Everyone's felt nervous in social situations before—whether it's on a first date or giving a presentation at work or at school—it's perfectly normal to feel butterflies in your stomach. But when this social nervousness causes an intense fear of judgment, self-consciousness, or embarrassment, and it begins to interfere with your daily routine, you may have social anxiety disorder (SAD or social phobia).
SAD (not to be confused with seasonal affective disorder) is the second most commonly diagnosed anxiety disorder, a chronic mental condition, affecting approximately 15 million American adults. The onset of SAD usually occurs during the teenage years and comes from the fear of being judged or scrutinized. Without treatment, social anxiety disorder can last for years or even a lifetime and prevent an individual from reaching his or her full potential.
People with SAD are intensely afraid of appearing anxious, stupid, awkward, or boring to others, to the point that they might alter their patterns or schedule to avoid social situations. If they cannot avoid a situation, they may experience extreme anxiety and distress.
For example, an individual with SAD may worry about a social event for weeks and even months leading up to it, losing sleep, and potentially experiencing physical reactions of anxiety.
Let's take a moment to again recognize that feelings of shyness and discomfort in certain social settings are normal. SAD occurs when intense fear, anxiety, and avoidance of social situations start to interfere with daily life.
Social anxiety disorder typically starts during the teen years but can be triggered by new social or work demands like giving a speech in public or making an important work presentation.
Diagnosing social anxiety disorder requires speaking with a mental health professional, who will do a screening and in-depth interview.
Initial screenings include the "Mini-Social Phobia Inventory" (Mini-SPIN), where the doctor will ask you to fill out a questionnaire. Your answers on the questionnaire will give you a score, and a high score may be indicative of SAD. However, only a licensed professional can diagnose after a full interview.
While screenings can be helpful in identifying possible problems, a diagnosis must be conducted by a mental health professional. Treatment is usually in the form of psychotherapy ("talk therapy"), medication, or both.
Social phobia can last for years or for a lifetime if untreated. Because it impacts how people go about their daily lives at work or school, the avoidance and fear of social situations will eventually prevent people from reaching their full potential or even enjoying life.
Depression and other mental health disorders often occur with social anxiety disorder.
We've seen that genetic and environmental factors may cause someone to develop social anxiety, but mindful and active steps to reduce symptoms can create progress:
Ultimately, early professional diagnosis and treatment are best for alleviating social anxiety disorder. An individual will see the results if they embrace the treatment with commitment and receive encouragement from loved ones.
Dr. Ho Anh
Chief Medical Officer at Cerebral