Tai's Psychology Blog // Social Anxiety Disorder

What is social anxiety disorder?

Social anxiety disorder (SAD) is an anxiety disorder in which people fear social situations where they might be embarrassed or judged. When put in a social situation where they might become anxious sufferers have symptoms such as a racing heart, trembling, blushing or even sweating. This anxiety disorder is not uncommon by any stretch of the imagination.

A diagnosis of Social Anxiety Disorder can indicate either a “specific disorder” or a “general disorder”. A specific disorder is when only some particular situations cause social anxiety. A generalized social anxiety disorder typically involves a persistent, intense, and chronic fear of being judged by others and of potentially being embarrassed or humiliated by their own actions. These fears can be triggered by perceived or actual scrutiny by others. While the fear of social interaction may be recognised by the person as excessive or unreasonable, considerable difficulty can be encountered overcoming it.

What are the symptoms?

People with SAD fear acting in a way that they believe will be embarrassing or humiliating or that may reveal physical signs of anxiety (e.g. sweating, blushing).

When people with SAD face feared social situations their physical symptoms may take the form of a panic attack (a discrete period of intense and sudden fear, apprehension or terror, with physical symptoms such as heart palpitations, blushing, trembling, sweating and faintness).

A person with SAD usually recognises that their fear is unreasonable or excessive.

People may fear specific aspects of social situations, such as writing or eating in public, using public toilets, and being observed at work.

While many people show signs of shyness and inhibition, people with SAD can experience considerable disruption to their daily lives and quality of life, with some people being unable to go out in public or facing intense distress when they do enter social situations.

People with SAD experience intense distress or they have difficulties maintaining their normal routine, including work, study, relationships and other social interactions.

Who gets Social Anxiety Disorder?

SAD usually develops in adolescence and it is uncommon for SAD to develop after the age of 25.

SAD has been found to be present in 4.7% of Australian adults over a 12-month period (nearly 5 in 100).

Factors that contribute to the development of SAD may include a biological and psychological vulnerability to being anxious about social evaluation, exposure to stressful social or performance situations, and developmental factors.

How is Social Anxiety Disorder treated?

Cognitive Behavioural Therapy (CBT) is the recommended treatment for SAD and has been associated with considerable long-term benefits. In particular, CBT that incorporates skill-training in facing feared social situations (exposure) and assistance with altering unhelpful thinking patterns and beliefs is effective. Other psychological treatment techniques include social skills training, assertiveness training and aspects of CBT such as education about anxiety, breathing and relaxation training, learning to alter unhelpful thinking patterns and beliefs, and assistance facing feared social situations. However, CBT has been found to be more effective than other psychological interventions.

Medication, such as antidepressants from the monoamine oxidase inhibitor, selective serotonin reuptake inhibitor (SSRIs) classes, and benzodiazepines may relieve some of the symptoms but does not help the person overcome the fear of being scrutinised.