Treat social anxiety online.

Social anxiety is a chronic mental health condition characterized by fear, anxiety, and avoidance of social situations. While some social nervousness is normal, the symptoms of social anxiety are intense enough to interfere with daily routines, work, relationships, school, and other activities.¹

The symptoms of social anxiety can be expressed through emotional, physical and social signs and behaviors.²

• Emotional signs and symptoms include fear, being quiet or soft spoken, "blanking" out in your mind, trouble paying attention, low self-esteem, procrastination and challenges with completing tasks. You may be overwhelmed with thoughts and worry of being judged, making a social mistake or nervousness about an upcoming social interaction.

• Physical signs and symptoms include sweating, rapid heart beat, feeling breathless, shaking, trembling, stuttering, blushing, restlessness.

• Social signs and symptoms include anxiety or nervousness in social situations, difficulty building relationships, isolating from others, fidgeting in social situations and avoiding eye contact.

The root cause of social anxiety is not fully understood yet. Researchers have been able to identify certain parts of the brain connected to fear and anxiety. Those sections of the brain can be influenced by genetics so there is some evidence to suggest that social anxiety is hereditary. Stress and environmental factors are at play in many cases as well.³

There are risk factors to developing social anxiety including:⁴

• Family history.

• Previous negative social experiences.

• Shy or reserved temperament.

• New social demands.

• An appearance or condition that draws attention (disfigurement, stuttering, tremors, etc.)

Autism spectrum disorder (ASD) and social anxiety disorder have many overlapping symptoms. It is also possible to have an ASD diagnosis and experience social anxiety.

Overlapping symptoms of autism and social anxiety include:⁵

• Anxiety or nervousness in social situations.

• Fear.

• Difficulty building relationships.

• Isolating from others.

• Avoiding eye contact.

Symptoms exclusive or more common with autism include:

1. Confusion and sensory overwhelm in social situations.

2. Social mistakes or missing social cues.

3. “Masking” to mimic others in social settings.

4. Fidgeting both in and out of social situations.

5. Talking too loud or standing too close to another person.

Symptoms exclusive or more common with social anxiety include:

• Fidgeting in social situations, but not fidgeting outside of social settings.

• Being soft spoken or quiet.

• Sweating.

• Rapid heart beat.

• Feeling breathless.

• Shaking or trembling.

• Having social skills but having fear of using them.

• Stuttering.

• Blushing.

• “Blanking” out in their mind.

Attention deficient hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms such as difficulty with focus, hyperactivity, and impulsivity. Social anxiety is an anxiety disorder characterized by fear of social situations that can negatively impact daily life.⁶

People with ADHD are more likely than the general population to experience social anxiety. Both disorders can impact daily life with overlapping symptoms like:⁷

• Difficulty with socializing.

• Trouble paying attention.

• Restlessness and fidgeting.

• Low self-esteem.

• Challenges with completing tasks and procrastination.

• Avoidance of social situations.

The main difference between ADHD and social anxiety is the cause and thoughts behind these similar symptoms. A person with social anxiety will be overwhelmed with thoughts and worry of being judged, making a social mistake, or nervousness about an upcoming social interaction. A person with ADHD is overwhelmed with thoughts about a variety of things, not necessarily related to social situations.⁸

Both agoraphobia and social anxiety are anxiety disorders with some similar symptoms. The main difference is what triggers the fear or anxious response.

Agoraphobia is an intense fear and anxiety of places or situations that might be difficult to escape from. People with agoraphobia are often afraid to leave the house or travel. Social anxiety is a fear of being judged or embarrassed by people. People with social anxiety are prone to avoid social situations and interactions.⁹

Both avoidant personality disorder and social anxiety are characterized by a fear of being judged or embarrassed by other people. The main difference between the two conditions is awareness.

Those with social anxiety often recognize their anxious symptoms and have some level of awareness that their anxiety is inflated. Those with avoidant personality disorder may lack this insight and are more likely to believe they are worthless and that their fears are warranted.¹⁰

Shyness is a personality trait or an emotion that most people experience at certain times in their lives. Some people are naturally more reserved while some are more social. Social anxiety is a chronic mental health condition that interferes with daily functioning.¹¹

Research shows that extroverts are just as likely as introverts to experience social anxiety. Extroverts still crave energizing social interactions, but their anxiety can get in the way.¹²

Research on social anxiety has shown it is associated with extensive disability and reduced quality of life.¹³ The U.S. Social Security Administration does include anxiety disorders as a qualifying condition.¹⁴

1. Mayo Clinic

2. Mayo Clinic

3. National Institute of Mental Health

4. Mayo Clinic

5. Simply Psychology

6. Simply Psychology

7. Simply Psychology

8. Simply Psychology

9. Psych Central

10. Psych Central

11. Mayo Clinic

12. Simply Psychology

13. National Library of Medicine

14. Social Security Administration

Social anxiety, like any mental health condition, is generally not overcome quickly. It may take persistence and several treatment options. There are effective treatment options, including:¹⁵

• Cognitive behavioral therapy.

• Exposure-based cognitive behavior therapy.

• Medication.

Social anxiety can be treated with medication. Some of the most prescribed include:¹⁶

Antidepressants

• SSRIs. Citalopram (Celexa®), Paroxetine (Paxil®), Escitalopram (Lexapro®), Fluoxetine (Prozac®), Sertraline (Zoloft®).

• SNRIs. Duloxetine (Cymbalta®).

• Bupropion (Wellbutrin XL®).

Betablockers

• Propranolol (Inderal®).

Social anxiety and shyness can be chronic. However, with therapy treatment and medication it is possible to overcome.¹⁷

Cognitive behavioral therapy (CBT) is a form of psychotherapy or talk therapy. It is typically used as a short-term, skills-focused treatment to help the patient change thoughts, behavior, or both.¹⁸

Exposure therapy is a form of cognitive behavioral therapy (CBT) that introduces the feared stimulus in increasing doses. In the case of social anxiety, the exposure would be to anxiety-inducing social situations.¹⁹

The first step to improving life when you have social anxiety is to seek professional treatment.

According to research on social anxiety and friendship, those diagnosed with social anxiety felt as if their relationships were worse. Their friends, however, did not report any negative effects from social anxiety on their friendship. Ultimately, your anxiety could be lying to you.²⁰

If your social anxiety is interfering with your ability to function or form relationships at work, it is time to seek out treatment.²¹

15. Mayo Clinic

16. Mayo Clinic

17. Mayo Clinic

18. National Library of Medicine

19. Mayo Clinic

20. National Library of Medicine

21. Mayo Clinic