Social anxiety disorder (also called social phobia) is a type of anxiety disorder characterised by extreme anxiety and fear in social situations. The person is afraid that others will judge them negatively or that they will embarrass themselves, and they may feel intense worry about what others think of them. This fear and anxiety leads to avoidance of social situations, impairs their performance at school/work, and impacts their relationships with others. Even thinking about the feared social situation may cause physical symptoms of anxiety, such as increased heart rate and nausea. This anxiety may stop them from participating in activities they used to enjoy, lead to them to isolate themselves from others, and cause very low self-esteem. Most people with social anxiety disorder know that this fear is irrational but they feel they have no control over it.
Social anxiety disorder can be caused by a mix of biological, psychological, and environmental factors. Risk factors include a family history of anxiety disorders, experiencing a stressful or traumatic event, or experiencing stress over a prolonged period of time. Those with certain personality characteristics, such as being shy, are also more at risk of developing social anxiety disorder.
- Fear or anxiety about social or performance situations.
- Worry about embarrassing or humiliating yourself, and/or fear of being judged negatively.
- Exposure to feared situation causes anxiety, and may cause a panic attack.
- Fear is excessive or out of proportion to the situation.
- Feared situations are avoided or endured with intense anxiety and distress.
- Avoidance and/or anxiety in social situations interferes with daily routine, functioning at work/ school, relationships, etc.
- Anxiety in anticipation of the feared activity or situation.
- Overthinking and analysing your performance after a social interaction or situation.
- This fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.
- Blushing
- Shaking, trembling
- Dizziness
- Difficulty concentrating
- Feeling your mind has gone blank.
- Sweating
- Upset stomach or nausea
- Increased heart rate
- Trouble catching your breath
- Increased muscle aches or soreness
There are effective treatments for social anxiety disorder. The type of treatment will depend on the specific symptoms and the impact social anxiety is having on daily functioning. The two main treatment approaches are psychological therapy and medication.
Psychological Therapy:
Cognitive behavioural therapy (CBT) is the recommended treatment for social anxiety disorder. CBT is a structured form of talk therapy which combines cognitive and behaviour therapies. Through CBT the client learns to recognise and change negative thoughts, and they learn skills to reduce anxiety in social situations. CBT to treat social anxiety disorder may include social skills training, cognitive restructuring, and exposure therapy.
Medication:
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed to treat social anxiety disorder. Beta blockers may also be prescribed to reduce the physical symptoms of anxiety. Ideally, medications are used in combination with talk therapy.
Other Ways to Manage Social Anxiety Disorder:
Lifestyle changes can be helpful in reducing anxiety and stress. These include regular exercise, getting enough sleep, eating a healthy diet, limiting caffeine and alcohol, and staying connected with others.
The Australian Centre for Clinical Intervention (CCI) has a collection of information sheets, worksheets, and self help resources to help you learn more about social anxiety disorder and how to manage the condition.
The Health Navigator website provides one place for New Zealanders to find reliable and trustworthy health information and self-care resources.
This website provides useful information on social anxiety, including symptoms, causes and different treatments. You will also be able to find other helpful resources and online courses to help cope with your social anxiety.
Extreme social anxiety and shyness can be crippling but they are readily treated using Cognitive Behavioural Therapy (CBT).
In this fully revised and updated edition, Dr Gillian Butler provides a practical, easy-to-use self-help course which will be invaluable for those suffering from all degrees of social anxiety.
Essential Strategies for Social Anxiety provides you with an effective toolbox to face your fears and feel confident whether you're having a conversation, interviewing for a job, or speaking publicly. Drawing on a variety of practices-like CBT, ACT, and mindfulness-this guide not only teaches you all about social anxiety but also helps you employ actionable techniques to transform it.
The Solution to Social Anxiety provides dozens of clinically proven techniques that will help you on your journey to overcome social anxiety. In this book, Dr. Aziz will guide you along the path towards greater confidence in yourself - you will discover what is keeping you stuck in shyness and learn exactly what to do in order to break free.
In this TEDx video, Dr. Fallon Goodman discusses social anxiety and social anxiety disorder. She provides an evolutionary perspective on social anxiety and discusses why it is that people develop a fear of social rejection. She addresses some of the myths around social anxiety disorders and emphasises how the disorder can look different in different people. This talk concludes with some advice on how we can address social anxiety, and a look at why it can be hard to manage social anxiety in our modern world.
This Osmosis video provides an overview of social anxiety disorder. It discusses the causes, DSM-5 criteria, symptoms, diagnosis, treatment, and pathology of social anxiety disorder, as well as the difference between normal social anxiety and a social anxiety disorder.