Social Anxiety Disorder : Causes, Symptoms and more

Social Anxiety Disorder : Causes and Symptoms

social anxiety disorder (SAD)

Also known as social phobia , is an anxiety condition marked by feelings of fear and anxiety in social situations, producing significant suffering and impairing capacity to function in at least some elements of everyday life.

Other people’s inspection, whether perceived or real, might cause these worries. People who suffer from social anxiety disorder are afraid of receiving unfavorable feedback from others.

Excessive flushing, sweating, trembling, palpitations, and nausea are common physical symptoms. There may be stammering as well as quick speaking.

Panic attacks can also happen as a result of extreme fear and discomfort. Some people who suffer from social anxiety may use alcohol or other medications to help them overcome their worries and inhibitions.

Social phobia sufferers frequently self-medicate in this way, especially if they are undiagnosed, untreated, or both; this can develop to alcoholism, eating disorders, or other types of drug abuse.

SAD is frequently referred to as a “lost-opportunity sickness,” in which “individuals make key life decisions to accommodate their condition.”

The key diagnostic criteria for social phobia, according to ICD-10 guidelines, are a fear of being the center of attention, a fear of being judged

To test for social anxiety disorder and assess the intensity of anxiety, standardized rating measures can be utilized.

  • Cognitive behavioral therapy is the primary line of treatment for social anxiety disorder (CBT).
  • SSRIs, particularly paroxetine, are effective treatments for social phobia.
  • a secondary source is required] CBT, whether provided individually or in a group context, is beneficial in treating this disease.
  • The cognitive and behavioral components aim to transform anxiety-inducing events’ thinking patterns and bodily reactions.

Since 1999, when medications to treat social anxiety disorder were approved and marketed, there has been a huge rise in the amount of attention paid to it. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors are commonly prescribed (MAOIs).

Social anxiety that also known as social anxiety disorder (SAD) or  social phobia, is a mental health illness marked by an overwhelming and incapacitating fear of social settings.

These emotions are felt on an emotional, bodily, and cognitive level, producing significant discomfort and maybe social avoidance.

People who suffer from SAD are fearful of being assessed poorly by others, which can cause shame, self-consciousness, and even sadness.

While it’s natural to feel anxious in new or unfamiliar settings, you may be suffering from SAD if your concerns linger, create severe misery, and limit your life. It usually manifests in shy persons during their adolescence.

SAD can have an impact on job, school, and other daily activities, as well as making it difficult to establish and retain friends.

Social anxiety is the second most prevalent anxiety condition, affecting over 15 million individuals in the United States. 2 In a 12-month period, about 7% of the general population in the United States will acquire some type of social anxiety disorder, and some studies suggest that the lifetime prevalence rate for developing SAD is 13 percent to 14 percent.

What is the source of social anxiety?

Despite the fact that you may feel that you’re the only one who suffers from social anxiety, it’s actually extremely common.
Many individuals are afraid of these things. However, the circumstances that set off the symptoms of social anxiety disorder might vary.
In most social situations, some people suffer nervousness. Others associate anxiety with certain social circumstances, such as conversing with strangers, mixing with strangers at parties, or performing in front of an audience. 

The following are some of the most common social anxiety triggers:

  • Making new friends
  • Getting into small talk
  • Speaking in front of an audience
  • Being the focus of attention when doing anything, such as performing on stage
  • Being ridiculed or chastised
  • Speaking with “powerful” or “authoritative” individuals
  • Calling on you in class
  • Having a date
  • In a meeting, speaking up
  • Making use of public restrooms
  • Exam preparation
  • Having a meal or a drink in public
  • Using the telephone
  • Getting together with friends at parties or other social occasions

Specific and broad social anxiety are the two categories of social anxiety.

The dread of speaking in front of groups is an example of particular or performance-only social anxiety, whereas persons with generalized social anxiety feel worried, apprehensive, and uncomfortable in a range of social contexts.

People with social anxiety are far more likely to have a generalized form of the illness.

A broad kind of social anxiety may be the reason when anticipatory anxiety, concern, uncertainty, melancholy, shame, feelings of inadequacy, and self-blame are present in most life circumstances.

Having social anxiety symptoms does not always imply that you have an anxiety condition.However, if these symptoms cause persistent emotional discomfort or impair daily routines, they may indicate social anxiety disorder.

When a person with SAD is presented with social settings such as making a speech, playing a sport, or performing in a performance, physical symptoms might occur.

