Table of ContentsView AllTable of ContentsWhat Is Social Anxiety Disorder?What Causes Social Anxiety?Symptoms of Social AnxietyDiagnosing Clinical Social AnxietyTreating Social AnxietySelf-Help StrategiesWork and SchoolSocial Skills
Table of ContentsView All
View All
Table of Contents
What Is Social Anxiety Disorder?
What Causes Social Anxiety?
Symptoms of Social Anxiety
Diagnosing Clinical Social Anxiety
Treating Social Anxiety
Self-Help Strategies
Work and School
Social Skills
Close
Social anxiety disorder(SAD) is a common but under-diagnosed mental health condition experienced across different age groups and cultures. If you or someone you know has been diagnosed with SAD or you think you may be experiencing symptoms of the disorder, learning more about what to expect can help.
People with social anxiety disorder have an irrational fear of being watched, judged, or of embarrassing or humiliating themselves. The anxiety and discomfort become so extreme that it interferes with daily functioning. While it can be a debilitating disorder, appropriate treatment recovery is possible.
SAD (not to be confused with seasonal affective disorder) is one of the most commonmental disorders, with up to 13% of the general population experiencing symptoms at some point in their life.
Social anxiety disorder usually begins in the teenage years althoughit may start in childhood.While the exact cause of SAD is unknown, it is believed to result from a combination of both genetic and environmental factors.
Imbalances in brain chemistry have been linked to SAD. For example, an imbalance in the neurotransmitter serotonin, a brain chemical that regulates mood and emotions, may play a role in the development of social anxiety disorder.
Over-activity of a structure in the brain called theamygdalahas also been linked to social anxiety.People with SAD may be predisposed to an exaggerated fear response and, in turn, increased anxiety.
Several environmental factors may also increase your risk of developing SAD. These include but are not limited to:
What Causes Social Anxiety Disorder?
People with social anxiety disorder know that their fear is out of proportion to the actual situation, but they are still unable to control their anxiety. The anxiety may be specific to one type of social or performance situation, or it may occur in all situations.
Some of the situations that are common triggers include interacting with strangers, makingeye contact, and initiatingconversations. People with social anxiety disorder may experience cognitive, physical, and behavioral symptoms before, during, and after these social and performance situations.
Examples of cognitive symptoms:
Examples of physical symptoms:
Examples of behavioral symptoms:
Symptoms of SAD
SAD is generally diagnosed through a clinical interview with a mental health professional in which one is asked a number of questions related to their symptoms.
In order to receive a diagnosis, a person must meet a number ofspecific diagnostic criteria. Fear must also be so severe that it significantly impedes daily life, schoolwork, jobs, relationships, or one experiences serious distress about their symptoms.
Depending on whether symptoms are experienced in only a few situations or in most areas of life, one may be diagnosed with either generalized or specific SAD. The best first step if you have symptoms associated with SAD is to make an appointment with a therapist or mental health professional via a phone call or email.
Social Anxiety Disorder Discussion GuideGet our printable guide to help you ask the right questions at your next doctor’s appointment.Download PDFSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide to help you ask the right questions at your next doctor’s appointment.
Download PDF
Sign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Sign Up
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
The most commonly used evidence-basedtreatments for social anxiety disorderare medication and cognitive-behavioral therapy (CBT). Often these two forms of treatment are used together for best results. In addition to CBT, there are a number of other types of therapy that may be used, either in an individual or group format
Medications used to treat SAD:
Talk therapies used in the treatment of SAD:
In addition to medication and therapy, technology-assisted interventions for SAD include Internet delivered CBT, virtual reality exposure therapy, and cognitive bias modifications. Some people also use alternative treatments such as dietary supplements or hypnotherapy. In general, research evidence does not yet exist to support the use of alternative treatments for SAD.
If you or a loved one are struggling with anxiety, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are struggling with anxiety, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
For more mental health resources, see ourNational Helpline Database.
