What is social anxiety disorder?

Social anxiety disorder (SAD) is a type of anxiety disorder that causes an overwhelming fear of social situations. It is also known as social phobia. 

Many people have some type of shyness in certain situations. However, social anxiety disorder is much more extreme than that. It is an intense and ongoing fear of being negatively judged or rejected in social situations.

The symptoms of social anxiety disorder are often very strong. They have an impact on one's day-to-day functioning and quality of life. This anxiety disorder includes both mental health symptoms as well as physical symptoms.

Social anxiety disorder is one of the most common anxiety disorders. It often co-occurs with other anxiety disorders and substance use disorders. 

 

What can cause social anxiety?

Anxiety is the body's natural response to stress. In SAD, it is the presence of other people and social interactions that activate this response. 

Social anxiety disorder, or social phobia, can develop for many different reasons. It is often associated with fear or worry about what other people will think of you. Those who suffer can be very self-conscious or have low self-esteem. They try to avoid all situations that will trigger this feeling of being rejected.

It is not known what exactly causes social anxiety disorder. Scientists believe that it is a complex combination of family history, brain activity, and environmental factors. 

The disorder often begins in the teenage years. It can develop from stressful experiences such as being bullied or ridiculed in a social setting. Other known risk factors are childhood trauma, being overprotected, or lack of social skills.

Each person will have a different reason for the development of this social phobia. However, the symptoms and fears associated with this phobia are similar amongst those who suffer from it.

Part of treatment and cognitive-behavioural therapy (CBT) is making connections between the underlying cause of the social phobia. Often, exposure therapy is also included to decrease the anxiety and the intensity of the symptoms associated with it.

 

Different types of social anxiety

Social anxiety disorder is an umbrella term that describes people who suffer extreme anxiety in social situations. However, the number and type of situations and outcomes that are feared can vary greatly.

For instance, some people only fear a specific situation that involves performance tasks. They do not experience anxiety in more general social situations.

Others fear many social situations or have multiple feared outcomes.  Therefore, some scientists suggested dividing the disorder into subtypes, generalized and non-generalized SAD.

People with generalized SAD fear most or all social situations. People with non-generalized SAD fear a limited range of situations, such as public speaking.

The Diagnostic and Statistical Manual of Mental Disorders is the standard classification of mental disorders in the United States. It is published by the American Psychiatric Association.

Its fifth and most recent edition removed the generalized specifier. Also, the social anxiety disorder DSM 5 section added the performance-only specifier. This means that the fear is restricted to speaking or performing in public.

The generalized subtype is associated with greater impairment.

 

What are the symptoms of social anxiety?

People with social anxiety often fear how they will appear in social situations or what other people will think of them. This includes thoughts of being evaluated, judged, or rejected by others. 

They try to avoid social gatherings, including meetings or parties, whenever possible. When the social situation cannot be avoided, it causes them significant distress. 

During the social event, people with SAD have difficulty making eye contact and low self-esteem. They feel extremely self-conscious or awkward in front of others and tend to have negative self-talk and thoughts. 

These mental health impacts of social anxiety can be distressing. But there are also physical symptoms that result from the overwhelming anxiety. 

Some physical social anxiety disorder symptoms include: 

  • blushing
  • sweating
  • racing heart
  • dry mouth
  • nausea or upset stomach
  • trembling/shaking

It can also lead to panic attacks or anxiety attacks.

 

How long does social anxiety last?

The length of time that social anxiety disorder lasts depends on many different risk factors that each person is experiencing. Without treatment, it can sometimes last for years.

The symptoms will often be limited to the time before or after social events or interactions. If the condition gets severe enough, the anxiety and anxious thoughts can start to occur regularly.

Treatment may help to decrease the progression from isolated anxiety to anxiety that is happening daily. It can also ease the intensity of the social phobia.

 

How to treat social anxiety?

There are many different options for treating social anxiety disorder. These include:

1. Health professional:

Getting the support of a mental health professional can be extremely helpful. 

Cognitive behavioural therapy (CBT) is a form of psychotherapy, also known as talk therapy. In most people, it helps decrease the impacts of situations that provoke or induce anxiety. 

Besides improving symptoms, it can also help you to learn to improve self-consciousness, shyness and social skills. This again makes it easier to be in social situations and meet new people.

Further, it is effective for several other mental health disorders. CBT can be used as a sole treatment but is also often used alongside medication. 

Other therapy forms that are used for social phobias or social anxieties include support groups, exposure therapy, and role-playing. 

2. Treat any co-occurring disorders

The treatment for social anxiety should also include treatment for other health or mental health conditions. 

These conditions may include obsessive-compulsive disorder (OCD), panic disorder, other phobias, anxiety and anxious thoughts. They may also include depression and negative thoughts, panic attacks and panic disorder. 

These other anxiety disorders and mental illnesses can increase the symptoms associated with social anxiety. This again can make the symptoms more intense and harder to treat.

SAD on the other hand can increase the risk for drug or alcohol addiction. 

3. Pharmaceutical medications

Several types of medication have been shown to alleviate the symptoms that come with social anxiety disorder. These include beta-blockers, anti-anxiety medications, and antidepressants. 

They often seem to be most effective when they are used in conjunction with cognitive-behavioural therapy (CBT). This combination is also effective in treating other mental disorders. 

Medications such as antidepressants should always be taken with the advice of a health professional. They can have severe and unwanted side effects either short-term or long-term.

4. Natural Remedies

Some various herbal products and teas are known for their calming effects. These include passionflower, chamomile, valerian, lavender, lemon balm and others. 

Some herbs seem to work in a similar way as certain drugs. One of them is passionflower which acts on the central nervous system. It binds to the GABA receptors that relax the body. This reminds the body to slow down and allows the body and mind to relax.

All of these herbs are considered safe at recommended doses. However, check with your doctor first, especially if you are taking other medications. Some herbs might alter the effect of certain drugs when used together. 

There are also some vitamins and minerals that are thought to help with SAD, especially if you are deficient. These include magnesium, zinc, vitamin D, vitamin C, and the B complex.   

Recent research suggests that high doses of vitamin B6 can also help reduce anxiety. 

5. Self-care

Stress management and meditation: Try to decrease stress with relaxation techniques. Exercise or take a walk regularly. Focus on including things that you love in your daily life.

Build on self-confidence. This can include therapy that investigates the root cause of the anxiety. But also finding ways to cope with it such as positive self-talk.

Eat foods that nourish the nervous system. Focus on a diet high in fruits and vegetables, as well as good fats (avocado, nuts and seeds, olive oil). Limit or avoid your caffeine, alcohol, and sugar intake.

Get a good night’s sleep to help reset the nervous system. Getting enough sleep is vital for your mind and body to recover from the stress of the day. 

And lastly, create a good support system. Find people that you can talk to when things get challenging. Many people feel alone in their anxiety and this can worsen the symptoms of it.

 

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