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Social Phobia vs. Social Anxiety Disorder

Updated on September 25, 2012
People with social anxiety disorder or social phobia can feel alone even in the most lovely places.
People with social anxiety disorder or social phobia can feel alone even in the most lovely places. | Source

What is Social Anxiety Disorder?

Social phobia and social anxiety disorder are basically the same condition with different names. They fall under the heading of mental health problems. While extremely life altering and frustrating at times, this disorder is relatively curable.

The identifying components of this type of disorder is the paralyzing fear and/or avoidance that usually characterize episodes. People with social phobias often fail to enjoy a normal lifestyle because they spend their time avoiding situations that frighten and might embarrass them.

While these anxiety disorders are not as severe as something like schizophrenia or other more crippling mental disorders, SAD or social phobia disorder can be debilitating for its suffers simply because it takes away being able to interact freely in life situations. In short, it limits one's possibilities.

What Causes Social Anxiety Disorders?

Social phobias have many different faces. Someone with stage fright for instance is termed to have a social anxiety disorder or social phobia.

Someone who has a fear of speaking in front of people they don't know has the same disorder.

Yet someone who has a fear of using a public bathroom or eating in a restaurant is experiencing the same thing only with a specific set of circumstances.

Social phobias arise sometimes from an incident that went badly in a person's past. For instance, this author has a terrible performance anxiety reaction with playing the piano in front of people--whether it's people I don't know or people near and dear to me. The only person I can comfortably play in front of is my husband Bob.

It also turns out this author had the same reaction when trying to read one of her Hubpages articles in front of a group of authors a year ago. I had never experienced this kind of anxiety reaction before in my life but do tend to get a little frightened when I have to stand up and speak in front of people. This time it was just an over-the-top kind of experience.

In my case, I think these reactions have their origins back in my recital days as a child. My mother is a very accomplished musician and music teacher and I was expected to always do well. I usually did but the anxiety that it created is still something I deal with and work to overcome.

These examples show how one type of anxiety can spill over into another realm entirely--(which actually was extremely disappointing since it made me aware that I had another thing I needed to work on.) But in thinking about it thoroughly, it does boil down to the same anxiety situation--performing in front of other people.

In other people's cases, anxiety disorders develop for whatever reasons. The anxiety is actually a chemical reaction that sets off adrenalin in the body. It's much like a fight or flight response in nature. Once someone has a particularly volatile anxiety reaction, it can develop into a trigger that recurs over and over in similar situations if not treated.

Social phobias can be as varied as fear of flying, fear of public speaking, going to the bathroom in public restrooms, eating in a restaurant, performing in front of an audience, going to parties, meeting new people, joining activities or just standing up in a group and introducing yourself.

Causes and Risk Factors

  • Family history--genetic versus behaviors that are learned
  • Gender--females are more likely than males to have this disorder
  • Environment--developing this as a "coping" mechanism to parenting styles
  • Personality--people who are inherently shy or withdrawn are at higher risk
  • Increased socialization demands--new job requirements to make a speech for instance
  • Physical conditions--anything that makes someone stand out can trigger anxiety
  • Chemical reactions in the brain--overactive parts of the brain can cause reactions
  • Blasts from the past--prior bad experiences leave an imprint and can spark fear


What are the Symptoms of Social Phobia?

Everyone reacts differently but these are some of the most common symptoms.

Physical symptoms

  • Trembling--hands or body
  • Sweating, even excessive
  • Rapid heartbeat
  • Flushing or blushing
  • Nausea
  • Diarrhea
  • Confusion
  • Cold and clammy skin
  • Voice that is shaky or trembling
  • Upset stomach
  • Muscle stiffness

Mental health symptoms

  • Fear of interacting with people you don't know
  • Avoidance of any type of situation in which you might be judged or evaluated
  • Rumination about humiliating yourself or being embarrassed
  • Loss of sleep and appetite thinking about an upcoming event
  • Not going to activities such as school, work or parties so you can avoid situations
  • Constant worry about how you appear to others in certain situations
  • Guilt over how anxious you appear or might appear and being ridiculed
  • Avoiding eye contact
  • Trouble talking or communicating
  • Avoiding the limelight and playing it safe


What if Social Anxiety Disorder isn't Treated?

