Social Anxiety Disorder Symptoms

Social anxiety disorder, also known as social phobia, is an intense fear of becoming extremely anxious and possibly humiliated in social situations — specifically of embarrassing yourself in front of other people.

A person who suffers from social anxiety tends to think that other people are far better at public speaking, or hanging out in a social situation and mingling with others at a party. The person tends to focus on every little small mistake they do in a social situation, and exaggerate them out of proportion.

Simply blushing may seem painfully embarrassing to a person with a social phobia, and they may feel as though all eyes are focused on them.

Some people with social anxiety have specific fears, such as public speaking or needing to talk to their boss about a concern at work. Other times, the fears may be more generalized — such as a fear of any social situation whatsoever, especially those involving strangers.

Some people confuse shyness with social anxiety.

In some rare instances, social anxiety may involve a fear of using a public restroom, eating out, or talking on the phone when others are present.

Social anxiety disorder is not shyness, although sometimes people mistake the two. While shy people may be uneasy around others, they generally don’t experience the same kinds of extreme anxiety someone with a social phobia does. Additionally, shy people generally do not engage in the extreme avoidance of social situations that a person with social anxiety does.

People with social anxiety may not be shy at all. They can be completely at ease with people most of the time, but particular situations, such as walking down an aisle in public or making a speech, can give them intense anxiety.

Social phobia disrupts normal life, interfering with career or social relationships. For example, a worker can turn down a job promotion because he can’t give public presentations. The dread of a social event can begin weeks in advance, and symptoms can be quite debilitating.

Most people with social phobia are well aware that their feelings are extreme and irrational. Still, they experience a great deal of dread before facing the feared situation, and they may go out of their way to avoid it. Even if they manage to confront what they fear, they usually feel very anxious beforehand and are intensely uncomfortable throughout. Afterwards, the unpleasant feelings may linger, as they worry about how they may have been judged or what others may have thought or observed about them.

Specific Symptoms of Social Anxiety

Social anxiety disorder is characterized by the presence of all of the following symptoms:

• A significant and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.
• According to DSM-5, a diagnosis can also be given if the fear occurs exclusively in the context of social performance situations.
• Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally-bound or situationally-predisposed panic attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.
• The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
• The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
• The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
• In individuals under age 18 years, the duration is at least 6 months.
• The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder.
• If a general medical condition or another mental disorder is present, the fear in the first criteria is unrelated to it, e.g., the fear is not of stuttering, trembling in Parkinson’s disease, or exhibiting abnormal eating behavior in anorexia nervosa or bulimia nervosa.

Related Information:

• Social Anxiety Overview
• Social Anxiety Disorder Treatment
• Psychotherapy for Anxiety Disorders
• Frequently Asked Questions about Social Anxiety Disorder

Criteria has been adapted for DSM-5