Social Anxiety Disorder (also known as Social Phobia) is a highly prevalent anxiety disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Social Anxiety Disorder is characterized by marked or intense fear of social or performance-based situations where scrutiny or evaluation by others may occur. Feared situations often include:

• speaking in public 
• meeting new people
• talking with authority figures

Physical and motor symptoms associated with the disorder include blushing, trembling, sweating, and speech block, as well as many individuals with social anxiety fear that these symptoms might be observable to others. As a result, exposure to feared situations is typically accompanied by anxious anticipation, distress, and avoidance.

Social Anxiety Disorder affects a significant proportion of the general community, with a lifetime prevalence of approximately 8–13%. The disorder typically develops in childhood or adolescence, with a mean age of onset between 14 and 16 years. The development of social anxiety is influenced by a host of factors, including:

• biological vulnerabilities
• psychological vulnerabilities
• genetics 
• temperament/personality traits 
• parental styles
• peer influences

Social Anxiety Disorder impedes normal social development and is associated with significant functional impairment. Specifically, individuals with social anxiety typically avoid social, educational, and occupational situations that are perceived as threatening. This avoidance can severely hamper educational achievement, occupational performance, social interaction, relationships, and quality of life. Not surprisingly, social anxiety is associated with low self-esteem, suicidal ideation, lower education and socioeconomic status, unemployment, financial dependency, and being single. 

In addition, it is often observed that people suffering from Social Anxiety Disorder either ignore their condition or avoid dealing with it, attributing it to personality traits such as “shyness”. It needs to be pointed out that shyness is a personality trait that makes the individual feel bashfulness when he/she is in the middle of a crowded place. However, shyness and social anxiety are differentiated as follows:

• greater intensity of stress in the case of social anxiety compared to shyness
• severe physical symptoms (e.g. increased blood pressure, tendency to vomit, etc.) in the case of social anxiety as opposed to shyness
• the most common coping strategy is “avoidance” in the case of social anxiety as opposed to shyness
• people with social anxiety may not be characterized by bashfulness during personal moments but under certain circumstances when they feel they will be judged (e.g. speaking in public), as opposed to shyness

Both medication and psychotherapy are recommended for the treatment of Social Anxiety Disorder. In particular, patients with Social Anxiety Disorder often take medication such as antidepressants and anxiolytics. At the same time, psychotherapy is recommended to reduce their symptoms and in particular, Cognitive Behavioral Therapy (CBT) is considered as quite effective.

Source: https://www.sciencedirect.com/science/article/pii/S0094730X13000648

Matilda Manaroli Clinical Psychologist, MSc