As in most mental health problems, treatment is the best way to overcome the disorder and get back to good mental health. However, sometimes that's easier said than done.

Repercussions of untreated social anxiety disorder/social phobia:

  • Excessive drinking or substance abuse--especially prevalent in men
  • Suicide or suicidal gestures
  • Low self esteem
  • Lack of assertiveness
  • Impaired social skills
  • Isolation and repeatedly failed or poor relationships
  • Low academic achievement or poor work performance
  • Hypersensitivity to criticism
  • Hopelessness and helplessness


How Do You Treat Social Anxiety Disorder?

First, you have to admit that Houston, we have a problem. Then you have to allow yourself the luxury of trying to fix it one baby step at a time. Fixing a mental health problem is not a one dose fix. Usually it is a cumulative effort over time of learning to cope better.

Often one of the best sources for overcoming anxiety disorders. Figuring out what triggers are present is the most important thing and then how to block them from controlling your life. This author has found that EMDR therapy is a wonderful way to take a negative memory and turn it into one with a more positive outcome. Cognitive behavioral therapy is said to accomplish much the same thing.

Some people find that antidepressants or anxiolytics are effective in treating this disorder. The important thing to remember is that the effect is only temporary--as long as you take the medication, you are "cured." This author happened to be on Cymbalta, an antidepressant for a short period of time to treat a severe muscle problem. I did notice that I no longer had anxiety over performance issues and while it was a pleasant side benefit, I didn't like the way the medication made me feel. Some antidepressants also have powerful side effects such as suicidality, extreme weight changes, etc. It is important to know that they may make the symptoms better but they do not erase the problem.

Beta blockers are also helpful treatments for slowing heart rates and blocking some of the physical reactions that occur with anxiety.

Anti-anxiety medications can help in the short-term but again they do not cure the problem.

Vitamin B, valerian (similar to an anti-anxiety drug only an herb), folic acid, and kava are said to be beneficial via the herbal or natural route.

Self Help
One of the best ways to treat social anxiety disorders is to join a support group or try taking steps on your own to mitigate the effects of the condition on your life. Something as simple as playing the piano in my case in front of a neighbor is just a small baby step along the journey. The next time maybe playing in front of 4 family members will reinforce that nothing "bad" happened. Finally, after incrementally increasing my comfort zone, playing with a group of other musicians my own age might be the final step to healing. The sooner you get help or seek help the richer your life will be.

Healing and Prevention
Once you start your healing process, don't give up on it. Maintain a healthy lifestyle and you will find that episodes have less impact on you.

Tips on Staying in the Moment

  • Don't smoke--it increases your heart rate and acts as a stimulant--which you do not need
  • Avoid drinking too much caffeine for the same reason
  • Alcohol will not help ease the discomfort--avoid drinking for "courage"
  • Get enough sleep--being sleep deprived can aggravate anxiety of any kind
  • Keep to a healthy diet and get plenty of exercise--excellent curative properties
  • Learn self talk--decide what you will let yourself believe about yourself and what not
  • Get your life organized--don't overdo and don't overextend
  • Role play--ask yourself what is the worst case scenario but also the best case scenario
  • Avoid being a palm reader or fortune teller--don't assume you know what will happen
  • Try to put the past on the shelf--think of today and not yesterday--go from here
  • Live in the now and create new positive experiences every day to outweigh the bad

My Personal Checklist for Growth

Play for Bob
Read to Bob
Play for son Pat and Bob
Read to Bob and son Pat
Somewhat difficult
Play for close friend Pam
Read to close friend Pam
Play for family get-together
Read at a family get-together
Play at someone's party
Read at someone's party

With anxiety disorders, it's all about baby steps

Curing Social Anxiety Disorder

It's interesting to this author that SAD can be very selective in terms of what triggers anxiety. While parties, going out and meeting new people, or defending an issue don't trigger any anxious symptoms for me, playing the piano or as I surprisingly learned, reading one of my Hubpages articles aloud triggered major physical symptoms for me.

