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Symptoms
Social anxiety disorder is a chronic mental health condition that causes an irrational anxiety or fear of activities or situations in which you believe that others are watching you or judging you. You also fear that you'll embarrass or humiliate yourself.
Social anxiety disorder can have emotional, behavioral and physical signs and symptoms.
Emotional and behavioral signs and symptoms of social anxiety disorder include:
- Intense fear of being in situations in which you don't know people
- Fear of situations in which you may be judged
- Worrying about embarrassing or humiliating yourself
- Fear that others will notice that you look anxious
- Anxiety that disrupts your daily routine, work, school or other activities
- Avoiding doing things or speaking to people out of fear of embarrassment
- Avoiding situations where you might be the center of attention
Physical signs and symptoms of social anxiety disorder include:
- Blushing
- Profuse sweating
- Trembling or shaking
- Nausea
- Stomach upset
- Difficulty talking
- Shaky voice
- Muscle tension
- Confusion
- Palpitations
- Diarrhea
- Cold, clammy hands
- Difficulty making eye contact
You may also be affected by:
- Low self-esteem
- Trouble being assertive
- Negative self-talk
- Hypersensitivity to criticism
- Poor social skills
Worrying about having symptoms
When you have social anxiety disorder, you realize that your anxiety or fear is out of proportion to the situation. Yet you're so worried about developing social anxiety disorder symptoms that you avoid situations that may trigger them. And indeed, just worrying about having any symptoms can cause them or make them worse.
When to see a doctor
If your fears or anxieties don't really bother you, you may not need treatment. For instance, you may not like making speeches but you do so anyway without being overwhelmed by anxiety.
What sets social anxiety disorder apart from everyday nervousness is that its symptoms are much more severe and last much longer. If social anxiety disorder disrupts your life, causes you distress and affects your daily activities, call your doctor.
Common, everyday experiences that may be difficult to endure when you have social anxiety disorder include:
- Using a public restroom or telephone
- Returning items to a store
- Interacting with strangers
- Writing in front of others
- Making eye contact
- Entering a room in which people are already seated
- Ordering food in a restaurant
- Being introduced to strangers
- Initiating conversations
Social anxiety disorder symptoms can change over time. They may flare up if you're facing a lot of stress or demands. Or if you completely avoid situations that would usually make you anxious, you may not have symptoms. Although avoidance may allow you to feel better in the short term, your anxiety is likely to persist over the long term if you don't get treatment.
- Social phobia (social anxiety disorder). In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 11, 2009.
- Hollander E, et al. Social phobia (social anxiety disorder). In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed June 11, 2009
- Bruce TJ, et al. Social anxiety disorder. http://www.uptodate.com/home/index.html. Accessed June 11, 2009.
- Phobic disorders. The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec15/ch196/ch196e.html. Accessed June 11, 2009.
- Social phobia (social anxiety disorder). National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/social-phobia-social-anxiety-disorder/index.shtml#SocialPhobia. Accessed June 11, 2009.
- Feldman MD, et al. Phobias. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008: http://www.mdconsult.com/das/book/body/142893743-5/851356429/1701/448.html#4-u1.0-B978-0-323-04134-8..50019-7--subchapter28_9560. Accessed June 11, 2009.
- Abramowitz JS. Self-help cognitive-behavioral therapy with minimal therapist contact for social phobia: A controlled trial. Journal of Behavior Therapy and Experimental Psychiatry. 2009;40:98.
- Ebell MH. Diagnosis of anxiety disorders in primary care. American Family Physician. 2008;78:501.
- Whiteside SP (expert opinion). Mayo Clinic, Rochester, Minn. June 17, 2009.