Get Support With the 7 Best Online Anxiety Support Groups
Self-help strategies for social anxiety disorder can be useful as an add-on to traditional treatment or for relieving mild symptoms. Examples of strategies include the following:
While self-help strategies are never a replacement for traditional treatment, they may help you to feel more in control of your symptoms.
Best Self-Help Strategies for Social Anxiety Disorder
Social anxiety disorder can have an effect on your ability to attend school and work at a job. Starting in a new place, making friends, giving presentations, eating with others—these and other aspects of school and work are all triggers for those with social anxiety.
If you have been diagnosed with SAD, you can apply foraccommodations at your workplaceor college. If you have a child diagnosed with SAD, communication with teachers and support staff will be important to ensure that your child’s needs are being met.
If SAD prevents you from working, you can also apply forsocial assistance. There are many support options in place to help those with mental health issues. If you aren’t sure where to start, asking your mental health professional is a good way to go.
Improving your social skills is an important component of social anxiety disorder treatment. Various aspects of social skills may be impaired in those with SAD, mostly because you’ve never had a chance to practice.
In general, you will want to work on improving communication skills—whether that means learning how to make small talk or understanding others’body languagebetter.
If You’re Recently Diagnosed With Social Anxiety Disorder
Slow down and take a breath. Although a diagnosis of SAD may feel scary, it is the best first step toward improving your situation. You will probably receive medication, therapy, or a combination of both to treat the disorder.You may also be eligible for more support if you attend school or work.
Living With Social Anxiety Disorder
In addition to receiving professional treatment, you can do a number of things to help cope with SAD. Some of these include practicing relaxation exercises, getting enough sleep, and eating a well-balanced diet.
It is important not to avoid situations that make you anxious. While avoidance may reduce your anxiety in the short-term, it will make things worse long term. If you find yourself feeling anxious, it may help to remind yourself that you can get through the situation, that your anxiety is usually short-lived, and that your worst fears are not likely to come true.
Remember that feeling anxious and nervous is not a sign of weakness or inferiority. SAD is a medical condition that requires attention. If left untreated, it can lead to other health problems such as substance abuse or risk of depression. However, with proper treatment and ongoing care, your quality of life can be much improved.
Next Steps to ConsiderIf you’re unsure whether you or someone you love is experiencing social anxiety disorder, it’s best to make an appointment with a doctor. This will put you on the path toward diagnosis, treatment, and living your life more fully. You may even find that down the road you can serve as an advocate for others in the same situation as you.
Next Steps to Consider
If you’re unsure whether you or someone you love is experiencing social anxiety disorder, it’s best to make an appointment with a doctor. This will put you on the path toward diagnosis, treatment, and living your life more fully. You may even find that down the road you can serve as an advocate for others in the same situation as you.
Although this may feel like a frightening journey you have embarked upon, learning more about social anxiety disorder and finding treatment can be the first step toward lessening the impact that it has on your life. It’s okay to feel afraid to take that first step—take a deep breath and know that you are making the right decision.
