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Social Anxiety Disorder: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Oct 31, 2023

Social Anxiety Disorder: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

It is acceptable to have anxiety in some social situations. You might get butterflies in your stomach before a presentation or a date, for example. However, social anxiety disorder, also known as social phobia, causes severe worry, self-consciousness, and humiliation about routine contact because it fears being closely examined or negatively judged by others.

Avoidance in social anxiety disorder is brought on by fear and worry, and it can have a detrimental effect on your life. Abnormally high levels of stress can disrupt relationships, everyday routines, work, school, and other endeavours.

While social anxiety disorder can be a chronic mental health problem, you can improve your social skills and self-esteem by learning coping mechanisms in psychotherapy and taking medication for it.

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Causes Of Social Anxiety Disorder

Like many other mental health disorders, social anxiety disorder most likely stems from a complex interaction between biological and environmental factors. Among the causes are:

  • Traits that are inherited. Anxiety disorders run in families. However, it's unknown how much of this could be inherited and how much could be learned behaviour.
  • Brain structure. One area of the brain that might be important in controlling the fear response is the amygdala. People who have an overactive amygdala may feel more anxious in social situations because they are more fearful.

Symptoms Of Social Anxiety Disorder

Shyness or unease in certain situations is not necessarily a sign of social anxiety disorder, especially in young individuals. Depending on their personality traits and life experiences, people have varying degrees of ease in social situations. Some people are quieter by nature, while others are more social.

In contrast to typical anxiety, social anxiety disorder is typified by concern, anxiety, and avoidance that obstruct relationships, day-to-day activities, employment, education, and other pursuits. Though it typically first manifests in the early to mid-teens, social anxiety disorder can occasionally affect adults or younger children at younger ages.

Signs of behaviour and emotions

One of the telltale indications and symptoms of social anxiety disorder is constant.

  • Fear of being perceived unfavourably in a situation
  • Fear of seeming foolish or embarrassing oneself
  • Extreme trepidation while interacting or speaking with strangers
  • Fear that others will see you're anxious
  • Fear of humiliating bodily signs, such as blushing, sweating, trembling, or shaking when speaking; avoidance of social situations or activities because of embarrassment fears
  • Avoid situations where you could be the centre of attention. Anxiety that comes on before a scary task or occasion. 
  • Following a social situation, an assessment of your performance and a search for areas where your interactions need improvement
  • fear of the worst after an unfavourable social situation encounter
  • To show that they are afraid of interacting with adults or their classmates, children may cry, throw temper tantrums, cling to their parents, or keep quiet in social situations.

You might not experience significant anxiety or panic in other, more relaxed social situations, but you might in public speaking or performing situations. 

Also read: Absence Seizures: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Signs throughout the body

The following physical signs and symptoms may occasionally accompany social anxiety disorder:

  • Blue, erratic heartbeat
  • Trembling
  • Sweating stomach discomfort or queasy feeling
  • Being unable to breathe
  • Dizziness or lightheadedness, or the impression that nothing is bothering you
  • Tense body parts
  • Avoid conventional social situations.

It may be difficult to deal with common, everyday situations if you have social anxiety disorder, such as:

  • Getting along with strangers or individuals you don't know well
  • Going to social events or parties
  • Travelling to work or study
  • Having discussions
  • Establishing eye contact
  • Courting
  • Walking into a room where people are seated
  • Replacing goods in a retailer
  • Eating in public view of others
  • Utilising a public lavatory

If you're dealing with a lot of expectations, stress, or changes in your life, they can get worse. If you don't get therapy, your anxiety is likely to worsen over time even though avoiding anxious circumstances may temporarily improve your symptoms.

If you suffer from social anxiety disorder, it could be challenging to handle typical, daily circumstances like:

  • Getting along with new people or those you don't know well
  • Attending social gatherings or parties
  • Travelling for work or school
  • Having conversations and making eye contact
  • Entering a room where people are seated and courting them
  • changing products in a store while eating in front of other people and using a public loo

Over time, social anxiety disorder symptoms may change. Things may worsen if you're juggling a lot of demands, stress, or life changes. Avoiding stressful situations may momentarily relieve your symptoms, but if you don't undergo therapy, your anxiety is likely to get worse over time.

Risk Factors Of Social Anxiety Disorder

The following factors may increase a person's risk of developing social anxiety disorder:

  • Family history: Your chances of developing social anxiety disorder are increased if any of your siblings or biological parents have the condition.
  • Unpleasant experiences: A child's likelihood of developing social anxiety disorder may increase if they experience bullying, teasing, rejection, ridicule, or embarrassment. Furthermore, other negative life experiences like abuse, trauma, or family strife may be connected to this illness.
  • Defining traits: Children who display shyness, timidity, withdrawal, or restraint in the presence of strangers or odd circumstances may be particularly vulnerable.
  • New standards in the workplace or society: Adolescence is the typical time that symptoms of social anxiety disorder emerge, although they can also show up for the first time when someone meets new people, gives a speech in front of a crowd, or presents a big piece of work.
  • Possessing a visible disease or physical characteristic: For example, Parkinson's disease-related tremors, stuttering, or facial abnormalities may increase social anxiety in certain individuals by making them feel more self-conscious.

