It is a persistent fear of doing something embarrassing or humiliating in social situations and performance situations which interferes with both personal and professional lives. People with the disorder have a persistent, intense and chronic fear of being scrutinized by others, in particular that people will judge them and think poorly of them. Another common fear is being embarrassed or humiliated by their own actions.

Although it is common for many people to experience some anxiety before or during a public appearance, anxiety levels in people with social anxiety disorder can become so high that they begin to avoid social situations. They often worry for days or weeks in advance of a dreaded situation. Normal social anxiety is not disabling, it settles quickly during or after the event, and it does not begin weeks before the event.

For some individuals with social anxiety disorder, their fear may be selective, e.g. writing in front of others, and are comfortable in other social and performance situations. Others may have several fears and experience anxiety at a variety of social situations in which their performance might be observed. 

Individuals with the disorder are acutely aware of the physical signs of their anxiety. This fear often results in extreme anxiety in anticipation of an activity, a panic attack when faced with an activity, or in the avoidance of an activity altogether. Individuals usually recognize that their fears are unfounded or excessive, but suffer them nonetheless.

Symptoms

Symptoms of social anxiety disorder manifest themselves physically and can include:

• Blushing
• Palpitations
• Sweating
• Nausea or discomfort in the abdomen

Other symptoms of anxiety are also often readily visible; difficulty talking, stammering, shaking and trembling, and may be sufficiently severe to induce a panic attack. These visible symptoms heighten their fear of disapproval in social settings and the symptoms themselves can become an additional focus of fear. Fear of symptoms can create a vicious cycle: as people with social anxiety disorder worry about experiencing the symptoms, the greater their chances of developing the symptoms. 

What happens? Consequences 

People use ‘safety behaviours’ as a means of coping, for instance, keeping quiet so as not to offend anyone and reduce the risk of scrutiny and judgement they fear. Situations that they find difficult are avoided or are endured with great distress.

For others the disorder can be very debilitating, interfering with a person’s ability to form and maintain close relationships, or they cope by confining their contacts to a number of safe people. It can interfere with occupational achievement where people turn down chances to advance their careers.

How common is Social Anxiety Disorder?

Social Anxiety Disorder is very common, affecting both men and women equally. More than one out of eight people will suffer from the disorder at some point in their lives. The onset is most common in mid-teens, but can occur at any time. 

What Causes Social Anxiety Disorder?

The exact causes are not fully understood, research to define the causes is ongoing. However, several things are believed to contribute to the problem:

• Genetics
• Prior experience
• Biological factors
• Negative thinking