Social Anxiety

Social anxiety disorder, also called social phobia, is an anxiety disorder in which a person has an excessive and unreasonable fear of social situations. Anxiety and self-consciousness arise from a fear of being closely watched, judged, and criticized by others.
This fear may be made worse by a lack of social skills or experience in social situations.
The anxiety can build into a panic attack.
As a result of the fear, the person endures certain social situations in extreme distress or may avoid them altogether.
People with social anxiety disorder often suffer “anticipatory” anxiety — the fear of a situation before it even happens — for days or weeks before the event.

Situations and Symptoms:

People with social anxiety disorder may be afraid of a specific situation, such as speaking in public. However, most people with social anxiety disorder fear more than one social situation. Other situations that commonly provoke anxiety include:

* Eating or drinking in front of others.
* Writing or working in front of others.
* Being the center of attention.
* Interacting with people, including dating or going to parties.
* Asking questions or giving reports in groups.
* Using public toilets.
* Talking on the telephone.

Symptoms of social anxiety disorder can include:
* Intense anxiety in social situations.
* Avoidance of social situations.
* Physical symptoms of anxiety, including confusion, pounding heart, sweating, shaking, blushing, muscle tension, upset stomach, and diarrhea.

How Common Is Social Anxiety Disorder?

Social anxiety disorder is the most common anxiety disorder and the third most common mental disorder in the U.S., after depression and alcohol dependence.
An estimated 19.2 million Americans have social anxiety disorder. The disorder most often surfaces in adolescence or early adulthood, but can occur at any time, including early childhood.
It is more common in women than in men.

How Is Social Anxiety Disorder Treated?

The most effective treatment currently available is cognitive-behavior therapy (CBT). Medication may also be used to help ease the symptoms of social anxiety disorder so that CBT is more effective.
The goal of CBT is to guide the person’s thoughts in a more rational direction and help the person stop avoiding situations that once caused anxiety. It teaches people to react differently to the situations that trigger their anxiety symptoms.
Counseling to improve self-esteem and social skills, as well as relaxation techniques, such as deep breathing, may also help a person deal with social anxiety disorder.
There are several different types of medications used to treat social anxiety disorder, including: antidepressants, tranquilizers (benzodiazepines), and beta-blockers (often used to treat heart conditions, may also be used to minimize certain physical symptoms of anxiety, such as shaking and rapid heartbeat).

Why is treatment important?

Without treatment, social anxiety disorder can negatively interfere with the person’s normal daily routine, including school, work, social activities, and relationships, causing avoidance and withdrawl.
The anxiety seldom goes away on its own, causing the anxiety to build until the person avoids social situations and becomes depressed.

What is the prognosis for people with this disorder?

With treatment, the prognosis is generally quite good. Many people overcome it and enjoy productive lives.

This handout was created by Dominique Samuels, PsyD. Much of the information was taken from
To contact Dr. Samuels, please call 415.358.4906 or email her at

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