This occurs because the perceived threat of the social environment has triggered their fight-or-flight stress response into overdrive.
When forced to perform in front of or be among others, people with SAD may feel the following symptoms: 

  • Blushing 
  • sweating
  • Nausea with trembling
  • A fast heartbeat
  • Having a stiff body posture
  • having minimal eye contact
  •  or speaking in a quiet voice

Social anxiety disorder emotional indicators and symptoms include:

In regular social interactions, excessive self-consciousness and Anxiety that lasts for days, weeks, or even months before a social event Extreme apprehension of being observed or evaluated by others, particularly strangers Fear that you’ll do anything that would shame or humiliate you Fear that people will see how nervous you are

You don’t have social anxiety disorder or social phobia just because you become uneasy in social situations on occasion.

Many people experience shyness or self-consciousness from time to time, but it does not interfere with their daily lives. 
On the other side, social anxiety disorder disrupts your daily routine and creates significant suffering.
For example, getting the jitters before making a speech is quite natural. 
If you have social anxiety, though, you may fret for weeks ahead of time, call in ill to avoid giving the speech, or start trembling so badly that you can hardly talk.


Social Anxiety Disorder : Causes and Symptoms
Social Anxiety Disorder : Causes and Symptoms

SAD’s psychological symptoms may go unnoticed by others, yet they are significant and can ruin a person’s life. The following are some of the symptoms:

  • Social encounters are avoided wherever possible.
  • Anxiety that is both excessive and unjustified
  • Fear of being judged and rejected is really high.
  • Self-consciousness at an all-time high
  • Having a want to communicate with people yet finding it difficult and frightening to do so

Risk Factors and Causes

Although the actual origin of SAD is unknown, a number of variables increase a person’s probability of acquiring social anxiety:

Biological markers: Brain imaging of persons with SAD indicate increased blood flow to the amygdala (a component of the limbic system responsible for fear).
The brain stem (which regulates pulse rate and respiration), the prefrontal cortex (which assesses risk and danger), and the motor cortex are all implicated in anxiety (controls your muscles).

Factors of genetic origin: 

There is a strong genetic propensity to developing social anxiety disorder, as with all anxiety disorders.

  • Environment: By seeing authoritative figures and peer groups, unhealthy coping techniques (such as conflict avoidance) and nervous emotions or behaviors can be taught.
  • Physical traits that stand out as odd in comparison to the surrounding social norm might contribute to social anxiety.
  • Excessive inhibitions of new activities, people, places, or things might be an indication of SAD in its early stages. 
  • When meeting new people, this is frequently manifested as great shyness or sobbing. 
  • Any substantial life events, whether favorable or bad, might be an underlying cause for SAD.


There are various varieties of social anxiety disorder, according to the National Social Anxiety Center:
The focus of par uresis, or shy bladder syndrome, is on what others might think if they were unable to start the flow of pee.
When interacting with strangers or acquaintances, conversational anxiety causes you to have erroneous and negative beliefs about what others think.
Male sexual performance anxiety is a vicious cycle in which concern over performing sexual activities leads to excessive self-monitoring and self-evaluation during sexual encounters, which can lead to erection or orgasm failure.
Glossophobia, or fear of public speaking, is one of the most common phobias, affecting over 73 percent of the population.
Internalized societal stigmas concerning the LGBTQ community, as well as being bullied or shunned, can cause anxiety.


Helping a person establish healthier cognitive patterns and coping methods, as well as other psychosocial changes, are some of the treatment approaches available. They can also be used to treat and alleviate the symptoms of social anxiety disorder.


Anxiety-specific cognitive behavior therapy (CBT), a kind of psychotherapy that teaches better ways of thinking, behaving, and reacting to events, has been proven in several studies to cause beneficial changes in brain areas involved in emotion processing and regulation.


In the near term, medications can help manage the symptoms of social anxiety. Medication alone, however, will not provide long-term advantages for patients with SAD if it is not used in combination with an active, organized CBT programmed.

The following medications may be used to treat SAD:

Anti-anxiety drugs include: Benzodiazepines such as Valium (diazepam), Xanax (alprazolam), Klonopin (clonazepam), and Ativan are among them (lorazepam)Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors are two types of antidepressants (SNRIs).
These drugs take several weeks to start working, but studies have showed that 50 percent to 80 percent of individuals with the typical type of social anxiety disorder react after eight to twelve weeks of using venlafaxine or an SSRI.
Beta-blockers: They’re utilized to aid with anxiety’s physical symptoms, particularly performance-related social worries.

Tags: mental disorders, Psychiatric illness

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