Social Anxiety Disorder
Social anxiety disorder, also called social phobia, is more than shyness. It’s an intense fear that doesn’t go away.
Social anxiety disorder is a long-lasting and overwhelming fear of social situations.
It usually starts during the teenage years. For some, it gets better as they get older. For many, it doesn’t go away on its own.
It can be very distressing and have a big impact on your life. But there are ways to help you deal with it.
Symptoms of social anxiety
Social anxiety is more than shyness. It’s an intense fear that doesn’t go away.
It can affect your:
- everyday activities
- work or school life
Many people worry about social situations from time-to-time. Someone with social anxiety feels very worried before, during and after them.
You may have social anxiety if you:
- dread meeting strangers, starting conversations, speaking on the phone, working or shopping
- avoid or worry a lot about social activities – group conversations, eating with company, and parties
- always worry about doing something you think is embarrassing – blushing, sweating or appearing incompetent
- find it difficult to do things when others are watching
- fear criticism, avoid eye contact or have low self-esteem
- often have symptoms such as feeling sick, sweating, trembling or heart palpitations
- have panic attacks
Many people with social anxiety also have other mental health issues, such as:
- generalised anxiety disorder
- body dysmorphic disorder
DSM-IV diagnostic criteria9,100
A. A marked 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 interactions with adults.
B. 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.
C. The person recognises that the fear is excessive or unreasonable. Note: in children, this feature may be absent.
D. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
E. 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.
F. In individuals under age 18 years, the duration is at least 6 months.
G. 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 (e.g., panic disorder with or without agoraphobia, separation anxiety, body dysmorphic disorder, a pervasive developmental disorder, or schizoid personality disorder).
H. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it, e.g. the fear is not of stuttering, trembling in Parkinson’s disease, or exhibiting abnormal eating behaviour in anorexia nervosa.