Diagnosis Of Social Anxiety Disorder

If you have social anxiety disorder in addition to another medical illness or mental health concern, or if other conditions might be the cause of your concern, your doctor will want to know.

Your healthcare provider may diagnose you based on:

  • Physical check to rule out any medical conditions or medications that can make anxiety feelings worse
  • Discuss your symptoms, how often they occur, and the situations that give rise to them.
  • See if any of the situations on the list make you nervous.

Self-report questionnaires about the criteria for social anxiety symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association. These include:

  • Persistent, intense fear or anxiety in specific social situations brought on by the concern that you'll be mistreated, ashamed, or denigrated Avoiding or going through social events that cause you to feel fearful or anxious
  • Excessive worry is inappropriate for the situation
  • Your daily tasks are being hindered by anxiety or worry
  • Anxiety or panic that is not sufficiently explained by drug abuse, a medical condition, or a prescribed medication

Also Read:

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Treatment Of Social Anxiety Disorder

Your treatment plan will be based on how much your social anxiety disorder interferes with your daily life. The most common treatments for social anxiety disorder are pharmacological intervention, sometimes referred to as talk therapy, psychological counselling, or psychotherapy in combination.


Psychotherapy lessens symptoms for most people with social anxiety disorder. In the course of treatment, you will discover techniques to help you recognise and change self-defeating thoughts as well as develop social confidence.

Cognitive behavioural therapy (CBT) is the most effective type of psychotherapy for anxiety, and it is effective both in groups and one-on-one.

Through exposure-based cognitive behavioural therapy, you gradually gain confidence in facing your greatest anxieties. This can make you more skilled at handling and provide you with the confidence you need to deal with stressful situations. You can also engage in role-playing or skills training to improve your social skills and gain comfort and confidence in your interactions with others. Exposing yourself to social situations is particularly helpful if you want to face your concerns.

First choices of drugs

Despite the availability of many different types of medications, selective serotonin reuptake inhibitors (SSRIs) are often the first class of drugs used for persistent symptoms of social anxiety. 

Effexor XR, or ventlafaxine, is a serotonin and norepinephrine reuptake inhibitor (SNRI) that may be used to treat social anxiety disorder.

To reduce the possibility of adverse effects, your doctor might start you on a low dose of your medication and gradually increase it to the full amount. Before your symptoms start to improve, treatment could take a few weeks to many months.

Extra Medications

Your doctor may also suggest other medications to address the symptoms of social anxiety, such as:

  • Other antidepressants: You may need to try a few different kinds of antidepressants before deciding on the one that works best for you and has the fewest negative effects.
  • Drugs that lessen anxiety: Benzodiazepines (ben-zoe-die-AZ-uh-peens) may help you feel less worried. Though their onset of action is often swift, they can be sedating and habit-forming. They are typically recommended for brief periods only.
  • Beta-blockers: The mechanism of action of these medications is to block the stimulating effects of adrenaline (epinephrine). They may reduce pounding in the heart, blood pressure, pulse rate, and shaking in the speech and limbs. Consequently, their effectiveness may be greatest when applied in moderation to treat symptoms for a particular situation, such as giving a speech. Generally, using them to treat social anxiety disorder is not encouraged.

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Prevention Of Social Anxiety Disorder

If you already suffer from anxiety, there are things you can do to minimise the severity of your symptoms, even if it is impossible to predict what will cause someone to develop worry:

  • Get help as soon as possible: Similar to numerous other mental health concerns, anxiety might become more challenging to handle if treatment is postponed.
  • Maintain a journal: By keeping a journal of your daily life, you and your mental health physician can identify what tends to help you feel better and what stresses you out.
  • Establish what matters most in your life: You may relax by making thoughtful decisions about how to spend your time and energy. Make sure you are doing things that you enjoy doing.
  • Avoid using dangerous substances: Drugs, alcohol, caffeine, or nicotine usage can cause anxiety or exacerbate it. If you are unable to stop these things on your own, speak with your doctor, look for a treatment plan, or join a support group.

Also Read: Narcissistic Personality Disorder: Causes, Symptoms, Diagnosis, Treatment, Prevention and Complications

Complications Of Social Anxiety Disorder

If social anxiety disorder is not treated, it can take control of your life. Anxiety can lead to issues with relationships, the job, the classroom, and just enjoying life in general. This disease could lead to:

  • Low self-esteem
  • Lack of self-control
  • Adverse self-talk
  • Intolerance for criticism
  • Poor social skills
  • difficult social relationships and loneliness
  • Poor performance in the classroom and at employment drug abuse, particularly binge drinking
  • Attempting or committing suicide
  • Major depressive illness, substance abuse problems, and other anxiety disorders are among the few mental health conditions that commonly coexist with social anxiety disorder.

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