Flushing and shaking were the most embarrassing symptoms for me personally as well as the shaky voice. When I reached for my coffee cup, I almost spilled it all over myself because I was so overcome with fear and panic--physical manifestation equaled shaking.

I got through it but at much personal expense of peace of mind. I vowed never to go back. However, that really doesn't solve the problem, does it?

The above self-imposed baby step program is my way of dealing with my own quirks of social anxiety disorder. It's important to note that you should achieve one of the steps completely before moving on. Healing is the goal and there should be no imagined or real time limit.

This author will probably attack one scenario at a time rather than attempting to cure both problems at the same time. Though similar, it's important to try to stop one trigger before moving on to the next one. I offer this as an illustration of how people who interact normally in life can have weak areas that seem nonsensical to the outside observer. People who know me would never dream that I had such intense anxiety reactions to these two situations.

Whether the disorder is a pervading disorder (meaning it occurs in many different situations across the board) or a selective one such as mine, there is hope for curing it or at least bringing the anxiety to a tolerable level. Everyone gets nervous when they have to speak in front of others or perform for an audience. However, it's the degree of anxiety that needs to be adjusted for people suffering from social phobias.

Great Information for All Ages


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    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      7 years ago from Washington

      Hi pino - thanks for stopping by - I would recommend that you definitely talk with someone about your feelings. In my experience, that is the only way that things can improve and there are some new and improved therapies, such as EMDR treatments (that you can even administer to yourself in times of stress). Wishing you every success!

    • profile image


      7 years ago

      My extreme social anxiety and social phobia had sidelined me in so many ways. I left a good PhD program after spending three years in it when I realized that I could easily pass the written portion of the candidacy examinations but I knew that the oral portion would be a Mt. Everest for me. I also couldn't go to conferences to orally present my research papers and to socialize with my peers. Those were three hellish years. I turned my back on a good number of professional opportunities mainly because I knew that I wouldn't be able to comfortably deal with peers and superiors, even make small talk during social events, etc. I also cut all ties with family members because talking and socializing with them are not in my comfort zone. Now I feel so alone, lonely, oftentimes depressed...

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      Thank you, Rhonda~ Tough subject for a lot of folks but the key is baby steps---from my perspective anyhow~

    • toknowinfo profile image


      8 years ago

      This is a wonderful article on a topic that is common to so many people. I enjoyed your personal chart. As always Audrey, this article is a top notch reference for someone who wants to learn more about SAD. Rated up, and awesome and shared.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      Thanks, Cathy~~~It is a painful experience--even when it's "little stuff"--I hate not being able to control my feelings most of all but oh is a work in progress.

    • profile image


      8 years ago

      You amaze me Audrey. Great job on this article. I can relate as I'm sure many of us can and I have close relatives that suffer from anxiety/social disorder and it's hard to watch them struggle. Good research and excellent suggestions.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      God Om--isn't it just ridiculous how we can "evole" and grow up and still have all these THINGS? OMG--I was so totally embarrassed--I was reading one of my funny hubs and the people were all like pretty old--(older than me)---of course they weren't "getting" my humor so maybe that was what triggered it. I freaked out!

      I still cringe every time I see the president of the writer's club--he must think I'm slightly "touched" as my grandmother said. Oh well--we can't all be perfect--and as you say--at least we're working on it!!!

    • Om Paramapoonya profile image

      Om Paramapoonya 

      8 years ago

      I have the same problem! I also hate reading and speaking in front of a group of people I don't know well. Back in grad school, almost every single class required me to make at least one long presentation, and that always got me so nervous. With repetitive practice, I managed to make decent presentations (If I don't puke or cry or sound completely incoherent, I call it "decent"!). Many would assume after having spoken in front of my classes so many times, I would finally feel comfortable doing it. Well, not really. Public speaking is still not my forte. At least, I feel good that I faced my fear instead of trying to avoid it, though.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      BJ--definitely--and my best friend Babs....Barbra is a perfect example. OMG - to be that talented and be THAT afraid~ I kind of tried to think of that the day I was jerking and spilling the coffee (or nearly) all over myself as I read a STORY...OMG--what if it was something like singing for crying out loud? I'd probably be unconscious before I got to "Peeopellll...."

