What is Social Anxiety

People with social anxiety disorder (or social phobia) are extremely anxious about what they will say or do in front of other people. This includes public speaking and day-to-day social situations. But it is more than just being shy or nervous before public speaking. The fear can begin weeks or months before an event. It can cause a fast heartbeat and make it hard to focus.

Some people fear only one or a few types of social situations. For other people, many situations cause stress. This problem affects your daily life. You may be so stressed or afraid that you avoid public situations, including missing work and school.

What causes social anxiety disorder?

Doctors don't know what causes social anxiety disorder. They think it may run in families. But they are not sure if it's because of genetics or a response to a traumatic situation.

What are the symptoms?

Social anxiety disorder causes both emotional and physical symptoms.

It can make you nervous, sad, or easily upset before or during a social event. You may worry a lot or be afraid that something bad will happen.

The anxiety can cause you to blush, sweat, and feel shaky. Your heart may beat faster than normal, and you may have a hard time focusing.

How is social anxiety disorder diagnosed?

To diagnose social anxiety disorder, your doctor will examine you and ask about your symptoms. He or she may ask other questions to see how you are doing emotionally. This is called a mental health assessment.

Your doctor may also do blood or urine tests to rule out other conditions, such as thyroid problems that can cause similar symptoms.

How is it treated?

Treatment of social anxiety disorder includes counseling, such as cognitive-behavioral therapy, and sometimes medicine, such as antidepressants. Whether you need medicine depends on how much the problem affects your daily life. If you already feel anxious around other people, it may be hard to ask for help. But treatment for social anxiety disorder works for many people.

Some people with social anxiety disorder turn to alcohol or drugs to help them relax. This can lead to substance use disorder. They may also have depression. It is important to treat these issues too.

4 Different Women Describe Their Ongoing Struggles with Social Anxiety

“I overthink almost every word that comes out of my mouth.”


OCT 29, 2015

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If you’ve never felt unsure of yourself at a party or networking event, you officially have envy-inducing nerves of steel. Pretty much everyone feels uncomfortable at one social event or another, but for those with social anxiety disorder, the prospect of interacting with other people can be more petrifying than even the scariest horror movie. Among other symptoms, the National Institute of Mental Health describes social anxiety, also called social phobia, as overwhelming nervousness when being around other people or talking to them, feeling embarrassed or afraid of judgment even when it’s not warranted, and avoiding places where other people are likely to be. Here, four women explain the reality of living with those feelings day in and day out.

Tiffany N.

“For most of my life, my social anxiety was subtle—just enough to make me awkward at parties or terrified of addressing large audiences. Since becoming a mother, though, my anxiety in social situations has grown exponentially. I'm not the type of parent who obsesses over whether or not my children are going to be safe or on developmental targets, but I am the one standing on the sidelines of the soccer game or in the corner at a birthday party chewing my fingernails and refusing to make eye contact. I am unwilling, though, to accept my reclusive tendencies as absolute. My children need to be involved in activities, and I enjoy being busy.

"Since becoming a mother, my anxiety in social situations has grown exponentially."

"I have learned to build friendships one by one, carefully choosing those who have strengths that I do not. If I go on a group outing and I only talk to one or two other parents, I consider it a success. I almost always regret something I say or do after a social situation because I replay it in my mind more times than anyone should, but I try to have grace for myself. I’ve learned that those regrets have to be learning opportunities. If there are actual offenses or misunderstandings, I address them right away so I can allow myself to move forward. Being a mother of teens now, especially a foster mother of teens, I have seen the damage of allowing social anxiety to have too much power. There are so many unknowns and shifting paradigms in teens’ lives, especially in the foster care system, and I want to model healthy coping with the ups and downs."

Women with higher levels of social anxiety may be more accurate in identifying emotions

New research indicates that women with higher levels of social anxiety display heightened performance in a test of cognitive empathy compared to less anxious women. The study has been published in the journal Psychological Reports.

“I became interested in researching empathy and anxiety because I wanted to better understand how anxiety presents itself and what cognitive changes may occur as a result,” said lead researcher Samantha Berg of the University of Central Florida.

In the study, 701 participants completed self-report measures of social anxiety, depression, and empathy. They also completed the Reading the Mind in the Eyes Test, which an objective assessment of the ability to recognize or infer someone else’s state of mind by looking only at their eyes and surrounding areas.

The researchers found that performance on Reading the Mind in the Eyes Test was associated with the social anxiety severity in women, but not men.

“Our results suggest that women with higher levels of social anxiety may be more accurate in identifying emotions from facial expressions than are less socially anxious women,” Berg told PsyPost.

But why were similar results not found among male participants? “It is possible that we did not find this relationship in men because men assess social situations and/or experience social anxiety differently than women,” the researchers said.

“Consistent with this theory, one study found that when women, but not men, are more socially anxious, their ability to accurately identify threat-related and approval-related facial expressions was heightened.”

The study — like all research — includes some limitations.

“One major caveat is that the study was completed with an undergraduate non-clinical sample,” Berg said. “Future research should ascertain if the results of the study generalize to individuals with social anxiety disorder as well as assess participants across ages and demographics.”

“Anxiety disorders are the most common mental illness experienced in the United States,” Berg added. “Examining how anxious people differ in their experience of the world paves the way for more effective treatment interventions.”

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