Social anxiety disorder, often referred to as social phobia, is one of the common mental conditions that cause strong anxieties or fears in social situations. Most affected individuals struggle to talk to others, attend social gatherings, or travel to new places. The fear of being judged or scrutinised intensifies these situations despite understanding that such concerns may be irrational. Social anxiety is different from shyness because it is persistent and severely impacts daily activities such as shopping or going to work. This blog is meant to discuss social anxiety disorder in detail, its symptoms, causes, diagnosis, and effective treatment approaches!

Symptoms of Social Anxiety Disorder

Social anxiety disorder leads to varied physical and psychological symptoms during social situations-

Physical Symptoms

Blushing
Nausea
Sweating
Trembling or shaking
Stiffness in body posture
Difficulty speaking
Mind goes blank
Dizziness or light-headedness
Rapid heart rate

Psychological Symptoms

Strong preoccupation before, during, and after social situations
Avoidance of social situations or trying to stay in the background
Fear of doing something embarrassing or self-consciousness
Fear or concern that others may notice the symptoms of stress or nervousness
Being unable to face a social situation without first having a drink
Missing work or school because of social fears

Situations in Which the Symptoms May Be Triggered

Asking questions
Job interviews
Shopping
Using public restrooms
Talking on the phone
Eating in public

Other people may have only general social anxiety, such as being anxious in most social situations. In contrast, others may experience limited or selective social anxiety in only a few particular situations, such as speaking to strangers or eating in front of others. In such severe cases, they would avoid all social settings altogether.

Causes of Social Anxiety Disorder

The cause of social anxiety disorder remains unclear; several factors appear to contribute to its development.

Biological Factors

Disruptions in brain chemicals like serotonin, dopamine, and glutamate
Abnormalities in neurotransmitter systems impacting mood regulation

Environmental Factors

Emotional, physical, or other forms of abuse
Negative interactions with peers
Over-controlling parenting styles
Insecure attachment style

Genetic Factors

Anxiety disorders can run in families, although it's still uncertain if genetics or environmental influences play a more significant role.

These factors interact in complex ways to lead to social anxiety disorder, which may also co-occur with other mental health conditions.

Diagnosis of Social Anxiety Disorder

There isn't a specific medical test available to diagnose social anxiety disorder. Typically, healthcare professionals use the criteria established in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for diagnosis. A doctor will likely inquire about the following:

Symptoms present
Family history
Other current medical conditions

DSM-5 Criteria for Diagnosing Social Anxiety Disorder

Fear of one or more social situations where the individual is exposed to possible scrutiny by others in a negative manner
Fear of acting in a way that may result in a negative evaluation by others
Specific social situations nearly always provoke fear or anxiety
Avoidance or endurance of a situation with intense fear
Persistent fear or anxiety about social situations lasting over six months
Fear and anxiety disrupt daily living
Other conditions or symptoms do not better explain the anxiety

Healthcare professionals may also rule out other conditions, such as personality disorders, substance abuse, and other health problems that present symptoms similar to social anxiety.

Treatment Options for Social Anxiety Disorder

Many effective treatment options are available to help people control their social anxiety disorder symptoms. Treatment plans may involve therapy, lifestyle changes, and medication.

Counselling and Therapy

Cognitive Behavioral Therapy (CBT)- Helps people replace negative thoughts with positive ones.
Acceptance and Commitment Therapy (ACT)- Uses mindfulness and behavioural strategies to help people live value-based lives despite negative emotions.
Group Therapy/Support Groups- Provides social skills training and practical solutions through role-playing in group settings.
Exposure Therapy- Gradually helps people face social situations under professional guidance.

Medications

Selective Serotonin Reuptake Inhibitors (SSRIs)- Paroxetine (Paxil), Sertraline (Zoloft)
Selective Norepinephrine Reuptake Inhibitors (SNRIs)- Venlafaxine (Effexor)
Propranolol- A short-acting medication to be used as needed

Medications may take several weeks to become fully effective, and a doctor will likely start a patient on a low dose and slowly adjust it. If one medication does not work, an alternative may be suggested.

Impact and Complications

Social anxiety disorder can significantly impact various aspects of life. Without treatment, individuals may face challenges such as -

Poor performance at work or in studies
Reduced social interaction and strained relationships
Low self-esteem
Poor quality of life

Up to 90% of people with social anxiety disorder also have other mental health conditions, such as -

Depression
Alcohol misuse
Suicidal thoughts or attempts

A combination of therapy, medications, and lifestyle changes can improve the quality of life for those affected.

Conclusion

Social anxiety disorder triggers overwhelming fear and anxiety in social situations, often leading individuals to avoid socialising, working, or participating in everyday activities. The persistent concern of being judged or offending others can severely disrupt daily life. However, effective treatments, including therapy and medication, can significantly reduce symptoms and improve overall life quality.

Reference Link-

https://www.healthline.com/health/anxiety/social-phobia
https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561