    • drbj profile image

      drbj and sherry 

      8 years ago from south Florida

      Many celebrities suffer with SAD symptoms before they perform - everything from mild anxiety to severe vomiting. Positive self-talk is important and group therapy may often be helpful. But it all starts with the individual and his or her desire to change. Excellent tips here, Audrey.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      Good for you, Lela~~ I always say Bob loved me enough to make me WANT to be okay~ He still does so that's saying somethin'....but he healed me that's for sure in many, many ways. Sounds like you are a balm to Bob, too or he wouldn't be able to do stuff he thought he couldn't ya know?

    • Austinstar profile image


      8 years ago from Somewhere near the heart of Texas

      Excellent analogy. I've tried with him, but it doesn't work very well. He needs to try too and he won't. So that's that. But I'm happy for every time he makes a concession. I'm getting him to go to Cancun this year, a place he swore he would never go.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      Ah yes, Lela--that old I'm fine the way I am deal~~ It works for most of us I guess but unfortunately I've always wanted to "fix" everything that I found annoying in myself~~ (Or was that others found annoying in me?)

      It is tough to let go of the past--I'm afraid that is where a lot of my anxieties took root, but it's like weeding---get in there and start pulling and you'll never believe the garden you can have in spite of what was there before!

    • Austinstar profile image


      8 years ago from Somewhere near the heart of Texas

      Believing in yourself can help too. I love that you said, "ask yourself what is the worst and/or the best that can happen?". That worked for me many years ago and I still practice it today. Now if I could only get my Bob to practice that as well as let go of the past. He just won't admit he has a problem though. Oh well.

      The worst that can happen to him is that he will still go on being the way he is which is 'normal' for him.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      Gosh JSP--if only I was so lucky to enhance my performance I'd probably not mind it so much~ Thanks and I do think you're right--we all have something and it's all a matter of degrees....and of course learning to live with it~

    • JSParker profile image


      8 years ago from Detroit, Michigan

      I wonder how many people are really totally free of social anxiety. There are not many totally uninhibited people, I'd guess, and I'm not sure I'd like them that much anyway. The great majority of people are anxious about speaking in public. A little bit of anxiety may be a good thing, kind of a defense mechanism to keep us out of unsafe situations. And stage fright, I know from experience, can actually enhance performance. But of course, I'm talking about relatively minor episodes of social anxiety compared to some you describe.

      A well considered Hub. Thanks, and best wishes to you.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      Chamilj--it can happen to anyone and in bits and pieces of regular every day life--or be a pervasive and overwhelming problem across the board. Strange how these reactions make our life a little "too" interesting!

    • chamilj profile image


      8 years ago from Sri Lanka

      Very useful. I think I also suffering from Social phobia.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      Algarview--I know--it can really be overwhelming in some cases but the good thing is that it can be treated or even cured. Thanks for sharing about your friend--that would be very crippling and hope she finds a way to make it better. Life is too short to let anxiety rule~! Thanks for the kind comment and for stopping in.

    • algarveview profile image

      Joana e Bruno 

      8 years ago from Algarve, Portugal

      Hi, Akirchner, I think almost everybody, not to say everybody, has some sort of social phobia, so your article is actually very helpful and interesting... I have some myself, though not to serious, but I have a friend that had quite some major problems because of social phobia, everytime she needed to go out she had diarrhea, nause, she is even fainted... So, it's a big problem that really needs to be addressed... Voted up and interesting and useful and sharing! Take care!

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      8 years ago from Washington

      Thanks so much, MPG--definitely as we've talked about's all about baby steps, eh? Thanks for the votes up and hope all is well with you!

    • MPG Narratives profile image

      Maria Giunta 

      8 years ago from Sydney, Australia

      What a great article on SAD and anxiety disorders, well done. Many people will relate to your story Audrey and it is so true that 'baby' steps are needed when dealing with anxiety. Your tips on how to deal with this condition, therapy vs tablets, will help many. I think it is very important for the individual to find what is right for their condition and follow through to achieve a better, healthier lifestyle. Voted up and useful.


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