Social anxiety — the nervousness that one experiences when in social situations, especially unfamiliar ones — is a normal part of life. However, when social anxiety becomes severe, persistent, and interferes with your life then it is possible that you may have developed a social anxiety disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, American Psychological Association, 2000), Social Anxiety Disorder (SAD), or Social Phobia, is “a marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others. The individual feels that he/she will act in a way (or show anxiety symptoms such as blushing or sweating) that will be humiliating or embarrassing”. Often this experience is accompanied by shame or guilt, which further contributes to feelings of anxiety.
The fear of being embarrassed, judged, rejected or even simply observed drives SAD sufferers to avoid such situations. Thus, SAD can lead to isolation and depression. Likewise, the significant distress that one might feel in social situations may lead to substance use/ abuse as a way to quell the anxiety in order to function socially.
There are two recognized subtypes of SAD: 1) A generalized subtype where anxiety manifests itself in most social situations; and 2) A specific subtype where the anxiety is limited to certain performance situations such as a giving a speech or performing on stage.
Decades of research have shown that SAD is very prevalent with up to 12% of adults developing SAD in their lifetime (Kessler et al., 2005). SAD often develops during childhood and adolescence (APA, 2000). Extreme shyness, avoidance and fear of new experiences are early indicators that a child may develop social phobia. The risk factors contributing to the development of SAD are multifaceted and may include: 1) genetic factors — social anxiety disorder tends to run in families; and studies show that children who later became socially anxious showed temperamental signs of behavioral inhibition very early on (Essex et al., 2010); 2) family environmental factors — e.g., if you have a parent that is socially anxious/avoidant or overprotective, you may learn to avoid social situations as well; and 3) significant life experiences — being bullied or teased may also contribute to the development of social anxiety (Stein & Stein, 2008).
In summary, social anxiety is very common. However, when the feelings of social anxiety become severe, intolerable, and interferes with your life, then it may be considered a social anxiety disorder. The good news is there are comprehensive treatments available that can lead to reductions in social anxiety. A first step is considering some of your personal reasons for working on your social anxiety and start making a plan for change.
References
- American Psychiatric Association (APA, 2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: APA.
- Essex, M. J., Klein, M. H., Slattery, M. J., Goldsmith, H. H., Kalin, N. H. (2010). Early Risk Factors and Developmental Pathways to Chronic High Inhibition and Social Anxiety Disorder in Adolescence. American Journal of Psychiatry, 167, 40-46.
- Kessler R. C., Berglund P., Demler O., Jin R., Merikangas K. R., & Walters E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.
- Stein, M. B., & Stein, D. J. (2008). Social Anxiety Disorder. Lancet, 371, 1115-25.
For more information on the link between Alcohol Use and Social Anxiety Disorder, see: http://pubs.niaaa.nih.gov/publications/arh26-2/130-135.htm