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Definition

Social anxiety disorder is the intense fear of social situations. People with social anxiety disorder:

  • Avoid interactions with other people
  • Are extremely afraid of being judged negatively by others
  • Feel humiliated, embarrassed, and inadequate more easily than others

Social anxiety may be:

  • Generalized to all social interactions
  • Specific to certain social situations, such as public speaking

Social anxiety disorder is much more severe than shyness. It can interfere with work, school, or other situations, as well as cause physical symptoms.

Physical Reactions of Anxiety

Physical reaction anxiety

© 2011 Nucleus Medical Media, Inc.

Causes

The exact cause is unknown. Possible causes include:

  • Genetic factors
  • Problems with the regulation of chemicals in the brain
  • Past emotional trauma in social situations
Risk Factors

Social Anxiety Disorder is most common in adolescence and early adulthood. Factors that increase your chance for social anxiety disorder include:

Symptoms

Symptoms may begin in any public situation such as:

  • Being teased or criticized
  • Being the center of attention
  • Meeting new people
  • Interacting with authority figures
  • Interacting with members of the opposite sex
  • Eating, writing, or speaking in public
  • Using public toilets

Symptoms during these social interactions may include:

  • Blushing
  • Excessive sweating
  • Trembling
  • Dry throat and mouth
  • Muscle twitches
  • Intense anxiety
  • Rapid heart beat
  • Lightheadness (feeling like you are going to faint)
Diagnosis

Your doctor will ask about your fears and symptoms. A physical exam may be done. You may be referred to a mental health therapist. The therapist may do a psychiatric evaluation.

Treatment

Treatments may include:

Cognitive-Behavioral Therapy

During cognitive-behavioral therapy , the therapist may:

  • Help you change your negative thought patterns and behaviors
  • Teach you techniques to help you control anxiety symptoms (eg, deep breathing, visualization, meditation )
  • Suggest changes to your social environment to minimize stress
  • Gradually expose you to feared situations in a controlled environment

A support group may also be part of your treatment.

Medication

Your doctor may recommend:

  • Selective serotonin reuptake inhibitors (SSRIs) or other antidepressants—to help relieve symptoms of anxiety and depression
  • Beta-blockers—to stop the physical symptoms of panic and anxiety (has been used to relieve the performance anxiety that often occurs with social anxiety disorder)

Your doctor may try using other medicines to help control your symptoms. Examples include:

  • Benzodiazepines
  • Anticonvulsants
Prevention

There are no guidelines for preventing social anxiety disorder. But early diagnosis and treatment can prevent complications, such as:

  • Drug abuse
  • Depression
  • Difficulties at school, work, or in your personal life

RESOURCES:

Anxiety Disorders Association of America
http://www.adaa.org/

Social Phobia/Social Anxiety Association
http://www.socialphobia.org/

CANADIAN RESOURCES:

Canadian Psychiatric Association
http://www.cpa-apc.org/

Canadian Psychological Association
http://www.cpa.ca/

References:

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Published May 22, 2009. Accessed August 27, 2012.

National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/. Accessed October 12, 2005.

National Mental Health Association website. Available at: http://www.nmha.org/. Accessed October 12, 2005.

Social anxiety disorder. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-usUpdated October 29, 2013. Accessed November 26, 2013



Last reviewed December 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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