Public Education

Social Anxiety Disorder

What is Social Anxiety Disorder?

Social Anxiety Disorder is the third largest mental health care problem in the world. Research has shown that at any given time, 7 out of every 100 people suffer from this disorder, and 13 out of a 100 people will experience it sometime during their life. Though it can start at any age, some individuals with this disorder report being very shy through their whole life, but many say the problem developed in early adolescence or in adulthood. Social anxiety is the fear and anxiety of being judged and evaluated by other people in social situations, but the person is otherwise usually fine when alone. Surprisingly, this fear is recognized as irrational and excessive by the individual, and they know that people are really not critically judging or evaluating them all the time. Yet, despite this knowledge and their best efforts, the fear of judgment and the insecure self-conscious feelings persists. Social anxiety can be divided into two types; a specific subgroup where fear is confined to speaking in front of groups only and the more common generalized subgroup, where the person is anxious, nervous, and uncomfortable in almost all social situations. Any social situation can trigger distress in a person with social anxiety such as having to say something in a public situation, meeting authority figures, being introduced to other people, being in the center of attention, being observed doing something and in even such trivial situations such as making a phone call.


Varying degrees of anxiety can occur in the feared situation such as blushing, trembling or shaking, or losing track of conversation, abdominal discomfort, dry mouth, rapid heartbeat or palpitations, tightness or pain in chest, shortness of breath, dizziness, frequent urination, difficulty swallowing and cold sweats. Typically these symptoms can appear even in anticipation of being in a social situation, causing people with social anxiety disorder going through considerable trouble to avoid these situations. As a result, those with social anxiety are often perceived as being shy and quiet, or unfriendly, aloof, and disinterested. It is of course true that varying degrees of shyness and anxiety can exist in anybody when being in a social situation. A person is said to have social anxiety disorder when these symptoms are so severe and disabling that it causes significant distress, or they interfere with the person’s schooling, work, family functioning, or social life. It is important to realize that social anxiety can occur in children. It frequently presents in a way much different from an adult, and can easily be missed. Physical complaints such as headaches and stomachaches are common in children with this disorder; and are frequently reported by the child instead of describing their anxieties. Since these children are usually quiet in school, teachers often do not recognize this disorder as the child may be viewed as just being shy but otherwise compliant. Parents on the other hand may fail to recognize their child’s symptoms, thinking that their child is always shy, and will soon outgrow this stage. Since routine social interaction is so difficult for them, these children may not develop the adequate social skills a child of their age is supposed to. This lack of social skills heightens the child’s anxiety and soon a vicious cycle develops. Many children with this disorder will eventually refuse to go to school.

Causes of Social Anxiety Disorder

As with many psychological problems, a single exact cause is unknown and it is most likely due to a combination of many factors. Genetic factors may play a role in some, but not all cases, as some individuals start life more prone to anxiety (an anxious temperament). The environment the person grows up in probably contributes somewhat as some societies and schools are better at developing social confidence and skills. Long standing stressful life situations may also have a role to play in the continuous process of social skills development. It is important to realize that people with social anxiety do want to be “normal”, have friends and be involved social interactions. It is their illness that prevents them from doing all these. Life is difficult for the person with social phobia because they feel they do not fit in with every one else. Furthermore, untreated social anxiety can lead to a myriad of other problems. High rates of alcoholism and other substance abuse are found in this group of people, which usually starts as a means to cope with their anxieties and fears, and ‘relax’. Lack of personal relationships is an obvious complication of this disorder, and they are less likely to marry than others. Family difficulties and problems in continuing with a stable employment are among the other everyday problems experienced. Children with this problem may not be able to do well academically and may not even finish school. Depression is a common but serious outcome, that unfortunately, when severe enough can lead to suicide.