy allow a person to regain control.

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