10 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health.Social Anxiety Disorder: More Than Just Shyness.Harvard Medical School.Treating social anxiety disorder. March 2010.Yuan, M., Zhu, H., Qiu, C.et al.Group cognitive behavioral therapy modulates the resting-state functional connectivity of amygdala-related network in patients with generalized social anxiety disorder.BMC Psychiatry.2016;(16):198. doi:10.1186/s12888-016-0904-8Affrunti NW, Ginsburg GS.Maternal overcontrol and child anxiety: the mediating role of perceived competence.Child Psychiatry Hum Dev. 2012;(43)1:102-12. doi:10.1007/s10578-011-0248-zRegier DA, Kuhl EA, Kupfer DJ.The DSM-5: Classification and criteria changes.World Psychiatry. 2013;(12)2:92-8. doi:10.1002/wps.20050Leichsenring F, Leweke F.Social anxiety disorder. Solomon CG, ed.N Engl J Med. 2017;376(23):2255-2264. doi:10.1056/NEJMcp1614701Stangier U, Schramm E, Heidenreich T, Berger M, Clark DM.Cognitive therapy vs interpersonal psychotherapy in social anxiety disorder: a randomized controlled trial.Arch Gen Psychiatry. 2011;(68)7:692-700. doi:10.1001/archgenpsychiatry.2011.67Kampmann IL, Emmelkamp PMG, Morina N.Meta-analysis of technology-assisted interventions for social anxiety disorder.Journal of Anxiety Disorders. 2016;42:71-84. doi:10.1016/j.janxdis.2016.06.007Anxiety and Depression Association of America.ADAA online support group.Himle JA, Weaver A, Bybee D, et al.Employment barriers, skills, and aspirations among unemployed job seekers with and without social anxiety disorder.Psychiatr Serv. 2014;(65)7:924-30. doi:10.1176/appi.ps.201300201Additional ReadingHales, R.E., & Yudofsky, S.C. (Eds.). The American psychiatry publishing textbook of clinical psychiatry. Washington, DC: American Psychiatric. Updated 2003.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Illnesses, 5th edition.2013.Rosenthal J, Jacobs L, Marcus M, Katzman M. Beyond shy: When to suspect social anxiety disorder. The Journal of Family Practice. 2007; 56: 369-374.
10 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health.Social Anxiety Disorder: More Than Just Shyness.Harvard Medical School.Treating social anxiety disorder. March 2010.Yuan, M., Zhu, H., Qiu, C.et al.Group cognitive behavioral therapy modulates the resting-state functional connectivity of amygdala-related network in patients with generalized social anxiety disorder.BMC Psychiatry.2016;(16):198. doi:10.1186/s12888-016-0904-8Affrunti NW, Ginsburg GS.Maternal overcontrol and child anxiety: the mediating role of perceived competence.Child Psychiatry Hum Dev. 2012;(43)1:102-12. doi:10.1007/s10578-011-0248-zRegier DA, Kuhl EA, Kupfer DJ.The DSM-5: Classification and criteria changes.World Psychiatry. 2013;(12)2:92-8. doi:10.1002/wps.20050Leichsenring F, Leweke F.Social anxiety disorder. Solomon CG, ed.N Engl J Med. 2017;376(23):2255-2264. doi:10.1056/NEJMcp1614701Stangier U, Schramm E, Heidenreich T, Berger M, Clark DM.Cognitive therapy vs interpersonal psychotherapy in social anxiety disorder: a randomized controlled trial.Arch Gen Psychiatry. 2011;(68)7:692-700. doi:10.1001/archgenpsychiatry.2011.67Kampmann IL, Emmelkamp PMG, Morina N.Meta-analysis of technology-assisted interventions for social anxiety disorder.Journal of Anxiety Disorders. 2016;42:71-84. doi:10.1016/j.janxdis.2016.06.007Anxiety and Depression Association of America.ADAA online support group.Himle JA, Weaver A, Bybee D, et al.Employment barriers, skills, and aspirations among unemployed job seekers with and without social anxiety disorder.Psychiatr Serv. 2014;(65)7:924-30. doi:10.1176/appi.ps.201300201Additional ReadingHales, R.E., & Yudofsky, S.C. (Eds.). The American psychiatry publishing textbook of clinical psychiatry. Washington, DC: American Psychiatric. Updated 2003.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Illnesses, 5th edition.2013.Rosenthal J, Jacobs L, Marcus M, Katzman M. Beyond shy: When to suspect social anxiety disorder. The Journal of Family Practice. 