Social anxiety disorder is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as at parties and other social events.
People with social anxiety disorder fear and avoid situations in which they may be judged by others. It may begin in the teens and may have to do with overprotective parents or limited social opportunities. Men and women are affected equally with this disorder.
People with social phobia are at high risk for alcohol or other drug use. This is because they may come to rely on these substances to relax in social situations.
People with social anxiety become very anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.
Some of the most common fears of people with this disorder include:
Physical symptoms that often occur include:
Social anxiety disorder is different from shyness. Shy people are able to participate in social functions. Social anxiety disorder affects the ability to function in work and relationships.
Exams and Tests
The health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends.
The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of your fears.
Behavioral treatment is often tried first and may have long-lasting benefits:
Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider.
Medicines called sedatives (or hypnotics) may also be prescribed.
Lifestyle changes may help reduce how often the attacks occur.
You can ease the stress of having social anxiety by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.
Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition.
Resources for more information include:
Anxiety and Depression Association of America: www.adaa.org
National Institute of Mental Health: www.nimh.nih.gov/health/publications/social-phobia-social-anxiety-disorder-always-embarrassed/index.shtml
The outcome is often good with treatment. Antidepressant medicines can also be effective.
Alcohol or other drug use may occur with social anxiety disorder. Loneliness and social isolation may occur.
When to Contact a Medical Professional
Call your provider if fear is affecting your work and relationships with others.
Phobia – social; Anxiety disorder – social; Social phobia; SAD – social anxiety disorder
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.
Calkins AW, Bui E, Taylor CT, Pollack MH, LeBeau RT, Simon NM. Anxiety disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 32.
Schneier FR, Bruce LC, Heimberg RG. Social anxiety disorder (social phobia). In: Gabbard GO, ed. Gabbard’s Treatments of Psychiatric Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2014:chap 18.