Social Anxiety Disorder (SA)
People with social anxiety disorder (SA) or social phobia, have an acute fear of social situations. They are so worried that they will embarrass themselves in social settings that they avoid most social interaction altogether.
Overview
Symptoms
Diagnosis
Causes/Why Me?
Epidemiology
Treatment Approaches
What Can I Do For Myself?
Comodbidities
Youth Specific Features
Personal Stories
Summary
Infographic
People with social anxiety disorder (SA) or social phobia, have an acute fear of social situations. They are so worried that they will embarrass themselves in social settings that they avoid most social interaction altogether. When people with SA disorder do have social encounters, they are often shy about meeting new people, quiet in groups, and withdrawn in unfamiliar social settings. They want to be able to interact normally but experience serious physical and psychological discomfort when they do so. Approximately 8% of Canada’s population reported experiencing SA in their lifetime, and onset tends to be in late childhood or early adolescence.
- Sweating
- Shaking
- Difficulty focusing
- Blushing
- Nausea, upset stomach
- Avoiding eye contact
- Avoiding social situations
- Avoiding meeting new people or visiting new places
- Passive behaviour: keeping own opinions private, letting other people do what they want, avoiding to take the lead in any situation
- Speak quietly, make quick replies when spoken to
- Constant thinking about how people might perceive you
- Imagining bad outcomes from social situations (embarrassing oneself)
- Low self-esteem, high self-criticism
- Focusing on what to say, instead of what people are saying to you
- Feeling inferior to others
- Feeling depressed or sad
- Paranoia: people looking at you or thinking certain things about you
- Anxiety about doing something ‘wrong’
- Frustration or anger with yourself or other people
- Rejecting invites from friends
- Faltering friendships due to avoiding social situations
A person experiencing SA will exhibit most of the symptoms listed above .He/she will be acutely aware of the source of distress (social scrutiny, embarrassing oneself in public) and recognize that his or her fear is unreasonable. The disorder will have a significant disruptive effect on the person’s normal life, including his or her ability to form and sustain healthy relationships.
The social fear or avoidance will not be due to another psychological or physiological disorder. Social situations will cause intense anxiety or distress. SA differs from shyness in its extremeness, detrimental effect to regular functioning, and persistence throughout childhood, adolescence and adulthood.
Click here for the DSV-IV Diagnostic Criteria for Social Anxiety Disorder/Social Phobia
Genetics
Some studies suggest that SA is heritable, meaning that a person with a family history of the disorder has a higher chance of developing it.
Biological
Further research indicates that serotonin levels and an ‘overactive’ amygdala may have a significant role in the excessive reactions seen in patients with SA [Read More].
Environment
There is ongoing research in the role of life experiences in developing SA, such as the effect of authoritarian parenting, sexual abuse, negative peer relationships, an unsuccessful marriage, and different cultural values [Read More].
What is epidemiology? Epidemiology is the study of the prevalence of disease in different populations and why [Read More].
A study done on Asian Americans and White Americans showed that Asian Americans report having higher levels of stress in social situations than White Americans, suggesting that ethnicity may play a role in the development of SA [Read More].
Onset occurs typically in childhood or adolescence, usually around the age of 15, and often goes untreated for an average of 16 years [Read More]. SA is associated with lower chance of employment, reduced chance of getting married or having a successful marriage, and higher chances of social isolation and disability. Approximately 8% of Canada’s population reported experiencing SA in their lifetime. Being unmarried or from a low-income household also puts one at a higher risk of developing SA [Read More].
Cognitive Behavioural Therapy (CBT)
What is CBT? CBT is a proven-to-work treatment that focuses on learning how to perceive and approach situations that make you anxious. It focuses on the belief that your thoughts (cognitive) influence the way you act (behavioural), and works on changing the way you perceive situations and yourself in order to manage your anxiety [Read More].
Pharmacotherapy
Pharmacotherapy is the treatment of a disorder using medication. Anti-anxiety medication and antidepressants are most commonly prescribed to help treat SA [Read More].
Learn about your disorder, the causes, and treatment options! Join a self-help group or an online forum to share your experiences with others diagnosed with SA.
If you think you have SA, go see your family doctor, a psychologist or psychiatrist. Ask your family to involve themselves in your treatment program, and adhere to your doctor’s recommendations. Don’t expect an immediate improvement; give yourself time to get better!
SA disorder often occurs with major depressive disorder, other mood and anxiety disorders, and substance abuse [Read More]. It is also often prevalent in people with autism spectrum disorders such as Asperger’s syndrome. Physical disorders, which can make a person subject to negative public attention, can overlap with SA.
Adolescents with SA are often excessively fearful of social and performance situations, worrying that they may embarrass themselves and that people will think badly of them. The onset of SA in adolescence may either be as a result of a stressful experience or a slow development over time. Youth with SA may perform poorly in school, have low confidence in social situations, appear to be depressed, and have trouble making and keeping friends.
Youth may also start skipping school or abusing drugs or alcohol in order to feel more confident. SA tends to remain largely undetected in children and adolescents until it results in missing school or getting bad grades [Read More].
Youth-specific resources
TeensHealth
AnxietyBC
Anxiety and Depression Association of America: Personal Stories – Social Anxiety Disorder
People with social anxiety disorder (SA) or social phobia, have an acute fear of social situations. They are so worried that they will embarrass themselves in social settings that they avoid most social interaction altogether. When people with SA disorder do have social encounters, they are often shy about meeting new people, quiet in groups, and withdrawn in unfamiliar social settings. They want to be able to interact normally but experience serious physical and psychological discomfort when they do so. Approximately 8% of Canada’s population reported experiencing SA in their lifetime, and onset tends to be in late childhood or early adolescence. There are genetic, biological and environmental causes of SA, and the disorder is often comorbid with depression, other mood and anxiety disorders, and substance abuse. Treatment includes cognitive-behavioral therapy (CBT), and medication (most commonly anti-anxiety medication and antidepressants).
