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Social Anxiety - Causes, Symptoms, & Treatments

Updated on December 25, 2013
Feeling isolated from everyone else
Feeling isolated from everyone else | Source

My Social Anxiety

During grade school, I was a very shy child. I had good friends, but I was very quiet around people I didn't know. However, at age 11, something changed. If I said a joke, it was always bad. If I made a mistake, it was always life changing. If I said the wrong thing, it would ruin my reputation forever. I was a social loser. Everybody seemed to understood some basic idea that had somehow slipped past me. I was inferior, and nothing I tried could change it. It was terrible, but I thought that this would be my life.

What I was too young to understand then was that I wasn't lacking some basic skill. My entire perception of the world had become warped to the point that my reality was no longer true. Unfortunately, it wasn't until the end of my junior year of high school that I realized this flaw in my thinking. The world wasn't rejecting me; I was rejecting myself. I finally realized that I didn't have a blank spot in my brain where social skills go; I had social anxiety.

A Definition of Social Anxiety

Social anxiety is defined as a type of anxiety disorder characterized by shyness and heightened self-consciousness in particular social situations. These feared social situations can be specific or general. Even if the level of anxiety felt is recognized as extreme by the sufferer, it can still be difficult to overcome. Because of the isolated feelings resulting from the anxiety, many people also fall into a depression. Social anxiety can even result in substance abuse in an attempt to reduce fear in social situations.



It appears that many people have a genetic predisposition to developing social anxiety. If you have a close family member with social anxiety, you are two to three times as likely to develop social anxiety yourself.

Family Environment

In addition to genetic correlations, it is believed that the environment that a child grows up in has a significant effect upon the likelihood of developing social anxiety. The way in which parents raise children can also have a significant impact upon development of anxiety. Extremely protective parents, as well as extremely critical ones, can greatly increase the chances of their children developing this disorder.


For many people who suffer from social anxiety, they can identify a specific event as a trigger for their anxiety, myself included. This can be either an embarrassing event for the sufferer, or the hearing of another's experience that can serve as this psychological turning point. Also, social awkwardness or bullying during adolescence can trigger social anxiety.

Social anxiety and depression often go hand-in-hand.
Social anxiety and depression often go hand-in-hand. | Source



The key psychological characteristic of someone with social anxiety involves a poor self image. When preparing for some sort of social event, sufferers focus on all of the different ways that the situation could go wrong and attempt to prepare for those possibilities. In many cases, this fear can result in a slight mistake being made, which can then result in a positive feedback loop.

In addition to the anxiety experienced before and during the social situation, people with social anxiety often interpret the results of the event as catastrophic. Negative experiences are amplified, neutral experiences are misinterpreted, and positive experiences are undervalued.


There are also some very direct physical symptoms of social anxiety. These include sweating, shaking, increased heart rate, blushing, and nausea. The fear experienced during social situations results in a fight-or-flight response, causing these symptoms to appear. As with the psychological symptoms, these can result in a positive reinforcement loop and cause an even stronger amount of fear. In some cases, this can become so severe that a panic attack is triggered.


People with social anxiety obviously want to avoid the discomfort it causes. As a result, many compulsively try to avoid or escape situations with social interaction. These events can range from the specific situations of social anxiety, or the complete avoidance of any interpersonal interactions.

Other Disorders and Addictions

Because of the difficulty from social anxiety, many sufferers attempt to address this disorder through the use alcohol and other drugs. It is actually fairly common for people with social anxiety to turn to these substances as a means of escape, or as a way to allow easier social interaction. Depression is also very common among social anxiety sufferers.

A man, free and smiling
A man, free and smiling | Source



The most common form of therapy for social anxiety is cognitive behavioral therapy. This typically involves the patient being shown some sort of situation that would normally result in anxiety for them. The therapist then guides the patient through the situation and helps point out all of the inaccuracies in the patient's perception. This provides a way of proving the fears to be incorrect. In addition to this, the patient is taught anxiety management techniques and how to analyze their own thought processes. After social situations, the patient is taught to break down what happened, logically analyze the conclusions they drew, and reevaluate any thought processes that resulted in their skewed perception.

In recent years, new online and published resources have been developed to allow independent treatment of anxiety disorders, including social anxiety. Group therapy sessions are also used because of their ability to provide acceptance for group members, as well as provide an opportunity to practice social interaction with other patients.

The other method less widely used involves exposure. Through gradual and structured exposure to social fears, the patient eventually gains a tolerance to those fears and increases the breadth of their social abilities. However, due to the extreme discomfort of this method, many patients quit before completion. This is a major reason why cognitive behavioral therapy is used instead.


The most common medicinal treatments are selective serotonin reuptake inhibitors (SSRIs). These antidepressants have proven to be very effective at helping sufferers of social anxiety. SSRIs are more widely used than other medications due to their effectiveness, decreased risk of tolerance, and decreased risk of dependence.

Another somewhat common treatment of social anxiety are benzodiazepines. These drugs are typically used for short-term treatment of social anxiety and help provide temporary relief from its stresses. Because of its greater risk of tolerance, dependency, and abuse; they are typically a last resort medication.

Social anxiety is an unusual beast. Due to its more recent acceptance by the medical community, people are only beginning to learn about its manifestations and treatments. As time goes on, more widespread diagnosis for this disorder should help to free many more people from its grasp. I have social anxiety, but it isn't all that I am. I'm a son, a brother, a friend, and a student. I want to live a happy and successful life, and I will overcome my social anxiety to do so. And so can you.

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