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by Scholten A
(Social Phobia)

Definition

Social anxiety disorder is intense fear of social situations. It can lead to avoiding other people or situations.

Physical Reactions of Anxiety
Physical reaction anxiety
© 2011 Nucleus Medical Media, Inc.

Causes

The exact cause is unknown. Possible causes are:

  • Genetics
  • Painful social experiences

Risk Factors

Social anxiety disorder often starts in teens and young adults. It is more common in women than in men. Other things that may raise the risk are:

  • Family history of anxiety or mood disorders
  • Other mental health problems, such as: anxiety , bipolar disorder , depression , or substance abuse
  • Being single, separated, or widowed
  • Childhood stress
  • Parenting that is too protective or harsh
  • Long term illness
  • Nervousness in new situations

Symptoms

Symptoms are intense fear of being judged by others. They may happen when a person is:

  • The center of attention
  • Meeting new people
  • Talking to authorities—such as bosses, teachers, or policemen
  • Talking to the opposite sex
  • Eating, writing, or speaking in public
  • Using public toilets

Physical symptoms of anxiety occur, such as:

  • Blushing
  • Sweating
  • Trembling or twitching
  • Dry throat and mouth
  • Fast heartbeat or lightheadedness

Diagnosis

The doctor will ask about your fears and symptoms. A physical exam may be done. You may need to see a mental health specialist. A mental health assessment may be done.

Treatment

The goal is to ease symptoms. Other mental health problems may also need to be treated. Options may be:

  • Cognitive-behavioral therapy —to change negative thoughts and behaviors
  • Relaxation skills—such as deep breathing and meditation
  • A support group
  • Lifestyle changes—such as healthy eating, daily exercise, and avoiding substances
  • Medicines, such as:
    • SSRIs, SNRIs, or other antidepressants—to ease symptoms of anxiety and depression
    • Benzodiazepines—to calm the nervous system
    • Some nerve and seizure medicines

Prevention

There are no guidelines to prevent social anxiety disorder.

RESOURCES

Anxiety and Depression Association of America  https://adaa.org 

Mental Health America  http://www.mentalhealthamerica.net 

CANADIAN RESOURCES

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

Canadian Psychological Association  https://cpa.ca 

References

Leichsenring F, Leweke F. Social anxiety disorder. N Engl J Med. 2017;376(23):2255-2264.

Social anxiety disorder. Anxiety and Depression Association of America website. Available at: https://adaa.org/understanding-anxiety/social-anxiety-disorder. Accessed March 9, 2021.

Social anxiety disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/social-anxiety-disorder . Accessed March 9, 2021.

Social phobia. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/social-phobia. Accessed March 9, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrian Preda, MD
  • Review Date: 01/2021
  • Update Date: 00/30/2021