2007; 56: 369-374.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institutes of Health.Social Anxiety Disorder: More Than Just Shyness.Harvard Medical School.Treating social anxiety disorder. March 2010.Yuan, M., Zhu, H., Qiu, C.et al.Group cognitive behavioral therapy modulates the resting-state functional connectivity of amygdala-related network in patients with generalized social anxiety disorder.BMC Psychiatry.2016;(16):198. doi:10.1186/s12888-016-0904-8Affrunti NW, Ginsburg GS.Maternal overcontrol and child anxiety: the mediating role of perceived competence.Child Psychiatry Hum Dev. 2012;(43)1:102-12. doi:10.1007/s10578-011-0248-zRegier DA, Kuhl EA, Kupfer DJ.The DSM-5: Classification and criteria changes.World Psychiatry. 2013;(12)2:92-8. doi:10.1002/wps.20050Leichsenring F, Leweke F.Social anxiety disorder. Solomon CG, ed.N Engl J Med. 2017;376(23):2255-2264. doi:10.1056/NEJMcp1614701Stangier U, Schramm E, Heidenreich T, Berger M, Clark DM.Cognitive therapy vs interpersonal psychotherapy in social anxiety disorder: a randomized controlled trial.Arch Gen Psychiatry. 2011;(68)7:692-700. doi:10.1001/archgenpsychiatry.2011.67Kampmann IL, Emmelkamp PMG, Morina N.Meta-analysis of technology-assisted interventions for social anxiety disorder.Journal of Anxiety Disorders. 2016;42:71-84. doi:10.1016/j.janxdis.2016.06.007Anxiety and Depression Association of America.ADAA online support group.Himle JA, Weaver A, Bybee D, et al.Employment barriers, skills, and aspirations among unemployed job seekers with and without social anxiety disorder.Psychiatr Serv. 2014;(65)7:924-30. doi:10.1176/appi.ps.201300201
National Institutes of Health.Social Anxiety Disorder: More Than Just Shyness.
Harvard Medical School.Treating social anxiety disorder. March 2010.
Yuan, M., Zhu, H., Qiu, C.et al.Group cognitive behavioral therapy modulates the resting-state functional connectivity of amygdala-related network in patients with generalized social anxiety disorder.BMC Psychiatry.2016;(16):198. doi:10.1186/s12888-016-0904-8
Affrunti NW, Ginsburg GS.Maternal overcontrol and child anxiety: the mediating role of perceived competence.Child Psychiatry Hum Dev. 2012;(43)1:102-12. doi:10.1007/s10578-011-0248-z
Regier DA, Kuhl EA, Kupfer DJ.The DSM-5: Classification and criteria changes.World Psychiatry. 2013;(12)2:92-8. doi:10.1002/wps.20050
Leichsenring F, Leweke F.Social anxiety disorder. Solomon CG, ed.N Engl J Med. 2017;376(23):2255-2264. doi:10.1056/NEJMcp1614701
Stangier U, Schramm E, Heidenreich T, Berger M, Clark DM.Cognitive therapy vs interpersonal psychotherapy in social anxiety disorder: a randomized controlled trial.Arch Gen Psychiatry. 2011;(68)7:692-700. doi:10.1001/archgenpsychiatry.2011.67
Kampmann IL, Emmelkamp PMG, Morina N.Meta-analysis of technology-assisted interventions for social anxiety disorder.Journal of Anxiety Disorders. 2016;42:71-84. doi:10.1016/j.janxdis.2016.06.007
Anxiety and Depression Association of America.ADAA online support group.
Himle JA, Weaver A, Bybee D, et al.Employment barriers, skills, and aspirations among unemployed job seekers with and without social anxiety disorder.Psychiatr Serv. 2014;(65)7:924-30. doi:10.1176/appi.ps.201300201
Hales, R.E., & Yudofsky, S.C. (Eds.). The American psychiatry publishing textbook of clinical psychiatry. Washington, DC: American Psychiatric. Updated 2003.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Illnesses, 5th edition.2013.Rosenthal J, Jacobs L, Marcus M, Katzman M. Beyond shy: When to suspect social anxiety disorder. The Journal of Family Practice. 2007; 56: 369-374.
Hales, R.E., & Yudofsky, S.C. (Eds.). The American psychiatry publishing textbook of clinical psychiatry. Washington, DC: American Psychiatric. Updated 2003.
Meet Our Review Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?HelpfulReport an ErrorOtherSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?HelpfulReport an ErrorOtherSubmit
What is your feedback?
